Her attitude keeps her going.
By Wednesday morning, Joanie was really getting anxious to get this all over with, and go home. Her calcium number was moving in the right direction, and her potassium level had reached the normal range, so at least that was no longer an issue, and there were only three more radiation treatments to go.
Joanie still wasn’t eating, or as the words in the doctor’s notes put it, “The patient was encouraged to taking clear liquids on hospital day #2 as tolerated, and her diet was advanced on hospital day #3. However, the patient continued to have decreased intake…” This did concern me. I had been through other times when she wouldn’t, or couldn’t eat, and nothing tasted good, and as hard as I tried to get her to eat more, she would push it away. This time in the hospital, she was mostly eating Jello, and would sip some clear broth, and then would ask for an occasional popsicle.
In spite of her weak appetite, she continued to feel stronger, and by the time Friday morning rolled around, and we went down for the last radiation treatment, she was more than ready to go home. They were also going to do one more blood draw, since her calcium had moved up again, just barely, but it had move up. They were going to have the results for us before we left, but Joanie was so intent on getting out of there, we told them to call us when they got them from the lab. It was Friday, and we wanted to get on the road to beat the rush out of town.
We hadn’t made it but about 80 miles when we got the call. Her calcium had moved up again, and we were told to go to Dr. Thomas’ office when we got back for a blood draw, and possible IV fluid therapy. They told us they had called Thomas’ office and gave him the same report.
We didn’t make it back to Bismarck soon enough. The office was closed when we got back, so I didn’t take her into the clinic until Saturday morning for the blood draw. We would find out the results on Monday when we met with Dr. Thomas.
Sunday, April 1st, and Joanie is still feeling the effects of her stay in the hospital at the U of M. Pain is still a problem, despite her supply of Dilaudid, and her appetite hasn’t improved either.
That morning, she even turned down a cup of coffee, and said, “I’m in sort of a fog, can you tell?” I just told her she had been pretty sick for that week, and in effect was still feeling the effects of radiation and the hypercalcemia, and it was going to take some time before she returned to normal. She didn’t understand the calcium thing, she just knew it had put her in the hospital, and never knew why. I also told her again, she was going to have to start eating more, and more often. She just looked at me and said, “I know.”
On Monday morning, we went to see Dr. Thomas, and he told us the calcium level was still about a point above the high level of the normal range, so they found a room for Joanie and began to give her some IV fluid and a drug called Zometa, which is one of the family of drugs used to treat high calcium levels.
Dr. Thomas told me that Joanie still had a case of moderate hypercalcemia, and now will be treated for that and monitored more closely in that area.
When they were done with the IV, I dropped her off at her office. She wanted to do payroll. I asked her if someone else could have done it, and she just looked at me, shook her head and told me to drop her off. She stayed until around 3:30 that afternoon when she called me to come and pick her up.
Now we were in a waiting mode again. We would wait until Friday to see where the calcium number was, and we would wait another three to four weeks before Thomas would start the next round of chemotherapy. Dr. Carson had ordered a new drug for the next chemotherapy treatment, a drug called Gemzar. It turned out to be a month long wait. He told us it would take three to four weeks for the radiation and its effects to clear out. We would also wait to see if the radiation had done what we had hoped it would, which was shrink the lesions in her chest, and we were waiting for the pain to diminish the further we got out from the radiation.
The waiting is what comes with the treatment of this disease, and it is the waiting that screws with your mind.
This was also a time when I realized Joanie was facing a serious challenge, probably the most serious one of the past 11 years.
She left all of that worrying to me. As far as she was concerned nothing had changed. The radiation was going to work, the chemo was going to work, and she was going to be okay, that’s all there was to it. The other part of my job besides keeping up to date on what was going on with her, was to support her attitude in that regard, and I did. I knew that it was her attitude and approach to this battle that had gotten her this far, in the first place, and I was never going to disabuse her of that idea.