Yesterday, after Dad got home from Moffitt, Mom called me at 4:30 p.m. to say that Dad had a fever, 100.4, and was experiencing some chills. Dad spoke to the Moffitt nurse via phone. The nurse told Dad to take Benadryl since she believed his fever was a reaction to his platelet transfusion. Dad traditionally takes pre-medications to prevent reactions, but for some reason, Dad didn’t take any prior to his platelet transfusion yesterday.
Yesterday evening, I spoke to Mom and Dad at 6:00 p.m. asking how Dad was feeling after taking the Benadryl. He indicated that he was improving.
On the way home from dropping the kids off at school this morning, Thursday, I called to check on Dad. Unbeknownst to me, I learned that Dad had checked into the hospital at Moffitt at 1:30 a.m.
Last night, Dad had taken another dose of Benadryl at 10:00 p.m. Dad had then taken his temperature multiple times at 11:30 p.m. Results were 98.4, 100.2 and 101.2. They had been concerned and had called the Moffitt night nurse again. Dad was instructed to come into Moffitt in the middle of the night.
I wasn’t happy that Mom and Dad sneaked off, in the middle of the night, to Moffit without my knowledge.
Upon arrival to Moffitt last night, Dad had numerous vials of blood taken and a chest X-ray, using a portable machine. Around 4:30 a.m., he has his nose swabbed. I arrived around 10:00 a.m. Shortly thereafter, Dr. Ayala, transplant doctor, came in with four others. They were dressed in their yellow, disposable gowns, bright blue gloves, and yellow, duck masks. Dr. Ayala gave Dad a brief physical exam. He wanted to know if Dad had been experiencing anything more than a fever. Dad said he hadn’t. Dr. Ayala also checked Dad’s mouth. No sign of redness. Dr. Ayala wanted a better look at Dad’s lungs since the portable X-ray was a bit cloudy and was showing a couple of patches. Dr. Ayala ordered another (better) X-ray. As the team of doctors were leaving Dad’s room, Dr. Ayala teased Dad about showing up too early for his Sunday, inpatient check-in for his stem cell transplant and said “…no more fun and games.”
The better X-ray showed spots in Dad’s right lung. Dr. Baluch, infectious disease, then ordered a CT scan of Dad’s lungs. Later, Harmony, physician assistant (PA), came by with the initial results of the CT scan. Dr. Baluch is concerned about two spots, which look like fungal pneumonia. Harmony pulled up Dad’s CT scans from February 11th and today. By comparing the two, it was evident that the two spots are new on today’s CT scan. Harmony said that fungal pneumonia is uncommon and mostly seen in patients who are neutropenic and could take weeks to months to eliminate.
Bronchoalveolar lavage (BAL)
Dr. Chan, pulmonary, came by to learn about Dad’s history and current symptoms. She described a bronchoalveolar lavage (BAL), a diagnostic procedure, where fluid is introduced into the terminal bronchioles and then recollected for analysis. BAL aims to establish a diagnosis to find out if an infection is present. Later, Dr. Chan consulted with Dr. Walsh, also in pulmonary. The plan is for Dad to stay at Moffitt tonight and to do the BAL in the morning.
We are still waiting to meet with Dr. Baluch, infectious disease, in order to get her view of how the fungal pneumonia impacts Dad’s stem cell transplant schedule. We know that the probability is high that Dad will not start his stem cell transplant preparations as an inpatient on Sunday as we were hoping. Mom is extremely disappointed.
As I was typing this post, Mom was assisting Dad with his shower. Mom stepped out of the bathroom, momentarily, to get Dad a fresh pair of pajamas. Then, we heard what sounded like Dad falling in the shower. Fortunately, he caught himself by pulling on the shower alarm. In an instant, Dad’s nurse, technician, and another gentleman ran to Dad’s room. Thank goodness it was a false alarm! I reminded Dad that he is at severe risk of dying from a brain bleed if he were to fall and hit his head. His platelets are so low that he has little ability to clot.
Dad, no more fun & games…especially in the shower.
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