The good, the not so good, and the in between.

Michael enjoying some "quiet time" during MRI of his knee.

Michael enjoying some “quiet time” during MRI of his knee.

The good news – Peter came home today! He is tolerating being on room air during the day. His ANC was up to 500. Still short of where he should be, but at least going in the right direction. The Peds ward was packed, so hoping having him home will be better as I always fear picking up an illness there…..flu, RSV and all the other junk going around. We were blessed to have really good care by kind staff that know him! He is full of energy which is always a good sign! He is in a great mood which is always a good indicator too! His special ed teacher just stopped by, brining Peter a bunch of “get well cards” from his classmates and a Dora book which I think he will never let go. So special!!

The bad news – Michael’s knee is worse than we thought. We had the MRI this morning, and told we would get the results tonight or in the morning. We hadn’t left the building when we were called back in. He has a lot of fluid in the knee – but the decision was made to not drain it yet and risk introducing something before the full treatment plan is in place. In addition to the dislocated knee cap (which is now as much in place as possible with all the fluid), he has a torn MCL and damage to other ligaments. The one in the back of the knee is sagging – still need to determine if that is additional damage or as a result of all the fluid there. What makes the situation more complex is that he has bone fracture too. I had understood that he may have some fracture pieces coming off the knee cap, but it was actually the end of the leg bone coming down into the knee (femur). There are at least two pieces – one of which is fairly large and pulled off the cartilage with it. The fragment is not in a good place (not sure there is a good place!). The growth plates looked ok, but more analysis from the radiologist was needed. So in a nutshell, on a very fast review, looked bad! We have a 7:30am appointment with a sports medicine surgeon, and if all goes well he should have surgery tomorrow or no later than Wednesday. The doctor we saw today felt very strongly about have a sports medicine doctor manage this, and that it needed to be done rapidly given the amount of damage she could see at quick glance. So, more to come tomorrow.

The in between is that Peter’s pulmonary pressure are much higher than the last time he had an echo. This could be as a result of being sick, or it could be that there has been a decline in his heart/lung function. They are not so high that immediate action is required – but enough that it won’t just be written off as “he was sick but should be fine”. He horribly failed his sleep study a few weeks ago – and was supposed to do it again this week. We have been asked to wait a couple of weeks to make sure he is over this episode. Then once the sleep study is completed, we need to re-do the echo to see if the pressures have improved at all. Often we talk about cancer being the elephant in the room that needs to be kept away, admittedly for me the elephant in the room is his pulmonary hypertension. While up until now he has been reactive, and responded to treatment, that can change. While it feels like we have “bigger” challenges with the leukemia, I don’t feel like we can take our eyes off the pulmonary hypertension. Pray he continues to respond to treatment as needed!

Anyway … there is our update in the next chapter of funding the healthcare system! We expect Peter to be home tomorrow, but hope he will return to school on Wednesday. Praying Michael’s appointment goes well and that his knee can be repaired before more damage occurs.

Thank you to all for you words of encouragement! Now I need to go back to finding a delivery liquor store, and enjoy a relaxing glass of wine 🙂



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