Hi everyone:
Sorry this update's taken a while. Patty and Kathleen were stuck in a signal-free zone (the E.R.) for much of the day yesterday, so I was picking up only fragments of details--fragments I was afraid to share lest I misinterpret them. I'm now here at the hospital with Patty, Kathleen, Joe, Amiee and Owen--and finally sorting through the chronology. I'm not sure I'll get this 100% right, but here goes...
After receiving three units of platelets on July 5th and two units of whole blood yesterday, Kathleen was given the go-ahead to leave the hospital's infusion clinic. Patty stopped at the oncologists' office on the way home to pick up meds for Kathleen, who waited in the car. When Patty returned, Kathleen was in tears from severe discomfort throughout her lower extremities and additional discomfort from a fever. She was feeling so poorly she asked Patty to get one of the nurses. The nurse followed Patty to the car, took one look at Kathleen and insisted she return to the hospital.
At the E.R., samples of Kathleen's blood were taken for CBC testing and for bacterial cultures, in case her fever was related to an infection. Initially, her oncologist suggested that, after a round of I.V. antibiotics, Kathleen could head home (in fact, he seemed a bit miffed that the nurses from his team were being so alarmist). Ultimately, the E.R. doctor conferred with Kathleen's oncologist and they decided to admit her. And here she remains...
So far, we've heard nothing back to suggest the fever yesterday (100.8 after heavy doses of both dilaudid and ibuprofen) was the result of an infection, although one oncologist expressed surprise Kathleen had such a strong reaction to infusions after having had so many. He suggested that many of the symptoms Kathleen's been enduring are a consequence of the triple-whammy of cancer, chemo, and sensitivity to blood antigens. More alarming was his suggestion that Kathleen has now become "transfusion dependent"--that is, her blood is no longer capable of bouncing back and she'll always require blood products to supplement her own. The biggest concern he expressed was that, even with bag after bag of platelets, her numbers are dipping so low she's at risk of "spontaneous bleeding inside the brain", words that immediately gave me goosebumps. Although he tried to paint a hopeful picture about leaving the hospital tomorrow, we have our doubts she'll be sent home until her numbers are less of a threat.
Okay, on to the numbers Kathleen's trying to walk around with; please don't attempt these at home:
Yesterday, after the three units of platelets and two of whole blood, Kathleen's numbers were mostly awful, and they're even worse today. Her hemoglobin yesterday was at 8.5 and today at 7.5; her platelets were at 7 yesterday and at 4 today. In fact, most every measure in her blood is down, including white and red cells.
All things considered, Kathleen seems relatively energetic and in good spirits, in spite of soreness throughout her hips, back and legs. The hospital's pain management team will be visiting soon. I suggested to Kathleen's doctor that they set Kathleen up with a pump for administering her pain meds, because she's needing it with greater frequency--and, much to Patty's irritation yesterday, nurses were eight hours late giving her doses of much-needed relief. Hopefully, we'll have a good answer on this soon.
As always, she's a tough gal and making the most of a terrible situation.
Love,
Brian
