Day 24, Chemo Round 1 :: Beads of Courage

A feverish Jade sleeps in Olaf's arms
with her newly strung Beads of Courage.

Jade had to take today easy for the most part.  She woke up talking about "circles" in her mouth; I took a peek inside and discovered two mouth sores. It's a fairly common side effect of the chemo -- and one that Jade has experienced before. The chemo attacks cancer cells and other rapidly dividing cells.  The cells that line the mouth, throat, stomach, and bowel fall into that "rapidly dividing" category. So a saline rinse and magic mouthwash, a mixture of maalox, benadryl, and lidocaine that is actually called by that name, were ordered to help with the inflammation.

No sooner had the nurse brought in the magic mouthwash and started to demonstrate how to use the dental swabs, I noticed bleeding on Jade's gums.  That prompted an order for a platelet transfusion by the doctors. Her platelet level was at 19, just above the transfusion standard of 10 but still way below the normal range of 150 - 400.  Before the platelets even arrived, Jade spiked a fever. Blood cultures were drawn to help determine if Jade has a bacterial infection, two IV antibiotics -- ceftazidime and vancomycin -- were run to begin treating potential bacterial infections, and Tylenol was administered to bring Jade's temperature down.

The blood cultures will be back in 24 hours; we hope that there is no bacterial infection found. Until then, no walks around the unit or trips to the art room.  The potential for passing something along to one of the other kids on the unit is too great.  So, Jade spent a quiet day in her room -- singing along with none other than Mary Poppins' A Spoonful of Sugar Helps the Medicine Go Down, watching princess movies, reading stories, coloring, sleeping in her Olaf (everyone's favorite snowman) chair. I also thought it would be a good time to string her Beads of Courage, an arts-in-medicine project for children with serious illnesses.

Ms. Elizabeth, one of Jade's favorite art therapists, introduced us to the project and walked us through bead selection a couple of weeks ago: beige for bone marrow aspirates, white for chemotherapy infusions, magenta for ER visits, yellow for overnight stays, red for transfusions, stars for surgeries, aqua for feeding tube placement, face beads for hair loss, and so on. For Jade's 2012 treatment course, we estimated some 300 - 400 beads.  Jade also received a special "Act of Courage" glass bead for her bravery throughout her course of treatment.  Jade was pretty excited about being able to make a "necklace" with her name on it; I thought it was a great, age-appropriate way to help tell Jade's story.  But, I was a pool of tears when Ms. Elizabeth gently explained two of the special milestone beads -- the Purple Heart to symbolize completion of treatment and the Anchor to symbolize relapse and restart of treatment -- and gave me the option to decide whether or not to include them.  I have since pulled it together - as much as I can -- and helped Jade start her Beads of Courage story today, which includes her triumph in 2012 and this test in 2014.  (She was most excited about spelling her name.)

Thanks for checking in on Jade.  Please join us in praying for the fevers to go away and stay away, for Jade to come home for a break soon, and for her complete healing!

Today's Counts:
Hemoglobin: 7.2 (down slightly from yesterday's 7.4)
Platelets: 19 (up slightly from yesterday's 13)
ANC: 0
Monocytes: 2%