Fever again with super low counts

We started the second half of Delayed Intensification on 7/2 with very strong numbers.  We did CBC on 7/1 and Lucas got CPM, AraC, IT MTX, and started Thioguanine on 7/2.  We stayed overnight on 7/2 for the clearance of CPM, just as we did with this chemo twice in Consolidation.  We came to clinic on 7/8 again for physical and CBC and got another IT MTX 7/9.  I have been doing his IV AraC at home for two weeks.  We usually don't turn on the AC unless it's over 85 but we kept the AC at 74 during the days when Lucas was accessed since we realize that his sweating would be problematic for the dressing.  I felt quite stressed for the past two weeks, doing the AraC, and worried that his dressing would come loose.  Luckily it only happened once when his dressing failed us and we had to go back to day hospital to get him reaccessed.  

7/13 Saturday -- the first day after all AraC is done and I felt like celebrating that there would be no more need to keep him accessed at home and administer IV medication for him -- he developed a fever at 10pm.  It was 100.6, then 100.8, then 100.6 -- we didn't rush to the hospital at once since he looked fine and we just thought it might get lower than 100.5.  By the time we got to the ER, it was almost midnight and by the time we got in a room on 12th floor, it was 4am.  Since last time we went to ER at the middle of night and Lucas got woken up on the way from ER to ward, he was very angry and loud and probably woke a lot of people up, I kept him awake until he got to the floor.  Jianwei thought I was cruel but I really didn't want to wake people up again.

His last fever of 101 was 1pm on 7/14 and he shows no sign of sickness other than tired and loss of appetite from chemo.  His ANC was 75, hemoglobin 8.2, platelets 25 at admission.  He was dehydrated that day and after some fluids, his ANC was 36, hemoglobin 7.1, platelets 9 on 7/15.  His heart rate has been above 120 and sometimes 150 so the doctors decided to transfuse him with platelets and blood in the morning of 7/15.   His energy level got a lot better after the blood transfusion.

Today he is due for Vincristine and Peg-ASP.  I didn't argue with doctor about this since I know the protocol says it very clearly that chemo will go on regardless of minor fevers and low counts.  The doctor would like to keep him hospitalized until he shows signs of improving/stabilizing of ANC.   At least he gets to go outside of his room this time.  We don't feel comfortable for him to go to the playroom if there were many other kids there, with is super low ANC.   However, he enjoys his walk in the hallway just as much.

I came home last night to spend some time with Alex and now I'm going back to the hospital so Jianwei can go to work in the morning.  Hope his ANC will rise soon!