Tuesday evening, his temperature rose and he had a rough night. The doctor came to visit in the morning to review his lab cultures and see what we could do to find the source of the fever.  He ordered a full body CT scan because Jacob was having real bad abdominal pain plus the pain in his chest.  The CT scan revealed pnumonia in his lower left lung. He was already on 3 antibiotics and an antifungal med, but he added another antibiotic to help fight the pnumonia.

Wednesday night he woke up coughing pretty bad and we could hear a wheeze plus some "crackling" sounds in his breath. He got a chest x-ray at 3am because they thought the pnumonia had spread. The x-ray showed basically no change so the noises were just from the same levels and those fluids moving around in his lungs.  

Thursday, he gave us another scare. He had a bad coughing spell that put a lot of pressure in his head and behind his eyes.  Then, he wasn't really waking up all morning and kept going in and out of sleep/consiousness.   It was actually entertaining to watch him dream, but it scared me because I had never seen him do this before.  He was talking to friends at school, having conversations and building things with his hands. He would reach out and grab for things and then put them together.  Sometimes he would get frustrated - like when he couldn't get a hold of the phone he was reaching for when he was really just pinching his sheet :). Then he would realize where he was for a minute and ask me what I was doing or where I was going. I wasn't sure if he was wondering why I was hanging out with this friends at Albion in his dreams or what we were doing at the hospital. I let the nurse know that he wasn't acting normal and that he seemed confused.  She checked on him and he said he told her he was confused and couldn't stay awake or stop dreaming. The Dr. evaluated him and decided to have a CT on just his head.  While we were waiting for the ct, he got a bloody nose and we couldn't get it to stop for at least an hour. Eeeewwww, it just poured...yuck! His head was getting worse through all of this and he coulnd't lay down because of the nose bleed. He went through another round of coughing and that's when he said the bomb went off in his head. That was really scary because I've never seen him in so much pain - even when he broke his nose twice last summer :) He was in so much pain and couldn't move. The Dr. rushed the CT scan and we just pushed his whole bed with him on it all the way out of the unit, down the elevator and into the CT radiology room.  By then he was shaking all over and I was about to pass out just watching him.  When he finally got to lay flat and they covered him with a warm blanket, he got better control of the shaking and made it through the CT. The doctor stayed watching the screen through the imaging process. He was looking for broken blood vessels that could be bleeding internally and causing pressure in his brain - or for symptoms of a stroke. Ya...it was scary for everyone there watching for what we would find.  The Dr. was kind enough to reassure me as soon as we left the CT room & let me know that the scan was clear and they didn't see anything scary or dangerouos. Whew!!! I was so relieved, I wanted to hug him and then collapse.  We decided that he was just too low on all of his blood components and that was contributing to all the problems.  His platelets (which help to stop bleeding) were super low - & that's why we couldn't stop the nose bleed. And his red blood cells (that carry oxygen to the brain) were low too.  Combining pain medicine with low blood counts and an empty stomach is probably what made him so delirious and confused.  The doctor filled his tank with 3 units of platelets, 2 units of plasma and 2 units of blood.  The next morning (yesterday) he got another 2 units of blood too. We have learned a lot from this experience:

1. Jacob needs more volume of blood than most of the other kids on this unit...he's a strong athletic kid  and he just needs more blood than most :)  Dr. decided to keep his Red blood cell counts higher and give it to him before he drops so low.  Like filling your gas tank on the half mark rather than waiting 'till empty.

2. The kids on this unit go through gallons of blood products every day! ...they need all types. Here's a big THANKS to all the angel people out there who take the time to donate blood, plasma and platelets! Keep it coming :) 

Well, that gets you up to date through Thursday... I'll post some more later today when I have some more time.