Update

Around 4:30 yesterday, Ruby woke up with a fever. She was fine all day, playing and eating and drinking just fine, but got up, snuggled on her aunt's shoulder and started burning up. With two measurements of over 38C (our threshold for going in), I packed a few bags and Ruby and I drove to the ER.

We knew before we got there that she'd stay overnight because of the timing. We've kept Ruby out of anywhere she might pick up germs (church on Christmas Eve, holiday parties, even Publix!) for the last week because her counts have been dropping, and we had a pretty good idea that they would be at their lowest yesterday. Close enough: her ANC was 50 (we need it to be over 500 and trending up for them to give us antibiotics and go home).

In the ER they drew lots of blood to test for cultures and other things (including the ANC). She received antibiotics right away, but her fever didn't drop at all, even after a dose of Tylenol; I think they said it got over 104F? Around 8PM, Ruby fell asleep waiting for us to be admitted. Once in her room, they hooked her up to fluids and she got something to eat. 10PM was bedtime and she slept very soundly thorugh the night.

Ruby's ANC is climbing: today it is 70 and she has a bunch of monocytes (precursors to the ANC spike). Unfortunately, this morning's RSV test came back positive,. However, she has not needed any oxygen support. Her cough still sounds horrible, but there is nothing (other than suction) they can do to fix that. Ruby received hemoglobin, as her red blood cell count was low. Things were great for the first hour and then somewhere after that, the blood suddenly came unhooked. Seriously… One minute with that, and the next it was dripping out of the tube. That was a lot of fun :)

Ruby also got more antibiotics. And of course more fluids. (I despise because they make her puffy and give her a diaper rash.) We will be here until at least tomorrow, to rule out any cultures and to see how her counts behave overnight again.