Cooper had a terrible night and day today.  He was up vomiting and in terrible pain for most of the night last night.  He was miserable.  He was finally able to sleep after a dose of phenergan at around 5:30am.  Once that medicine started to work, he fell asleep.  And he slept until after 2 this afternoon.  He deserved it.  Pretty much as soon as he woke up, he started vomiting again.  And again, it was worse with any movement.  In addition to all of that, his ears seemed to be worse, his legs continued to hurt, and his belly hurt so badly that just picking him up or putting on a diaper caused him to yell out in pain.  I called Dr. Bhakta and he worked us in as his last appointment of the day.  Before we went in, I spoke with Dr. V about Cooper's labs.  His hemoglobin and ANC were higher than they have been, but it is likely that those numbers aren't actually higher, just more concentrated in his blood at the moment because he is dry (working on getting dehydrated with all the vomiting).  His electrolytes are a bit off - BUN is up and CO2 is low - all pointing towards him being on the dry side.  The most alarming labs, however, were Cooper's liver function tests.  His ALT and AST are high.  His triglycerides are also high.  So what does that mean for Cooper (for Kevin and me it means this will be a long week until we do another set of labs on Monday and recheck these numbers)?  Elevated LFTs can be caused by sepsis and infections, pancreatitis, gall bladder issues, and actual liver problems stemming from long term use of TPN.  The last option would be a nightmare come true, so we are praying against it and BELIEVING that his numbers will go down, not up.  If his LFTs are still up next week, there are some other labs that will be run along with another abdominal ultrasound.  Please pray and BELIEVE with us that those numbers will normalize.

Now onto Dr. Bhakta...Cooper has a super ear infection in his right ear and a pretty good one going in his left ear now as well.  Dr. B was as puzzled as Dr. V was yesterday about how on earth Cooper could have an ear infection when he has been on such super duper antibiotics for the past week.  In addition to that, despite our using xopenex with Cooper about every 4 hours, he is wheezing very badly.    So, after speaking with Dr. V, we went ahead and drew a culture from Cooper's line to have one brewing, just to be safe, since Cooper is running fever again and then Cooper got 2 shots of antibiotics to try to knock out his ear infection.  We left Dr. B's office after doing another breathing treatment there and drove home in the snow.  Yes, it is snowing in Houston for the 3rd time this winter.  That means people are driving like complete idiots even though the roads were perfectly fine.  We will go back to Dr. B's office tomorrow morning so that he can listen to his chest and take a look at his ears again.  If the antibiotics haven't knocked the infection back, we'll have no choice but to go back into the hospital for IV antibiotics.  Unfortunately, using "oral" antibiotics on Cooper is fruitless because we put them in the j tube and he just vomits them back up (or they drain out into his ferrell bag) because his motility is pretty much reverse.  We suspected this, but after getting his iron labs back last week, we are much more certain that medications put in there are not doing much good at all.  We give Cooper iron twice a day every day and yet his iron levels in his blood are so low that they are not even measurable.  So he isn't absorbing anything we put in there.  That doesn't leave us a lot of options as far as treatment for even kid bugs like an ear infection.  Please pray that the antibiotic shots Cooper had tonight will do the trick and knock out the infections.  Going back to the hospital doesn't sound good to any of us.  The other issue is, we need Cooper to stop vomiting so much so that he doesn't dehydrate.  Please pray that his belly settles down.

And of course, please pray very hard that Cooper's Call comes soon.  His elevated LFTs have reminded Kevin and me again about why we hate TPN so much.  It has saved Cooper's life by allowing him to be nourished and grow, but at the same time, it is toxic to his liver.  The sooner he is transplanted and able to be fed through his belly, the better.  We know that transplant will bring a new set of issues, but we BELIEVE that Cooper will beat the odds and do amazingly well post transplant and have a more normal life.  Please BELIEVE with us!