Fever

5:05 AM: Melissa called me at the Ronald McDonald House to share that Myla had finally spiked the fever she had been flirting with during the last couple of days. The plan is to put her on antibiotics.

11:21 AM: Temp now at 104.2.

12:45 PM: Myla's heart rate had jumped to over 200 at one point--a side effect of the fever--but it's now back down in the 150 range, which might indicate that the fever is breaking. She is totally asleep right now, and the nurse came in to put a cool, damp cloth over her head. Personally, I thought it would have made more sense to put the wet cloth of Myla's head, but I'm not the medical professional here.

1:33 PM: Myla's heart rate is back up into the 170-range. The doctor came in to share that Myla's fever is likely due to an infection. As I write this, Myla's heart rate just shot up to 208. Anyway, the doctor stated that Myla may have an infection either in her mouth (due to the mouth sores caused by the chemo and the bacteria in her system) or around her central line--that tube that runs into her for chemo infusions and blood withdrawals. A blood sample was drawn early this morning for analysis, and we'll hear back from the lab when they know what the infection is. In the meantime, Myla is groaning like she did when she came out of the surgery for her central line. She is a very uncomfortable little girl, and as one of the nurses shared earlier, "This is the most sick she has ever been."

1:53 PM: The nurses just brought in a morphine pumping unit and attached it to the bottom of the chemo pole. This way, we'll be able to give her additional doses of morphine every 20 minutes as needed.

4:05 PM: Temp is now 101.3--good news. At least it's headed in the right direction.

8:34 PM: A lot is unfolding right now, more than I'll have the time to update here. Myla's condition has worsened and the doctors think she might be septic. Her fever has not gone down, her color is bad, she is retaining lots of water, and lots of other things. We've had a ton of doctors and nurses in the room tonight, and this attention on Myla is likely to continue. They are bringing and x-ray machine to our room to take a closer look at her lungs, and there is a lively debate about whether to use a bolus on Myla. That's probably misspelled, but it has to do with flushing her system, which apparently also runs the risk of flooding her lungs, etc. I'm not sure if I'll be able to update again tonight, but I'll try if things get slow and if the Internet is working. In the meantime, we would appreciate your prayers. Thanks.

9:21 PM: The Internet is hit and miss at the hospital tonight, so I might not be able to hyperlink images, but if you want to see pictures from today, click on http://flickr.com/photos/bluefork/. I'll try to post some specific images below if the computer will let me:

1. Myla with a wet washcloth on her head.
2. Melissa feeding Myla with a bottle, a first for her.
3. Nurses trying to see in Myla's eyes.
4. Myla opened her eyes to see the commotion of the double pole being assembled to bear the extra equipment she needs. Raul Matthew put the old pole to good use in the hallway.
5. And now for the warm-n-fuzzy picture of the day: A shot of Raul Matthew making friends with a stray cat at Jackson Morrow Park in Kokomo yesterday.

10:08 PM: Some of the doctors just stopped in after looking at the x-rays. Myla's lungs looked find, and that's great, but they also found that her central line had become dislocated inside her chest. From the way I understand it, the opening of the line is pushed up against the wall of her vein. The bottom line is that she'll need to undergo surgery to reinsert the line on the other side of her chest. We're not sure when this surgery will be, but we know at least that they will get her infection under control before doing this procedure.

10:22 PM: The ever helpful wikipedia provided this description of septic shock: "Septic shock is a very serious medical condition caused by decreased tissue perfusion and oxygen delivery as a result of infection and sepsis. It can cause multiple organ failure and death. Its most common victims are children, immunocompromised individuals, and the elderly, as their immune systems cannot cope with the infection as well as healthy adults are able. The mortality rate from septic shock is approximately 50%." The article went on to state: "Treatment primarily consists of 1) Volume resuscitation 2) Early antibiotic administration 3) Rapid source identification and control and 4) Support of major organ dysfunction." I see the staff here working on #1 by giving her the bolus, on #2 by giving her 3 antibiotics, and on #3 by taking her blood for analysis.

10:27 PM: Once the blood work comes back soon, then Myla will get 2 hours of blood transfusions followed by getting a diuretic called Lasix followed by 2 more hours of blood transfusions.

12:12 AM: Wow! Myla erupted into a fire hydrant of green vomit. How something so little could gush that much is truly amazing. Despite this and her high temperature, Myla is at least looking around and moving her hands for the first time all day.

1:40 AM: Things have been more quiet the last hour and a half.