This was Heather's morning post. (I'm copying the text, but if you click on the link, you'll see a cute picture.)
When Jon and Grace got back from Dartmouth, Jon asked me to take her temperature. He could feel that she was hot, but the thermometer they used at Dartmouth did not register a fever (it was the kind that you hold a centimeter away from the forehead.) My initial armpit reading was 101.8. That means Boston admission. So I had Joy and Nathaniel pack a few more days of clothes for Jon and Grace (our emergency bag in the car only has two days' worth) and Jon got her medicines and his work stuff ready. By the time they left, her armpit temperature was 103.3.
Jon's midnight update included that her fever had gone down to 38.1 (100.8) by the time they arrived at the ER and that she had eaten half a popsicle and smiled for the first time all day. She got all sorts of tests done and abdomen x-rays. So far, according to the portal, she is negative for flu and cold viruses and x-rays show nothing unusual. Her hemoglobin fell significantly, so I expect she got/is getting some blood this morning. At midnight, she had not been admitted yet, but she is in 6 West now.
First, I have to make a correction. That may have been the first smile Jon saw yesterday, but we Skyped with her mid-morning, and she was smiling then, even though she had just thrown up.
(Kudos to Heather, who had to clean up what must have been an all-time record for spreading vomitus in the most inconvenient places.)
Since then, she has had some very welcome visitors, having had the good sense (?) to get herself admitted just in time to catch our favorite Boston Childrens' pediatrician before she becomes our favorite pediatrician at Children's Hospital of Philadelphia. (Whether it was a good move to show up just in time for the arrival of the annual batch of newly-minted residents is another question.)
The plan is to talk with the gastroenterology people today. In preparation, Grace is not allowed to eat. Apparently that is making her sad, which is actually good news, because since getting sick she has had little to no interest in eating. Is she still getting nutrition through her NG tube? I don't know. Is there any medical person who can tell me if "NPO" means "no input to the system" rather than literally "nothing by mouth"? If the point is to have her system empty for her procedure(s), putting the food directly into her stomach would seem just as bad.
I don't know if she received blood or not, but maybe not, since they're blaming her hemoglobin drop on having pumped a lot of fluids into her (because of the fever, I assume).
That's all, folks ... for now.
The interns don’t work on the bone marrow transplant service, if that helps! Mostly third year and sometimes second year residents only.
NPO is tricky — I would use it to say no tube feeds or eating by mouth, but I’ve seen others interpret it to mean nothing by mouth but tube feeds are okay.
For Grace, NPO includes tube feeds. They updated her orders to clear liquids. But she'll be back on NPO for Friday's procedure.
And she did get blood.
I hope for her sake that includes popsicles. At least once that aren't red or orange.
I just realized that my 4:00 a.m. comment was not very clear. NPO means nothing in the stomach, so I meant including not feeding her by tube.
