March 7-9, 2010 – Would I disappear on you?

I haven’t posted for a few days.  Really, I had a good reason.  Woke up Sunday morning, feeling weak with a temperature of 100.4F.  (Note aside:  don’t get sick on a Sunday morning.)  During this stretch of the chemo cycle, my white blood cell count goes down to nil and any infection is serious.  The line in the sand is a body temperature of 100.5F.  I didn’t want to quibble over a tenth.  We talked to the doctors in Boston and the doctors in Worcester, and it was decided that going to the ER at Worcester’s St. Vincent’s Hospital made the most sense.

We processed through to a room in the ER where they accessed my port and drew tube after tube of blood, had me pee in a cup, and took a chest x-ray.  I saw the Emergency Medicine doc, he asked the standard questions, poked and prodded, got my white blood cell counts, and determined that I should be admitted.

I was given a really nice single room, very sunny and bright.  Looking out my window, I could see the DCU Center, Worcester’s arena where Carrie Underwood, Michael Buble, and The Worcester Sharks (AHL) will all be playing this month. 

A view of DCU Center from my window, Monday at 6:00 am:

A parade of doctors saw me, from Internal Medicine to Infectious Diseases to Oncology.  A regimen of IV antibiotics was prescribed, some once or twice a day, others on intervals – like every 8 hours.  They also scheduled diagnostic tests.

What I didn’t understand is that the hospital is a late night scene.  It was a good thing I brought my iPhone and plenty of music!  The 3:00 pm – 11:00 pm shift would race around getting the station buttoned down for the late night rockers of 11:00 pm – 07:00 am.  I was ready for sleep at 10:00 pm, but why go to sleep when my vital signs would be taken at 11:15 pm, followed a late night cocktail at 11:30 pm – one of the antibiotic IV’s?  Then it was catnap time, stretches of yummy sleep punctuated with blood drawings, medications IV and oral, and more vital signs.  The bed was comfortable, the staff friendly and in good humor.  I had a light show from the DCU Center’s multiple advertising boards.  The late night nurse would also cruise the rooms, checking on her charges every hour.  I discovered that IV’s and iTunes go remarkably well together.  A little Lee Rocker mixes well with IV’s; hey they both are medicine!

I got to like my room, especially when the afternoon sun poured in.

What was the outcome of this three-day, two-night vacation?  The antibiotics got the infection under control.  The medicine injected into the skin of my stomach woke my bone marrow early and they produced white blood cells.  And I have even more meds to take over the next 10 days.  I may need a second shoebox to hold them all!

The cause of the infection is still “to be determined.”  All the tests were negative. It’s not unlikely that we won’t know the cause.  When the white blood cell count hits nil, bacteria have an open court to play on.  On Thursday, I have an appointment with Dr. S., the local oncologist Dr. Deb referred me to.  I have a lesion (doc talk for boo-boo) on the fleshy part of my right hip.  It’s one of those skin things I take as commonplace as a 57 year male.  Normally, my immune system would take care of it without me even noticing.  But on chemo, my body is unconventional.  With nil white blood cell count, the lesion doesn’t even raise puss.   By Thursday, there will enough to sample with a syringe.  Dr. S. feels the lesion may be the cause of all this.  Throughout this whole incident, Dr. S. was stellar, not only his medical talents, but also the way his calmness and understated competence made me feel in good hands.  Thanks, Dr. S., for everything.

Tomorrow, Ann & I will head to Dana Farber to meet with the radiologist.  I imagine we’ll review the details of 35 treatments, and what we have to do get ready.  In between, there is one more chemo treatment, but we’re moving forward day by day.

Thanks everyone for your calls and emails.  It will take me a while to answer.  I’m tired from my “vacation.”  This cycle has shown the chemo is cumulative and my mouth, though better today, is still quite sore; my tongue is still a mess.  I had my low point of the cycle in hospital (oh, fun getting bland food that I could eat without chewing – will spare you the food chronicles!) but each day going forward will be better.  Soon, I’ll be eating mass quantities in a guiltless fashion.

Ok, time for a power nap.  Thanks, all y’all for your love and support.

Love…

Richard