Day +6

Raul did not have to have dialysis today! His numbers are still elevated, but his weight had not gone up since last night and he had not gotten too puffy. They will decide in the morning if he will need it tomorrow, but the overnight BMT doctor was reassured that his numbers were close to the same tonight as they were this morning. 

Over the past few days Raul has been getting more jaundiced, and today his bilirubin numbers were pretty high, so they ordered another ultrasound. Luckily his liver only showed mild inflammation with normal blood flow. This most likely means that his liver was just impacted by the chemo or the kidney damage, but it will hopefully not be another major issue! They do not need to do anything to treat it at this time. 

Raul's breathing has also been more of an issue today, so we switched him to a high flow nasal cannula. This seems to be keeping him more comfortable with his breathing and keeping his oxygen at a good level. He must be liking the easier breathing, as he doesn't seem to be bothered by the nasal cannula at all! 

This morning Raul's INR was low (as were his PLTs), so he got a vitamin K infusion. His mouth and around his g-tube have been pretty bloody, and he had two episodes of vomiting blood. These issues are not surprising given the lab results, his EB, and the mucositis. This is actually probably the most common issue he is having! His other side effects/complications are less common, so it is a bit unusual for him to be getting them all at once. I am hoping that means that once he recovers from this he will be over the major issues! 

Raul still slept most of the day, but sat up on and off. He seems to be most awake for a while in the morning. He is still not wanting to play, but watched videos on his iPad, and even imitated a Donald Duck laugh (video below)!