A Visit To Medical City
The Balkum’s Visit To Medical City

Under A Microscope

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On January 31, 2019, I took my twin daughters in for a basic checkup. While there they got their normal vitals, height, weight measured and recorded. One of the things that is normally asked is, “Are there any concerns?”

Well, this one thing has had me pretty puzzled. Both of my daughters are normally all over the place. They are very independent, funny and playful. However, Genevieve would get some dark colored bruising – almost black at times. She typically would just randomly fall, clumsy-type of antics, run into the side of a coffee table and boom she would get these bruises. Then what appeared to be rashes surfacing on her chest I thought maybe this is a reaction to our detergent. Then there was this random blood spot on her bed. Not long after seeing that I noticed she was poking her nose and her finger would prick the inside causing a nose bleed. So for a while there the nose bleeds were not trickling or running down. But it would get crusty and just be a bloody discharge. There was no signs of blood in her urine, poop or gums. Nor was she running a fever. And she definitely wasn’t ill or running a fever.

Early on my children both had minor ear infections. But since then they have been primarily healthy. So at the doctor’s office, it was recommended for Genevieve to have a blood test. That was AN ORDEAL. Having to hold my daughter down while they drew blood. Her blood was very dark and just came out very slow.

Once they had the sample, we received the results within hours and we were told that it clotted so we needed to return. Well, we couldn’t just return. And my husband and I didn’t exactly feel okay for her to go through another round of trauma back to back. So I said that we could try the following Thursday. The admin was very concerned that we need to come back soon. In this particular case, I made some arrangements to return on Monday, February 4. So I took Genevieve to get another blood sample done. This one was not so bad and the blood came out much quicker. Results came back that the white and red blood cell count was normal. But the platelets were really low. It was 2,000. At the time, I did not know what to think. I answered a call from Medical City in Dallas from a hematologist that they are ready to schedule my appointment in the morning. It was happening pretty quickly. But I went ahead and scheduled the appointment for 8:30am, Tuesday, February 5.

So we arrived and the building entrance had the words, “oncology”. Yes, it is typical that you would have certain types of questions swirling through your mind. But I just refused. We had a little one on one with one of the doctors who gave us the low down why we were there. Genevieve’s blood work showed that she had 2,000 in platelets. The normal average is 140,000 to 500,000. Of course some can be between 20,000 and 40,000. But 2,000 is very concerning.

When you don’t have enough platelets, it’s called thrombocytopenia. Symptoms include easy bruising, and frequent bleeding from the gums, nose, or GI tract. Your platelet count drops when something is preventing your body from producing platelets. There are a wide range of causes, including:

Medications
A viral infection

An inherited condition
Certain types of cancer, such as leukemia or lymphoma
Chemotherapy treatment for cancer
Kidney infection or dysfunction
Too much alcohol

Platelets are the cells that circulate within our blood and bind together when they recognize damaged blood vessels.

Platelets, the smallest of our blood cells, can only be seen under a microscope. They’re literally shaped like small plates in their non-active form. A blood vessel will send out a signal when it becomes damaged. When platelets receive that signal, they’ll respond by traveling to the area and transforming into their “active” formation. To make contact with the broken blood vessel, platelets grow long tentacles and then resemble a spider or an octopus.

So after another blood test, it appeared that Genevieve was producing a lot of platelets. But they were being attacked by her own body. So the hematologist shared we have a couple of options. Either wait for our insurance to go through the approval process and risk a few days or we can admit you into the hospital for Genevieve to receive an Intravenus Immunoglobulin (IVIg). Your body’s immune system normally makes enough antibodies to fight germs that cause infections, but if you have an immune deficiency, your body can’t make enough of them. IVIg gives you antibodies that your body can’t make on its own so you can fight infections. So our hope was this treatment to give a distraction for the platelets to start getting back up in numbers.

It was supposed to take a few hours to drip in her body through an IV, but it all depended on her body’s reaction. Otherwise, we would have been able to go home instead of an overnight stay.

So while my husband handled the details of administration and getting our other children squared away with family to take care of them while we stayed in the hospital with Genevieve. I just started to worship in our hospital room. Just me and Genevieve. Recently, a Facebook friend shared this video just days before and it just was good to breathe some life in to knowing who we are in Christ.

“Throne Room Song” by Sean Carter, People & Songs

And of course, there was always something to try to cause an interruption. Someone knocked at my door. It was an older gentleman who I learned later was the hospital’s chaplain. He walked in and I thought maybe he was coming in to tell me that my music was too loud. But instead he said, “I hear that you are expecting bad news.”

I answered back and said “No. We believe that God is going to do the right thing and He has us in the palm of His hand.”

He offered to pray for us and I was fine with it. Unfortunately, I do not remember what he said. Mainly I was praying in my spirit over us to remember God’s goodness and His power. And how many countless times He has rescued me in some amazing ways that no one could ever really grasp the enormity of how God is so gracious.

So when he left…I just looked at my precious baby and wept. I think it was the first time I actually cried in front of her. Of course, she had no idea what in the world is going on. But my heart just sunk and I just remembered who He is.

On my personal Facebook page I shared a quick PSA to bring awareness of Acute ITP. Mainly, to just change the conversation that I was having in my spirit. Asking for prayer and I truly felt we did receive answered prayer(s).

We spent time in the playroom. Had a decent tunafish croissant with a pickle and a quarter of a cookie. Our patient had the hospital food version of beef raviolis, carrots and mash potatoes. Chocolate pudding for dessert.

Later after her nap she was ready to get her IV inserted. Her medicine the IVIg arrived late in the afternoon and the drip process began. The nurse at the time put a sock over her arm to help prevent her from messing with the IV. But it turned out not to be a good idea.

While the nurses shift changed – they didn’t immediately do a routine check-up. So for about an hour my daughter’s arm and hand started swelling up with fluid. It was painful for her. And then we had to start all over with a new IV insertion. After having to contact multiple departments to help find a viable vein and 4 tries later. It wasn’t until about 1am before she had a dog house unit attachment to her arm. By the time she finally went to sleep the drip lasted for a few hours. That ended around 5am.

Her arm and hand swelling reduced some. The Petechiae or the small bumps on her chest area were actually spots of blood underneath her skin. There was what looked like scratch marks on the back of her neck which was also Petechiae.

Around 7:30am, another blood sample was taken. This time it was just a prick of her finger. By 8:30am, results were in. But we had to wait to hear from another doctor. Around 9:15am the doctor came in to share good news that her platelets are at 17,000. She seemed pleased with the results and said that we could be discharged. And to avoid trampolines or any rough activity. In addition to this she mentioned that the fact in such a short timespan there was a spike in platelets that it was a good sign that it will climb daily.

It took a while to be discharged. From physically taking the hardware off her little arm to awaiting approval from the Accounting Department. Information that was neglected to be shared in our available options was the expected expenses. While my husband was taking care of our administration he had to put down a $300 deposit and agreed to a payment plan. As I was packing up I received a call from Accounting asking how would I like to pay for this $3,000 hospital visit? I asked, “I’m sorry are you asking for me to pay you $3,000 over the phone so that we are able to be discharged?” She said, “Yes.” She mentioned, “That the day before my husband paid $300 and is calling to collect and how I would like to pay for it?” So I said, “I’m sorry, I believe that my husband said that we are doing a payment plan.” So she continued, “Okay, then I will put you down that you have chosen the payment options so when you receive your billing statement call the number on the document to make your first payment.”

Then about an hour later we finally received our discharge papers.

Another thing that we noticed is a difference in the parking fees. Instead of paying for the Parking Garage hourly fees. We parked in the outdoor uncovered parking lot for a flat $4.00. It was steps away from the parking garage next to the hospital.

When we finally got home that afternoon I noticed that Genevieve’s bruising and the Petechiae have faded away. Her skin was looking so good.

Later that evening, about 9:30am she did vomit and another hour later she got a fever. We called the doctor’s call service and they recommended to take 3 ml of Benadryl.

Next week, we will have a follow-up appointment by reviewing blood work again and hope that this was just an acute episode and not a chronic concern.

We believe that God is going to do the right thing and He has us in the palm of His hand.

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