Three pints, not two.
These few days in the hospital were disconcerting to me. Not only because I was worried about what might have been happening to Joanie, but because I really didn’t have a clue about what was going on. I understood the numbers from the lab work, I understood what low potassium meant, and I understood what being anemic was, and I understood, albeit, vaguely, what the creatinine and BUN numbers indicated. What I didn’t understand was what was going on with her inability to keep any food down. Her days in the hospital this week, and the days at home following did nothing to inform me as to what the problem was. Suffice it to say, at this point, I was relying on the doctors more than ever to get to the bottom of that issue, and often, they weren’t sure either.
The lab work done while Joanie was in the ER that late afternoon, plus the ultra sound came back. The ER doctor told me that while the ultra sound showed both kidneys slightly enlarged, he attributed that to her inability to empty the Miami Pouch completely when she was home. When she came into the ER, they put in a catheter, and hooked up a Foley bag, and it drained it on a continuous basis. The output in just four hours was significant, and he told me that was evidence the kidney function was okay.
By seven o’clock that night, they had transferred her to the oncology floor at St. Alexius, and hooked her up to some potassium chloride to begin dealing with her hypokalemia. She was resting comfortably when I left that night.
The next morning, it was now Tuesday, Dr. Thomas came in and told us he was ordering two units of blood, and they would start them some time later in the morning. He also told Joanie, her creatinine and BUN numbers are coming down a bit, but they are not down where they want them yet.
Thomas also told her she wouldn’t be going home today. Joanie was not happy when she heard that, but I told her we had to get a handle on what was going on, and we couldn’t do that at home.
When I got back to the hospital a couple of hours later, the nurse told us they were going to give her three units of blood, not two. This made me realize just how serious things had been, when I brought her in.
As she lay there waiting for them to start the blood transfusion, she asked me if this was Tuesday. I told her it was, and she said she thought it was Monday. Then she said, “I’ve missed a work day.” She was still a little disoriented, and she couldn’t remember that we had come to this room from the emergency room yesterday until I reminded her.
The three units of blood did their work, and when I got to the hospital on Wednesday morning, she was looking good. She had color in her cheeks, her voice was strong, and she began hounding Dr. Thomas to let her go home. He wouldn’t, not just yet.
Thomas told her that her hemoglobin was looking good again, and while her platelets were still a bit low, that was probably attributable to the carboplatin chemo drug. He said her creatinine was coming down, but they wanted it down a little more. Then he told her he wanted her to get up and do some walking, and he was writing orders for the physical therapy folks to come up and get her going. She was not happy again, but grudgingly agreed to his plan.
I was then dispatched to pick up some cranberry juice cocktail and yogurt for her. She continued to have incidence of throwing up over the next day and a half, no one was sure what the cause was. When I got to the hospital on Thursday morning, she had just thrown up everything she had eaten the night before. She seemed to feel better, but told me she hadn’t slept well and was anxious to get home. About nine, she went walking with the PT nurse and while she had doubled her distance from the day before, she promptly threw up when she got back to the room. I was really confused. Her color was good, her eyes were bright, and her general demeanor seemed normal to me.
Dr. Thomas came in around ten that morning, and told us her creatinine numbers were down even more, but he would like her to stay one more day. Joanie looked at him, and said, “What if I promise to drink lots of fluid and get some exercise, would you let me go home then?” Thomas smiled, and said, “Okay, if you promise me.” He told her he did want her to come into the clinic Friday morning for some more fluid through an IV. She hastily agreed. She was not going to stay another day.
He wrote the orders, and by noon on that Thursday, she was on the couch with Muffin on her lap, and saying, “It’s so nice to be home.”
She may have been home, and glad of it, but the issue of her inability to keep anything down, continued unabated. I won’t detail every instance, but here is a briefl picture of what I saw over a period from Friday morning through Sunday.
On Friday morning, she threw up twice before we got to the clinic for the IV fluids Thomas had ordered, and after that was done, she wanted to stop by her office so she could do payroll since it was Apri 28th, the last workday of the month. When we pulled into the parking lot at her office, she opened the car door and promptly threw up. I wanted to take her home, but she would have none of it, and went in to do the payroll. The rest of the day she threw up four more times, and I was getting nervous again.
I had asked Kathy, Dr. Thomas’ nurse when she was in getting the IV about the problem, and she got hold of Thomas who was somewhere waiting for a plane and described what I saw going on. He told her to have me get some Ducolax or Milk of Magnesia, to see if that helped. I did, and it didn’t.
On Saturday, my notes showed this:
4:00 A.M.–Gets milk. Drinks milk. Throws up milk.
7:00 A.M.–Gets up. Throws up.
3:10 P.M.–Takes Ativan. Drinks cranberry juice. Throws up.
6:05 P.M.–Drinks 7-up, Throws up.
After the last time, I gave her another Dulcolax to see if that might work, and by Sunday morning I thought, “Hooray, it worked.” My excitement was premature, for there was to be one more episode.
After that last episode on Sunday, something happened, and I don’t have a clue what it was. She did well the rest of the day, feeling better as the hours went by. Monday morning, she was feeling good. We went for a good long walk, and that afternoon she went into her office. We followed that same routine on Tuesday, Wednesday, Thursday and Friday, and it seemed she just got stronger every day. For me it was hard to believe the difference I could see on Friday from a week ago. She was not the same person.
She was feeling so good, that she told me on Friday morning while we were walking that she had made a decision regarding the chemo treatment. She told me she expected Thomas was going to want to change it again, and she wasn’t going to let him, even after all she’d been through.
That was my girl. She was feeling stronger than ever.