Wednesday, October 28, 2009

Globulin Not Goblin

Halloween is just around the corner. That means Tricks or Treats, Costumes, The Great Pumpkin Charlie Brown and Goblins for Elias! Just kidding, actually it is Globulin that Elias received. Yesterday evening Elias received an infusion of Immunoglobulin G as requested by Dr. Mehta & the FA team. IgG antibodies are predominately involved in the secondary immune response. Lab test showed that Elias’ levels were low. So given that plus the fact that we are entering the crazy season for Flu and colds it was decided this should be done to give Elias an immune system boost. In a few weeks they will test again to see how things did and determine if it is something that he will get again and if so how frequent. With the infusion of this we will also put on hold any vaccines due for the next 60 days and will roll forward if we continue to infuse. There can be a contradiction in the vaccines ability to grow the antibodies and be effective in the system while being infused with IgG. He seemed to accept the infusion without any side effects or issue.
Today started well, but has quickly spiraled out of control. Elias woke from a long afternoon nap very junky and tons of suctioning. He also began to vomit. At first it was not a big deal then he did it 5 times in 15 minutes for a total of 9 times including once on the doctor as she evaluated him. All but the final time was feeds mixed with mucus, but the last time was only mucus. That makes sense as we had stopped his feeds almost and 45 minutes before that and vented his stomach via the G-tube which drained the feeds left in his stomach. His temperature is slightly higher than his baseline, but still within what they consider an acceptable range. We are continuing to hold them to give a rest for a bit longer and will resume. If he vomits again then they will run some labs and a few other test. Hopefully this is nothing much and a good night sleep will see it off.
Otherwise things here are what they are. Not much else to report. Grandma M is here to visit. She had a chance to cuddle with Elias this afternoon for a bit before he started getting really sick. The new attending came in today to let us know he had reviewed all of Elias’ charts and procedure videos and he too is very perplexed at how Elias is doing what he is doing so well, if only it were well enough not to need the vent! With so many doctors saying this now it hard to wonder what he would be like if he was behaving the way they would expect. I pray we never find that out.
Since I have been unable to send this yet I can add to it…… The latest on the vomiting is that Elias’ temperature continues to rise which is concerning. The other interesting element is that While Elias was on a feeds rest after the first 9 vomits he did not have anymore. Twenty minutes after they resumed the feeds and he began to vomit again. The nurse had already been told to stop the feeds if he had done it a 10th time. Since we stopped them again he has not vomited, but has needed frequent suctioning. Labs will be drawn I’m sure, but its possible it could be a viral stomach bug since it appears to be revolving around the feeds.….I hope not, but suppose there could be worse alternatives. We will keep you posted.  

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