Thursday, April 17, 2014

It's in the Blood

Today, we had our appointment with the hematologist (a doctor who specializes in blood). This was a follow-up to help determine what is causing the decrease in Max's white and red blood cell count and to make sure the drop in those levels are not a sign of something more acute.

Wrong type of blood specialist. 

They took a quick blood smear and discussed a number of things with us about Max's blood history. This was the same physician we consulted with about Max's blood clot after surgery, so the physician was already familiar with Max's situation. The hematologist was less concerned with Max's white blood cell count than he was with his red cells. Last week, we found that Max was slightly anemic, but he was put on an iron supplement and we didn't think anything of it. However, his red count is still low and it is something that needs to be closely monitored. The test today showed a slight increase in both red and white counts as well as positive signs that Max is creating new "baby" red blood cells. This is good news.

"The red circles are your red blood cells. The white circles are your white blood cells. The brown circles are donuts. We need to talk."

While his numbers are still lower than average, they are not in the "danger" zone as of yet. Although, he is close to that threshold, so if they start to drop again it could cause some serious complications. Max's cocktail of medications has countless potential side effects, two of them being neutropenia (low white blood cells) and anemia (decreased red blood cells). After the results of Monday's blood draw, we stopped a couple medications that often cause these types of side effects. Even though the counts were up today, the hematologist explained that it was far too soon for those medications to have left the body, so it is even more promising that the counts were up even with those medications still in Max's system. The physician also explained that for babies of this age--around 10 weeks and up--the natural physiology of the body suppresses red and white blood cell counts as the body is still learning to regulate itself. This is a natural phenomenon in all children, but since Max is immunosuppressed and is on medications that have undesirable side effects, it is likely that everything is compounding together and altering his blood composition in a negative way. Max has so many forces affecting his physiology, that it isn't surprising something like this happened. Luckily, the doctors are on top of his testing and are constantly watching for any changes in his internal composition.

We have to test his blood again on Monday and hope that everything is still looking better. He usually has a blood draw every 1-2 weeks, so this will only be a slight increase for him. We also have to look and make sure that Max's body isn't creating antibodies to his own blood cells, because this is a situation that can sometimes arise with transplant patients. In this type of situation, the body would basically start destroying its own cells, which is a potential cause of the lower white and red blood counts. This likely isn't the case, but we always have to cover every base.

This picture is guaranteed to be scientifically accurate. 

No matter how much time we spend in that hospital, it never gets any easier seeing sick kids, especially those with cancer. Since our appointment was at the office of hematology and oncology, this is where all the other kids with blood disorders go and this is the main area for outpatient chemotherapy. It is easy to forget that Max is sick because other than his rapidly fading scars, he has no outward physical ailments to suggest that he is different, let alone in a constantly precarious situation. Not only is this a reminder that Max is different, but it also a little reminder that as Max ages, his risk for developing cancer is drastically higher than average because of his transplant and suppressed immune system. Unfortunately, there is nothing we can do other than teach him how to be healthy, be wary of the sun, and to also monitor him very closely. These are things that every person should be doing--especially those of us that grew up at a high altitude--but it can sometimes start to feel a bit overwhelming. The last month and a half has been so incredible and we couldn't be happier to have our whole family at home. However, it has been easy to forget what it was like to cut through rough waters and to live at the hospital. This week was a wake up call that even though Max is doing better than we could have ever dreamed of, he is still fresh off a heart transplant and we will always have bumps in the road. There will always be good days, and there will always be bad days. Let's just hope the former vastly outnumber the latter.

In other news, Max officially outgrew his first onesie (and it happened to be one of our favorites)! This was kind of a big deal for us and slightly bittersweet. It's awesome that he is putting on weight so quickly and this means that he is almost into the next clothing size bracket.

The little man is growing up so quickly already. Even though we really want this first year behind us so Max will have less risk of infection and rejection, we also want to savor each moment with our adorable little guy. Before we know it, we'll be at his high school graduation. Until next time.

1 comment:

  1. Keep up the good work mommy & daddy!!!! He looks awesome!!!