THE BAD DAY (NIGHT) FINALLY ARRIVED

Here is the lovely Miss Hanna at about 1am this morning, trying to figure out what sort of dinner her system will handle.  The softer the better.  Taste doesn't matter any more as her taste buds have been eliminated by the Chemotherapy Drug.

Until today, our daily routine was, check in at the Transplant Clinic.  Get examined and consulted by a variety of medical professionals.  Go back home.  And usually that was it.  If something were to be wrong with the blood tests, etc., they would call and have us come back in for treatment.

The closest we ever came to the "call back in" was a week ago Sunday when her Potassium levels had dropped drastically, likely caused by the extreme hydration during the transplant itself.  They had us come back to the Clinic to pick up some Potassium tablets at the Pharmacy.

That all changed yesterday.

They called and asked us to come back in as her platelets had dropped drastically.  The nurse told us to finish our lunch, and then be there at 2pm.

I would be remiss without including sarcasm in any blog post, so here goes.

For several weeks now, we (me and various medical professionals) have heard from Hanna about how she has a stomach of iron, that she outgrew vomiting while still a youth, and that she just doesn't vomit any more.  I believed her and, even given my rank and status within the Boy Scouts of America, unfortunately did not "prepare" our vehicle for vomiting episodes.

About half-way back to the Clinic, Hanna had to vomit and was serious about it.  I had no choice but to give her my favorite stocking cap, and she pretty much filled it up with nasty Toxic Vomit.  I then pulled into the next gas station and threw the nasty Toxic Vomit along with my completely full and contaminated cap into a garbage can.

Now, I'm trying to decide which Caretaker Deed is more mortifyingly embarrassing (or heroic in Hanna's point of view):

1. Standing in front of the Feminine Hygiene Aisle at the local Hy-Vee store for several minutes reading a Depends Package to make sure I get the absolutely correct Depends that Hanna wanted, all while several elderly ladies gawked at me suspiciously, probably wondering if I was a super helpful husband or some sort of freakish pervert.

2.  Let her puke nasty Toxic Vomit into my favorite cap.

It's all good.  She has her favorite protective (in the correct size even) Depends and she already has plans to crochet me a new hat just like her cool cancer hat with the pom pom on top so we'll match, except mine will be green like my JEEP.  (Thanks Maren for teaching her how to crochet.  She has been enjoying it and now I will enjoy a new cool green cap.)

Sorry for the derailing there.

Once back at Station 9-4, we learned Hanna could not receive a transfusion of platelets until she was thoroughly examined.  It turned out that her blood pressure was low and she had a fever.  Not good.  A fever will immediately kill the new platelets.  And it could be a sign of an infection.  So the medical staff began an all out search for an infection or virus.  She has absolutely no white blood cells right now and her body will not fight off an infection or virus.  So, this is kind of critical.

Our awesome nurse pulled out her White Board Marker and made the checklist below.

As accountants, we love checklists.  This checklist easily communicated to us, the other medical professionals helping, and the nurse herself what was going to happen and what hadn't been done yet.  The checklist made us both very happy.  Even after the vomit episode.

Some of the blood tests take up to 48 hours, but the ones that were fast all came back negative.  With the Tylenol, the fever dropped.  And they gave her an IV of fluid which brought her blood pressure back up.  So, they started the platelets.

15 minutes into the transfusion, her blood pressure was dropping once again and she spiked yet another fever.  So, they stopped.  And proceeded to test for a reaction to the transfusion.

At this point, the doctor saw that her last blood draw was nearly 12 hours earlier, so ordered another one just to see how the platelets and other things they test daily were doing.  That came back with her Hemoglobin as crashing now.  So, the doctor also added a transfusion of red blood cells to the mix.

After a bit, her fever dropped again, blood pressure settled down, and the "reaction" tests came back negative.  So, they tried again and it was successful.

Transfusions take two to three hours each.  So we did the platelets, and then the red blood cells.  You do the math.  Plus they found that she has antibodies to the red blood cells, so they had to spend a bunch of time in the lab finding an exact match so she wouldn't have a reaction.

Here is a picture of the White Board as we were leaving.  All checked off.  And that clock says almost midnight, not noon.  This turned into a ten-hour appointment.  But, we were grateful that they didn't just up and admit her and finish this in-house.  That is a blessing as we feel that outpatient option is much healthier, especially emotionally.

They put her on some antibiotics just in case which must be administered via IV twice a day.  So our routine is now come in earlier in the morning and come back at eight that night for the antibiotics.

Once back home, as the tough Caregiver that I am, I pointed out to Hanna that she probably didn't consume enough protein or calories during the day.  She puked her lunch up, so I doubt those proteins and calories count, and she never ate dinner because she was at the clinic and she didn't feel up to it.  Failure to keep nourished on your own, as I firmly reminded her, could result in her being admitted and fed intravenously.  That would be miserable for her, lonely for me, and Frivvy would be very confused as to where she was at.  So, there's that first picture, consuming soft food at 1am.

Here's a picture of Frivvy, very excited that we finally came home, but also coveting a taste of her peanut butter.  At 1am.

Hanna was struggling as we went to bed.  She felt chilled and was shivering a bit.  She took another Tylenol and soon was asleep.

She is doing fine today.  All blood tests this morning came back in the normal ranges.  No vomiting.  Still outpatient in our comfortable home where she can nap to her heart's content with no medical interruptions.  She ate three scrambled eggs for breakfast, and they stayed down!

New development though, as expected.  Her hair is falling out in clumps.  In fact, she and Frivvy are having a contest to see exactly who can shed the most.

None of this is easy for any of the three of us.  Your prayers are certainly felt, needed, and appreciated.

 

Today's Miracle:  It is nothing short of a miracle that her fever just happened to spike while she was actually in the Clinic so they could immediately start the cool checklist and get her on the antibiotic sooner than otherwise.

And yes, we now have puke bags in our rental car.......................