Is This An Emergency?

Today there is fever....38 to 38.8 and I am worried and not happy. I don't like fever, especially when the fever is way too high and Nick's ANC count is way too low. Nick's ANC (absolute neutrophil count) has been going in the wrong direction for several days. After a high of 794 a few days ago, it was down to 370 on Sat. Despite this drop in counts, Nick was told he didn't have to come into the IPOP on Sunday. This I also don't get. We have called and bothered the doctor all day about Nick's fever. The doctor seems willing to let Nick stay home "as long as nothing else is wrong." Huh??? This stuff is more than a little bit scary.

I am not sure I understand why the instructions we have received from EVERYONE up to this point have been very specific about how we MUST call for any fever greater than or equal to 38C and then when we do call we get hassled by the answering service.

Phone Lady: Doctors on call service, may I help you?
Me: (Following instructions for BMT patients with fever) I need to speak with the BMT attending on-call please.

Phone Lady: "Is this an emergency?"
Me: Ah...well, not exactly. (Define emergency...like my son has just had a BMT and his ANC is extremely low and he basically has no immune system and therefore cannot fight off any kind of germ of bug that gets into his body and if one does and it does not get treated immediately, then really bad things can and will happen...like that kind of an emergency???????)

Phone Lady: "Well this line is for emergencies only mam."
Me: Well, I have very specific instructions to call for any fever and I need to speak to the "Bone Marrow Attending" on call.

Phone Lady: "What is the name of his doctor?"
Me: What do you mean? (Does this lady understand how many doctors Nick has seen? Not to mention the fact, that Nick's current doctor has nothing to do with who is actually on call!) I really wanted to climb through the phone and strangle this person.

Me: (cont.) I then proceeded to outline all the doctors and let her pick one. Hmmm....let's see now, there was the doctor who admitted Nick (Dr. Krusty) or the one who is his medical oncologist (Dr. Crinoline) or the fellow who actually saw him in outpatient clinic (Dr. Filament) or the attending who saw him when he signed all his consents (Dr. Braid) or the one who came when Dr. Braid went off service (Dr. Jenga) or the one who came on when he went off service (Dr. Ping ) or the one who is apparently on now (Dr. Livin' Large). Now we have never met Dr. Livin' Large and Dr. Livin' Large wouldn't know my son if he fell over him. I WANT TO SPEAK WITH THE BMT ATTENDING ON CALL!

Phone Lady: "Ok I will page Dr. Livn' Large."
Me: Grrrrrrrrr!

Meanwhile back at the ranch, Dr. Livin' Large seems to think it is OK for Nick to hang out here at home with his fever of 38.8 so I pray that the Lord watches over him tonight. Nick was very tired tonight before he went up to bed. He was not with his Mama all weekend so it is hard for me to say why. It could be just the general malaise and fatigue that is normal after all the chemo that Nick got and also the fact that his white count and hematocrit are still low. I will be going up soon to take his temperature and I hope it has gone back down and stays down for the night. This is the first time Nick has had a fever throughout the entire day. Can a fever of engraftment be that high or is he brewing some kind of infection? I don't know about everyone else but I am finding this whole "being at home" thing to be very stressful. I am looking forward to going to IPOP tomorrow and getting all this crap straightened out. Oh yeah, and I am planning to turn in all the thermometers...why do we need them anyway?