It was pushing 3 a.m. when we shut down last night, after the handover from the Emergency staff to the 2B staff was complete, bed made, my Korean War issue cot set up, etc.
Alex found it hard to fall asleep. A main complaint at 4 a.m. was that he was too hungry to sleep. Unfortunately, the doctors had declared him "NPO" jargon for nothing by mouth (nil per os for the Latin students, I think.)
The good news is that he was not in any pain. The last dose of painkillers in fact was around 11:00 p.m.. Mind you he'd probably had enough to numb a horse by then.
More bloodwork early this morning and Alex's level of amylase was elevated from last night. Amalyse is an enzyme from the pancreas and a high level can indicate pancreatitis. So that was back on the table and an ultrasound ordered.
The results from the ultrasound appeared to be normal so back to the head scratching - what caused this incredible pain?
Alex has just completed the first 21 days of a 56 day protocol called "Delayed Intensification." It involves very heavy chemotherapy and is quite intense. Part of it involves being on high doses of Dexamethasone, a steroid, for seven days, then off for seven days and then back on for a final seven days which we have just completed. The steroids make one very moody, depressed even and generally exaggerate and amplify the range of one's emotions. Apparently, another side effect, particularly in teens, particularly at the end of the steroids or near the end can be .. pain. One of the doctors had warned us this could happen, the others seem less certain.
But that is the working theory for now. Or it's mine anyway and we seem to have eliminated just about everything else.
Alex is dozing, still pain free. Hopefully he will soon be allowed to eat, he hasn't had anything since early yesterday afternoon.
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