Neutropenic Fever After I.E. Chemo and The DRC at Moffitt

This is what happens when Mathew’s white blood count drops as an after affect of the chemo and causes a neutropenic fever. This is the first time it would happen and it always seemed to happen late at night. Eventually I could look at Mathew in the morning and knew he would have a fever before the night was over. 

Here is a perfect time for a caregiver tip. Keep a go bag packed and in the car or by the door. My friend Sandra gave us a really nice overnight bag to function as our go bag. That way Mathew and I only need to grab his journal and meds for traveling (The Monkey Bag) and get in the car.

3-21-14

The diarrhea mentioned in the last post was a symptom of his white count dropping. At the time I thought he had had too much pineapple juice along with the MiraLax, trying to combat the painful constipation. 

As I remember it, his fever just started creeping up a bit in the early evening. I had put the one page of instructions with the Sarcoma Clinic 24 hour phone number and to call if his temperature goes over 100.5, on the side of the refrigerator in my sister’s kitchen. 

In Mathew’s Journal, he kept detailed notes of when he took medications, drained his bill bag and his bowel movements. On 3-21-14, he has himself taking his 11pm Ativan and then over the next few hours he writes that the nurses have taken over draining and measuring his bile.

Here is the chain of events with a Neutropenic Fever.

Once Mathew had a fever I called the number provided for the Sarcoma Clinic. Since it was after hours (almost midnight) I spoke to an answering service who took  Mathew’s name, date of birth, Sarcoma Doctors name and what the problem was. Within a few minutes, a doctor returned my call and asked if I could have him to Moffitt within an hour. We were told to go to the DRC, The Direct Referral Center at Moffitt. Take a moment to read what the DRC is and how it functions. This is important because there are times when a cancer patient is having trouble. It was explained to us that Mathew could go to the DRC or the local ER but the problem is that if his immune system is compromised an Emergency Room isn’t the best place for him and all of his information, procedures, chemo, medications, etc are already in the system at Moffitt. I don’t believe an ER would have given Mathew the pain medications in the doses he had been prescribed.

My sister was asleep in a recliner in her living room. I came through the house and told her I need to take Mathew to Moffitt. She helped me get everything together and get Mathew into the car.

It took me forty minutes to drive to Tampa and another few minutes to figure out where to park at that time of day. The routine would become that I would pull up to the main entrance, go inside and get a wheelchair and let Security know we were coming in. Then I would push Mathew down the hall and around the corner to the DRC. As they were doing the initial intake I would run back out to my car and take it around to the parking garage and make my way back to the main entrance and to the DRC.

Once in a room, blood was drawn, urine and bile samples taken, and x-rays ordered. More likely than not, the fever was due to the drop in white blood cells, but an infection needed to be ruled out. 

At the time, neither of us had any idea that this would become a routine. I started calling them The Midnight Rides to Moffitt.