“Bring me some #14 Red Robinsons.”
2007 off to a rocky start.
There is a melancholy that accompanies the melody and the words from “Auld Lang Syne” that always seems to envelop me when I hear it on New Year’s Eve. It is palpable, and I think it comes from the idea of saying good bye to a part of your life you won’t see again. It doesn’t last long, maybe only until the last notes of the song have left the building, but for a moment it is real. Then, as you kiss the one you love, or the one your with, and wish them a Happy New Year, you begin to think about what lies ahead. Reality smacks you on the head, and you start thinking about tomorrow.
Joanie and I had our brief moment of melancholy on New Year’s Eve, but on January 1st, 2007, we were thinking about tomorrow. Our hope was that this year would be an improvement over the last one.
Our New Year’s Day was a quiet one. She wasn’t hungry, so I just fixed some bacon and bagels with cream cheese. While we watched the Rose Parade, as we always did, she ate half a bagel and one slice of bacon, and then, on the couch, with the TV showing endless football games, she slept most of the afternoon with Bailey on her lap. I went down in the basement where the other TV was and watched some of the games, and I was joined by Brandy, where we both had a nap.
If someone could have looked inside our house from the outside, they would have seen two people, and two Siamese cats, enjoying a leisurely holiday afternoon, seemingly without a care in the world, not unlike many other couples in the country on New Year’s Day. The difference was that in our house there was a dark cloud I couldn’t escape.
I was worried, and she was tired. I was worried because she was tired, and I knew she was tired because of the chemotherapy treatment that had just ended. The shots of Neulasta and Aranesp had yet to kick in, to boost her blood counts, and I was hoping they would be doing so soon.
Her appetite was almost non existent. I could get her to eat some lime Jello, and she was always up for a cherry popsicle, but not much else. Nausea didn’t seem to be a major problem, but there were a few incidents that didn’t seem serious.
She didn’t go to the office that week. New Year’s Day was on a Monday, so it would be a short week anyway. She was just not bouncing back from the latest treatment like she had from the first two. I kept a close eye on her those first few days, looking for any sign that would tell me there might be a problem. In the back of my mind was the incident from last May. I didn’t want to see a repeat.
By Friday morning of that week, I knew things were going south again. Fatigue, which had plagued her since the end of the last chemo treatment was worse. She still wasn’t eating, and all she wanted to do was lay on the couch. I stopped by Dr. Thomas’ late that morning and told his nurse Kathy and him what I was seeing. I was supposed to bring her in that day for some lab work, but someone had not set it up. I mentioned her temperature seemed to be on the move. That afternoon, it spiked over 101 degrees, and they told me to bring her into the emergency room. We got there about 3:30, and I was glad we were there. Her blood pressure was 90 over 30, and that bottom number reminded me again of what she went through in May.
A nurse came to get her and take her to do a chest x-ray, and I went out for a smoke. This was turning out to not be the way we wanted to start off the new year, and I was worried about what the lab work was going to show. The blood pressure issue was also on my mind.
When I got back to her room in the ER, they had done the x-ray, and also taken blood to do the lab work. Then we waited for Dr. Thomas and the lab results. Meanwhile, her blood pressure wouldn’t move. The Systolic number, the higher one appeared to be stable, right around 90, but the Diastolic number, the lower one. was bouncing around from 26 to a high of 45. I knew that number wasn’t where it was supposed to be.
At 5:30, the emergency room doctor came in and told us Joanie was going to be transferred to the Intensive Care Unit. Now I’m more worried. Shortly after that, Dr. Thomas came in and told us what the results were. His notes showed Joanie had developed a sever neutropenia sepsis, severe anemia, and was hypotensive. My understanding was this. Her white count was in the toilet. Her red count was in the toilet. Her platelets were in the toilet. Her diastolic pressure was in the toilet, and she had an infection.
Thomas told me they were concerned about the white count and the blood pressure, because of what had happened in May of last year. He said the Neulasta hadn’t kicked in yet. About the red blood cell count and the hemoglobin, he said that Topotecan makes it hard for those two to recover between treatments. The ER doctor alluded to the fact that chemo does that to the bone marrow. It makes it difficult to produce enough new cells to overcome the effects of the chemotherapy.
The got her up to the ICU, and began giving her antibiotics along with the continuing IV hydration. Thomas ordered a unit of platelets, and four units of blood, which they gave her from Friday evening through Saturday morning. Joanie’s numbers began to move in a positive direction late Saturday, except for the blood pressure, that remained low. Thomas had told us in the morning they were going to keep her in the ICU for one more day, then they would move her up to the oncology floor. Thomas told her the blood pressure number was still a concern, and they also wanted to do an MRI of her abdomen and pelvis
Joanie was disappointed, to say the least. I knew she was feeling better, and wanted to go home, but I told her it was a good thing we were here. I told her she hadn’t been here that long, but things were looking better.
On Sunday, still in ICU, they gave her two more pints of blood, bringing the total for the weekend to six. I remember thinking, no wonder she was tired.
They were going to move her up to the oncology floor this afternoon, but when they got her up there the room they were going to move her into was a corner room she had been in before, and it was a depressing place. They brought her back down to the ICU until a different room could be prepared. She didn’t seem bothered by the delay. I think some of the pain killers they had given her for her back pain had mellowed her out just a little. Besides that, she knew by moving, she was one step closer to getting out, hopefully by tomorrow. The back pain that had been bothering her for some time now was something else that bothered me, but that wasn’t a major consideration right now. It would turn out to be significant in the future.
She was resting well, and though she wanted to go home, she had resigned herself to at least one more night in the hospital. I hung around with her until about ten o’clock that night and went home, secure in the knowledge that we had escaped what could have been another serious episode.
Then, about 10:25 P.M. I got a frantic call from Joanie. She wanted me to bring a few catheters, the #14 Red Robinsons she used to empty her Miami Pouch. Seems there were none to be found in all of St. Alexius Medical Center on that Sunday night. She told me they had tried a #12, but it wouldn’t work. I made it to the hospital in about ten minutes with the catheters, and everyone was relieved. I still couldn’t believe they couldn’t find any, and it reminded me that medical treatment is not always an exact science.
Joanie and I had a late night laugh about the situation, and I learned again, how a caregiver has to be prepared for almost anything.
She was feeling good now, and about 11:00, I kissed her good night and told her to get some sleep, and maybe we could get her out of here in the morning.