Febrile Seizure

So we've had a few days of drama with these chest drains! We went from having one on each side to neither of them working.. the left came out and the right wasn't in the correct place as the air was collecting in a different plural space than where the drain was. They left the right one in but added a second one lower down on Wednesday.

Then on Thursday afternoon the lower right one also stopped working and Dyaln got very distressed very quickly. A quick wiggle and it started working again but now he had developed a fever and a cough so antibiotics were started and we were sent back to the ward at 11.30pm where it was cleaner for him.

At 4am Friday morning Dylan woke up distressed and struggling again and another chest X-ray was ordered. The lower right had stopped working again! Ironically by the time X-ray arrived he had settled and fell back to sleep though but it needed dealing with so the plan was to reasses when he woke up in the morning..

Dylan woke up at 7.30am on the Friday morning, he seemed fine with only a little discomfort. His heart rate was still high so an X-ray was ordered. The X-ray came and went an hour later and whilst waiting for the results he started to get worse.. 

Only it was not his lungs causing the issues! He started to be sick and panicked because he couldn't breathe properly, we upped his oxygen straight away as his sats dropped to 46% and then his temperature shot up from 37 to nearly 40 in minutes (the earlier paracetamol had just started wearing off) and he started having a seizure. They had to massively sedate him to stop the seizure so then he required help breathing and had to be intubated and ventilated, he was then transferred back to ICU..

It appears he had a febrile seizure from infection, thankfully we had seen it coming and started the antibiotics the night before so he responded fairly quickly. He needed a blood transfusion as his levels were already fairly low from the chemotherapy and he was neutropenic which makes him more prone to infections anyway. Despite having the blood transfusion done quickly he went very grey.. upon X-ray it was discovered the pressure from the ventilator had caused both his lungs to collapse very significantly and the air accumulation was so large it almost crushed his heart from the pressure. Two new chest drains were quickly put in and he then started to improve.

He had a fairly settled night which was good. The decision was made that him being ventilated was the perfect opportunity to get the MRI scan done to check his skull and brain for LCH and also rule out any other reason for the seizure so Prof. Grundy pushed this through for this morning. He also managed to convince them to do another CT scan this afternoon that previously radiography had refused so that was good news as we can see how effective treatment has been so far.

The MRI results came back as all clear, this means there is no signs of Langerhans Cell Histiocytosis in his skull or pituitary gland etc. and no other reason for his seizure except infection. We are still awaiting the blood culture results and a lumbar puncture to rule out certain infectious diseases.

Praying for a smooth night!