Massimo came back on Monday night and Tuesday we had a lovely day with my friend Ann and her two cavalier spaniels. We went to SGH for a review by the doctor and this week’s chemo.
On Wednesday morning however, he spiked a temperature of 39.3ºC (nearly 103ºF), his heart rate was high and he was very restless. Paracetamol brought it down and at 10 am he was pretty OK, smiling happily on his gym and although his heart rate was still high, it was settling. By 11 am all that had changed and he remained unhappy for most of the day. There were and are plenty of signs of teething and his blood tests (taken on Monday) showed no signs of bacterial or viral infection. By the end of the day his breathing was beginning to sound strained and we called the ward and spoke to the doctor to get some advice. The doctor and I decided that we wouldn’t be giving Massimo anything more on the ward than we were giving him at home and we decided that we would keep a close eye on him and take him in if the situation got worse. She also told me that I could continue giving him the paracetamol and codeine as I had started to do, in order to keep him as comfortable and settled as possible.
At 2 am, he started to get restless again and I gave him some more paracetamol which he was due. This seemed to help him but by 3 am he started to get upset again and I could not settle him at all. His heart rate soared (it hit 213 at one point – Massimo’s normal is 160 when awake!). When I read panic in his eyes, I woke Justin and called an ambulance. They were here before I was dressed! By the time we were getting into the ambulance Massimo was beginning to look a little blotchy which we have learnt is a sign of excess carbon dioxide in the system. This indicates that even though he was on oxygen and therefore getting enough of that, he wasn’t getting the carbon dioxide out and this is nearly as bad as not getting enough oxygen in. I went to A&E with Massimo in the ambulance while Justin followed in the car with essentials like a wallet and keys.
The amusing side of this was that I recognised one of the ambulance men, the staff in A&E were pleased to see us again and were all amazed at how much Massimo has grown. Within an hour we had two doctors turfed out of their beds to come and see us and after an x-ray and some bloods being sent off to the lab, were installed in PICU, on CPAP with a little sedative to help calm him down and let him get a good nights rest. By 6.30 am Justin and I flopped into bed exhausted. The previous 36 hours had been very stressful!
Massimo was still a little restless and working quite hard on his breathing yesterday. He was tired and still trying to recuperate. Earlier today he was still a little subdued and although no smiles yet, he is definitely improving. His CPAP settings have been reduced, twice, and they are going to try taking him off CPAP tomorrow and seeing how he manages. They started him on 2 intravenous antibiotics yesterday, more as a precaution than because they had any indication that he needed them and also because he is on chemo he is much more prone to infection anyway. His bloods today show he probably has a viral infection so we shall see tomorrow whether they will continue with the antibiotics. This is important because if he comes off CPAP and is on a little oxygen he can possibly come home, unless, of course, he is on iv antibiotics which are usually a course of 7 days. However antibiotics do not help viral infections. We shall see!
I hope you haven’t missed our updates too much in the last week and I am assured that our back-up procedure will be improved.