Tachycardia

A case for working out:  When Johnny relapsed he was in pretty good shape.  He got some form of exercise almost every day, and when we first settled in to this hospital stay many of his doctors and nurses commented on how low his resting heart rate was.  While sleeping his heart rate regularly fell into the mid 30 beat/minute range, and while awake he would be in the 60s.  I guess for a kid his age this is really low.  All that conditioning has really paid off.  When Johnny had his first bacterial infection I remember how frightening it was to see his heart rate in the 160s.  When he got his second bacterial infection it went to 200 when his fever hit 106.  Both of those episodes were short lived, and as soon as the infections and fever were under control his heart rate dropped.  It never got back to normal for him, but it dropped into the 70s/80s.  Then he got AML.  When his WBC first spiked several weeks ago his heart rate jumped up into the 180s/190s and stayed there.  For days on end.  Even now that his white cell count has dropped to less than 1 his sleeping heart rate is in the 150s.  For weeks now his heart has not beat slower than 120 beats per minute regardless of fever or white count.  This is probably another side effect of the chemo used to fight the AML since many of these drugs can have a negative effect on the heart.  The cardio team just completed a 24 monitor of his heart functions and we should have the results in a few days.  Their immediate impression is that his heart is still functioning properly, and does not appear to be damaged.  It's just going really, really fast.  I'm just glad its beating, but I do hope it slows down a little.

Today was relatively uneventful.  Johnny is on morphine for the pain in his hands and feet, so he slept most of the day.  It does look like all of the drugs are starting to cause some liver problems, so the doctors and pharmacists are trying to work out a program that might be a little easier for him to handle.  He also spiked a fever this evening.  Nothing has grown in any of the cultures, so he may have a virus, or it may just be because of the pain.  All of his labs were good, and his WBC was down to .03!  

Onward,

MR