Several small bruises showed up on various parts of Nico. He almost never bruises like this. The only other times were when he needed a platelet transfusion. This really is not a big deal. Kids on chemo need blood products sometimes, and doctors warned us that Nico would probably need blood by the end of DI. So I immediately reported to the fellow (the doctor in training that sees us before the attending oncologist) that I thought Nico needed platelets. Like always, the nurse drew some blood to check. I also mentioned the possible need for platelets to the attending physician. After seeing the doctors, we went back to the infusion area (if you have seen Breaking Bad, it is exactly like that – a bunch of patients in Lazyboys lined up against a wall with their bags of strangely-colored IV fluid). We met our assigned nurse, and I immediately asked about Nico’s platelets again. We got our chemo shot (ouch) and then did our mandatory hour-long wait to make sure Nico did not react to the chemo. All the while I am telling Jeff, “I really hope they checked his platelets and they don’t wait until we’re leaving to figure out that he needs a transfusion.” I guess I should have brought up the platelets a fourth time? Anyway, we are getting ready to leave, the nurse is about to take the needle out of his port and I ask, “So his platelets are OK?” She leaves and I can see her print out his labs and immediately go to find the doctor. ARG! Well, at least it was caught?
After an apology from the doctor (he threw his hands up and yelled “I suck!”), he ordered platelets for Nico. But platelets take a while before they can be transfused. Nico is extremely upset by all of this because he thought we were going home and now we are looking at another three hours at least. I remind the nurse that Nico had a blood reaction in the past and that since then he is usually pre-medicated. So the nurse gives Nico the usual Tylenol (to stop the fever that would come) and IV Benadryl (to stop an allergic reaction). Apparently, if you give IV Benadryl too fast to some kids, they freak out.
Nico freaked out. I do not mean that Nico cried or threw a tantrum. I mean that Nico turned into the Incredible Hulk. I knew immediately that he was having a reaction to something, but I did not know what. His eyes were wild and he was screaming and scratching at his face. It reminded me of how I felt when I got Compazine the one and only time. Compazine made me feel like I needed to crawl out of my skin. So Nico is flipping out, and Jeff initially thinks he’s throwing a tantrum and starts to loudly scold him. My reaction to this was to loudly scold Jeff (this is a nice way of saying that we were all yelling at each other). The nurse’s reaction to our yelling was to softly, kindly and gently ask Nico if he wanted to go for a ride in a wagon with her. Nico’s reaction to the nurse was to repeatedly hit her in the face and then try to rip off her glasses. When she managed to save her glasses, Nico grabbed his IV tubing and tried to bite through it. We wrangled the tubing away from him, but the miracle that needed to occur did not and he ended up pulling the needle out of his port at some point during this fit. Everyone just stood there staring at Nico as he screamed, kicked and hit. By this point more nurses arrived on the scene, but everyone was powerless. It appeared we had to let Nico ride out the Benadryl. At one point, he actually chomped down on my hand and pulled the skin back farther than I thought possible. Apparently the people writing those zombie shows do their homework because it looked just like that. After about 20 minutes, Nico passed out. At that point the nurse told me that platelets have to be given within a 30-minute window or be discarded. In other words, we had to start the platelets that minute. So Jeff and I braced Nico and ourselves as three nurses stuck another needle in his port (without numbing cream because of the lack of time) and got the IV fluids going. As a general rule, patients’ vital signs are supposed to be monitored frequently while getting blood products. But Nico was determined not to lose any more battles of will. After several attempts, the nurse gave up on wrestling the blood pressure cuff out of Nico’s hands and he passed out again.
It gets worse.
Just as the platelets finished, Nico coughs violently, projectile vomits, and breaks out in a rash all over his body. We have been down this road before. He has a blood reaction in spite of premedication (we are 4/4). Nico’s breathing becomes labored and his cough is reminiscent of the time he went into anaphylaxis. So Jeff runs back into the office area where we spied our doctor earlier. I hear Jeff yell to the doctor that we need help.
All is well that ends well? I am adding the question mark to avoid The Jinx.
Once filled with Benadryl, hydrocortisone and Zofran, we were allowed to leave. On the way home Nico perked up and asked for chicken nuggets. Good sign. And I am sure the extensive soft tissue damage done to my hand will heal . . . in several months. It is seriously swollen, but hey, I got a great story out of it? Not really.
On a positive note, since I like to end there, we have ten more days of front line chemo, and then we get a break! These experiences, watching our little boy, not even three-years old, endure all these traumas and then just bounce right back, reminds us of our priorities. After spending several days feeling a little homicidal over Jeff’s last employment experience, we left the hospital thinking, “Who cares?” Jobs come and go. Money comes and goes. These things are not important. Nico continues to teach his bumbling parents the lessons of life.
Thank you, Nico. I am so sorry that you have had to endure all this. I wish that I could have protected you from all of it. But you take it all in stride. You inspire me every single day, little man. Be patient with Frick and Frack – We do love you so much.
P.S. The picture attached was taken on the very night after all of this occurred (and after eight chicken nuggets).
P.P.S. How often does a doctor apologize for inconveniencing you? Today’s attending was not our usual, but he is one of the doctors that we really like. I think I’ll start using “I suck” for all my apologies now.