Still in ICU

Alyssa is finally sleeping so I am going to take a minute and try to get an update posted. She has had a very hard day today.  She can't get comfortable, her back hurts and her shoulders hurt. Overall she feels lousy and just wants to get rid of the oxygen masks.

As the chemo breaks down the leukemia cells, they get flushed out through the kidney's, so she is on a lot of fluids to aid that flushing process.  Part of the side effects of all those fluids going through her system is the possibility of fluid building up in her lungs, which would cause the diminished breathing capacity. The doctors look for a certain level of urination to make sure the fluids are not building up. Alyssa's urination is way above the level they need. That plus the lack of blood and fluid when they did the scope, gives more precedence that there is not a fluid build up.


In an earlier post I mentioned that the breathing troubles could be because of a reaction to one of the medications. Based on the fluid levels as stated above, the doctors are now almost positive that a reacton is the cause and have stopped giving her ATRA. There have been several xrays since the scope and each time the xrays are either the same or worse. As a test they did an xray of her lungs this morning and gave her a does of ATRA, then xrayed her lungs again this afternoon. They had gotten worse, which tells them it was the ATRA causing the problem.  They have stopped that for the time being, and will not start it up again until her lungs get better. I asked about this happening again once they start her on ATRA again and the doctor said that this is only an issue during the initial stages of chemo, by the time she is back on ATRA she will be far enough along in her chemo treatment that this won't be an issue.  Their primary concern now is to get her lungs and her breathing capacity back to normal, at the expense of the benefits the ATRA is doing for her.  As one of the nurses explained it to me, the ATRA helps the baby blood cells to know what they should do, whether the become white blood cells, red blood cells, clotting agents, etc. So although that is needed, it is not going to hurt to not have that for a short period of time. If her lungs don't clear up, then the next step is a ventilator and they don't want that unless it is absolutely necessary. Taking her off ATRA is a little bump in her progression, but the ventilator is a major step backwords.

Right now they are thinking she will stay in ICU through Saturday and possibly Sunday. They want to make sure that she is breathing well enough on her own before moving her. It's better to stay here for longer rather than making trips up and down between ICU and her leukemia room.