Sugar, Sugar Baby

So, we're in the hospital again.  Life has been pretty crazy these last few days.

Cole has been suffering from episodes of extremely low blood sugar for the past several months.  On Thursday morning Cole's blood sugar was 36 but dropped lower to 21, even after juice and crackers.  Dalynn called rescue and Cole got to take an ambulance trip to CHKD.  I arrived shortly after they did (I had to stay behind to make sure Logan and Ava were situated).  Thank God that Gary had come to help us paint.  He always seems to be here when we need him.  He's a good Granddaddy!

Thursday we spent most of the day going through test after test.  Cole had an ultrasound of his gall bladder, an echo of his heart and and EEG.  They admitted us in the afternoon and we came up to 8B in room 813.  It has a really nice view and is a very comfortable room.

The basic gist of what's going on is that they ("they" being the doctors) believe that Cole has adrenal suppression brought on by the steroids he takes on a regular basis and a steroidal skin cream called Vanos.  The adrenal gland is responsible for producing cortisol, and cortisol is involved in blood sugar management (among other things).  The belief is that, since his adrenal gland isn't producing enough cortisol it's causing his blood sugars to plummet.

If it is adrenal suppression the fix is to put him on a low dose of another steroid called hydrocortisone.  This will help with cortisol production and will alleviate the problems he's having.

To find out if it really is adrenal suppression they've taken Cole off almost all of his chemo and steroids in hopes of inducing a blood sugar below 40.  When his blood sugar goes below 40, they can run some specialized tests which will confirm or deny the adrenal suppression theory.  So far, his blood sugar has stayed well above 40...

Barring his blood sugar dropping naturally the plan is to introduce a medicine called AHTC which will stress his adrenal gland, causing it to produce as much cortisol as possible.  They'll then take blood and measure the levels.

There is another theory being kicked around.  Dr. Owen came across a case study of a patient with similar problems to what Cole is experiencing that was caused by another of his chemos, 6MP.  It's only one report, but it's something else to consider.  Right now, he's off of 6MP and no blood sugar issues.  We'll see.

While we're here we're going to also take advantage of the situation to see if we can find the reasons for Cole's constant belly pain.  He'll be having an upper and lower scope on Monday to take a peek at his GI tract.  He'll of course be sedated for all of that. 

He'll also be undergoing a head MRI on Tuesday and we're hoping to slide a full body CT in there, too.  The scans will be in order to take a look at the fungal infection in hopes that we can take him off of his voraconazol.  His bilirubin and liver enzymes are way up, and they believe that the voraconazol is the reason.

We're definitely here til Tuesday, so I'll try to keep you informed of any new developments.