Last cycle, Averi only needed one transfusion each of platelets and red blood cells. Well today she doubled that.
Last night I mentioned to Dan that she was looking pale and that she might need some red blood soon. When we got up this morning I was informed that her hemoglobin was low and she would be receiving some red blood. Is it sad that I can read the signs of needing a blood transfusion?
I was actually kind of glad that she needed some more blood because great grandma has donated blood twice for Averi and last time she didn't end up using it and this time the blood hadn't been processed when Averi needed it last week. After all that trouble I was grateful that Averi finally got to use great grandma's precious gift (and so was Averi)!
This afternoon great grandma and grandpa offered to hang out with Averi while I took Kaili out for some fun. Unfortunately, they had to experience Averi's worst dressing change EVER.
I don't know if I've ever explained it, but there is a sterile dressing that covers the area where Averi's central line enters her chest. It has to remain sterile to prevent any infections from entering her blood stream and is changed at least every 7 days. Changing it requires everyone wearing masks, gowns, and gloves. The old dressing is removed, the site is thoroughly cleaned and allowed to dry, the area is covered with a skin protector that also has to dry, the line is taped down in a loop to prevent it from being pulled out if there is any tension on the line, and finally a new sterile dressing is placed over the site.
All of this has to be done without anything touching the site or contaminating it. Try doing that to a 2 year old and you will understand why it is a two person job and why we have to pin Averi down to the crib to prevent her from pulling off her mask or touching her chest. Fortunately, it usually only takes about 5 minutes.
Today's particular dressing change did't go quite as smoothly as it normally does. Just as the nurse was getting ready to put the new dressing on, Averi, who was already not cooperating as much as usual because she didn't feel well, pulled her arm loose and brushed it across her chest. She then had to be held down while the nurse went and got a new dressing change kit and redid the entire process.
Averi screamed the entire time (I don't know if it was more traumatic for Averi or my poor grandparents). When I got back this afternoon I noticed that Averi had petechiae (red dots of broken blood vessels) all over her face and head. We finally decided it was from the intense amount of screaming and straining she did during the dressing change.
Petechiae are due to low platelet counts but because that was the symptom that led us to having her blood checked and ultimately finding out that she had cancer it just sends up a red flag for me. I had the doctor come in and requested that she have some more platelets. He said that even though she just had some yesterday she was getting low again (obviously) and they were going to wait until tomorrow to give her some more but that they could do it tonight if I wanted. I made sure she got the platelets tonight.