We were finished the ultrasound yesterday at 11 a.m. and as noted it looked normal. Alex seemed fine, a little wary that the pain might return, but his main complaint was being hungry. His status had been changed from "NPO" to clear fluids only but a cup of chicken broth isn't very satisfying when you're starving.
The oncology people said they wanted the surgery people to advise on whether Alex could eat or not. They have more experience with pancreatitis as they deal with gallstones and other gall bladder conditions that can result in pancreatitis. So we waited for one of the surgeons to come by.
And waited.
And waited.
And waited some more.
Finally at about 7 p.m. a surgeon came by. We were by this point pretty much resigned to the fact that Alex would be on clear fluids until the morning, this would be fairly standard procedure for pancreatitis - except this didn't seem to be normal pancreatitis, Alex seemed just fine.
Happily the surgeon thought so too and advised that Alex could eat solids but to go with a low fat approach - the enzymes one's pancreas emits are in aid of breaking down and digesting fat. This, she said was the conventional wisdom in treating pancreatitis, but that actually there was very little evidence to support it. Really! Low fat or not, this was great news and, after a run to Earls for some takeout, we were soon munching happily away in front of the Canucks game, some of us drinking Peroni in a coffee cup - the Pilsner Urquell drought continues at the local shop.
We were pretty tired and shut 'er down right after the game.
This morning Alex's bloodwork came back and showed a dramatic difference in his amylase level. "Normal" is considered to be 30 to 100 somethings per something. Alex's was 26 when we got to Emerg on Sunday night but on Monday morning it had jumped to 200. That isn't actually wildly high, for pancreatitis apparently, but it was a big change. This morning it was back down to 18. Weird, I know. (And 18, although quite below 30 according to my math, is not a concern apparently.)
The theory is that it was the Asparaginase ("the peg") that caused the amylase level to increase, it's a known side effect albeit that he had the peg two weeks earlier. The pain may have been due to the high level of steroids - after a while this can happen in adolescents. Usually pain from steroids is in the joints and only after long term use.
Alex was just fine, he had handled the food very well, was still pain free and I was pretty optimistic we would be going home today.
Wrong. They want us to stay another night. Seems like a very cautious approach to me but ...
So, another night here. Oh well.
I wouldn't one reading this to get the wrong impression and think we were unhappy with the care here. We aren't. Waiting eight hours to see a surgeon is frustrating (especially when you're hungry!) but surgeons are busy doing ... surgery. "What's that? Consult on possible pancreatitis? Sure. Is he in much pain? No pain for the last twelve hours? With no painkillers? The ultrasound was clear? No temperature and he seems perfectly fine? Quite hungry, you say? Sure, we'll put that at the top of our list and get right on it and we'll do this kidney transplant later on."
I mean, we get it. And we get it that not everything can be explained perfectly, it comes with the territory. And we get being cautious.
We have received great care here. These are outstanding professionals.
But we really would just like to go home.
