Jerry moved to the Physical Therapy department today and will begin PT for three hours a day starting tomorrow. Also, he is having a test done tomorrow that Dr. Matthews (Oncology) told me about on Monday.
Basically, Dad exhibits all the symptoms of an infection, but no cultures have grown so it cannot be proven. Tomorrow, they will take blood from my Dad, separate the white blood cells, label them, and then return the cells to Dad. If they are good little white blood cells, they will report for duty to the infection site to fight. Because they will now be labeled, the doctors can just look and see where they go. Dr. Matthews didn't explain to me exactly how they label the white blood cells, but I'm assuming it's more sophisticated than an extra-fine point Sharpie.
So, here are the questions I have about this very cool Starfleet Medical procedure: If the white blood cells go straight to the site of infection, does that mean that the specific infection type can be learned, and if so, does that mean that we can better target that specific infection and thus heal it faster? If the cells do not go to an infection site does that rule out infection, and if so, can we focus on the PT with the goal of getting ready for surgery sooner?
Nolie decided that after tonight, she is going to start sleeping at the RIBM instead of in the room with Dad. I think she's starting to realize that if she doesn't get enough sleep and doesn't take care of herself, that she's not doing Jerry any favors. I knew she would come to this realization eventually. She's pretty smart. She is spending the night with Dad tonight since he's in a new room.
If anyone remembers Dr. Selar, bonus points if you can name the only ST:TNG episode she appeared in. I figured McCoy, Crusher, and Pulaski were too easy, but I almost went with Boyce. Double bonus points for the episode with Dr. Boyce. (Hint: TOS)
Tuesday, March 20, 2007
Monday, March 19, 2007
A Lack of Urgency
Nolie and I arrived at our 1:30 p.m. How To Change the Dressing on Your PICC Line class at 1:33 p.m. and they wouldn't let us in because we were late. If they had let us in we probably would have been like those kids who sit in the back row, cut up, and make Cs. Heh heh. There's another class at 2:00 p.m. that Nolie can go to. I have a 4:35 p.m. flight.
He's Not Dead Yet
I got to Dad's room at 8:00 this morning, and Nolie and Jerry were both asleep. I sat quietly in the chair listening to music on my non-Apple brand MP3 player. While listening to "Kodachrome" by Paul Simon, I noticed that the lyrics don't quite make sense. The song goes "I got a Nikon camera/I love to take a photograph/So Mama, don't take my Kodachrome away." Kodachrome is a registered trademark of the Eastman Kodak company. So, is he singing about a Kodak camera, or a Nikon? Is he using Kodak Kodachrome film in a Nikon camera? I think it's very misleading. Also, how is it that I've been listening to this song for so long and have never noticed this before?
The Rheumatoid doc was the first to arrive this morning, and immediately commented that Jerry looks better than he did on Friday. He noted that the red spots that turned black are healing and that whatever was causing the pain and spots seems to have stopped. He reiterated that none of the blood cultures had produced anything yet, and that they may not ever, but his symptoms are consistent with some kind of infection, and that a prophylactic antibiotic course is the standard treatment.
Next, the Oncology doc came. Oncology actually overlapped with Rheumatoid, so they got to confer with each other, which I think is good. Oncology wanted to start Dad on Celebrex, but Rheumatoid felt like sticking with Prednisone was OK since it seems to be helping. Oncology asked me if I had any siblings and then wanted to know what it was like growing up an only child, since he has an only five-year old. I think I scared him when I told him about playing Monopoly with Prissy (poodle) and Missy (Schnauzer). Nolie claims that I turned out OK, even though at lunch today I arranged my Chick-Fil-A dipping sauces in the order that they appear in the color spectrum.
Oncology had initially felt like long term care was a good idea because it's so exhausting for the caregiver. Nolie and I presented the idea that since they plan to stay at the RIBM until this is all over, and therefore she doesn't need to cook, clean, or really do anything else, that she could handle getting Jerry to the clinic every day for his IV treatments. Also, Jerry is able to get out of bed and get to to the bathroom with little help, so, Oncology felt like some type of home health care combined with some type of physical therapy would be OK.
So, to summarize, Jerry's not quite in the grave yet. He scales his pain on a scale from one to ten as around a seven in the morning, and a two or three in the evening before he goes to sleep. Once he gets going in the morning, he does all right.
The Rheumatoid doc was the first to arrive this morning, and immediately commented that Jerry looks better than he did on Friday. He noted that the red spots that turned black are healing and that whatever was causing the pain and spots seems to have stopped. He reiterated that none of the blood cultures had produced anything yet, and that they may not ever, but his symptoms are consistent with some kind of infection, and that a prophylactic antibiotic course is the standard treatment.
Next, the Oncology doc came. Oncology actually overlapped with Rheumatoid, so they got to confer with each other, which I think is good. Oncology wanted to start Dad on Celebrex, but Rheumatoid felt like sticking with Prednisone was OK since it seems to be helping. Oncology asked me if I had any siblings and then wanted to know what it was like growing up an only child, since he has an only five-year old. I think I scared him when I told him about playing Monopoly with Prissy (poodle) and Missy (Schnauzer). Nolie claims that I turned out OK, even though at lunch today I arranged my Chick-Fil-A dipping sauces in the order that they appear in the color spectrum.
Oncology had initially felt like long term care was a good idea because it's so exhausting for the caregiver. Nolie and I presented the idea that since they plan to stay at the RIBM until this is all over, and therefore she doesn't need to cook, clean, or really do anything else, that she could handle getting Jerry to the clinic every day for his IV treatments. Also, Jerry is able to get out of bed and get to to the bathroom with little help, so, Oncology felt like some type of home health care combined with some type of physical therapy would be OK.
So, to summarize, Jerry's not quite in the grave yet. He scales his pain on a scale from one to ten as around a seven in the morning, and a two or three in the evening before he goes to sleep. Once he gets going in the morning, he does all right.
Sunday, March 18, 2007
A Bump in the Road
The red dots have turned black now, and it turns out that they didn't mean Jerry needed a platelet transfusion after all. He did need the platelets, it's just that these particular red dots weren't the indicators. What they were indicating is that Jerry has a blood infection, which is bad. Turns out the joint pain isn't arthritis either. Yep. Blood infection. So, Jerry will now be treated with IV medication for four to six weeks to try to knock out the infection. This means that the bladder surgery has been postponed again, and there is a possibility that the cancer could grow back while we're treating the blood infection. If the tumor does come back, Jerry will not be a candidate for chemotherapy a second time. This is when the medical team used the words "long term care facility" and "hospice" to Mother. I don't think she heard anything after that. When Nolie called me, we didn't so much have a conversation, as I listened to a monologue. There were no pauses where traditionally the listener (or decoder in the basic Speech Com 101 communication model) can insert the occasional "uh-huh" or "yes." It was just a really really long run-on sentence punctuated only with tears. Being a person whose glass is generally half full, I would like to point out the following positive aspects regarding this latest development:
Dad had a PICC line installed today, and Mom has to attend two classes to learn how to care for it. I may go with her if my schedule allows. We watched the "Care of Your Central Venous Catheter" video on the patient room on-demand system today. There are lots of on-demand videos available. A few of my favorite titles are "How Your Bowel Works," "Cancer and the Hispanic Woman: Her Experiences in Sexuality" (en Espanol), and "Scarves: A Fashionable Alternative."
Dad just informed me that he is hungry, which I think is also a good thing, so we ordered milk shakes. Jerry is having vanilla and Nolie and I are having chocolate, which is weird, because Nolie is usually the vanilla one and Jerry is usually chocolate. Sometimes, Nolie is strawberry, but never chocolate. Anyway, Jerry's is free and Nolie's and mine are $3.00 each. How cool is that? They are real milkshakes too. Not those fake ones like at McDonalds, they're real, like at Earl's in Leaky, which is a restaurant we used to eat at when I was younger, and is also an Exxon station. The room service menu here is quite extensive. You can check it out here.
Hazel just arrived to begin another bag of medicine. Hazel is our R. N. today until 7:00 p.m. If I were Hazel, I would draw a little smile on my Cancer Mask. I am not Hazel though, and do not wear a Cancer Mask.
- The surgery is still scheduled, it is not cancelled.
- The blood infection is being treated with Vancomycin and Rifampin, and tomorrow will be the completion of week one, leaving only three to five weeks left of treatment.
- While the tumor may grow back, it may also not.
Dad had a PICC line installed today, and Mom has to attend two classes to learn how to care for it. I may go with her if my schedule allows. We watched the "Care of Your Central Venous Catheter" video on the patient room on-demand system today. There are lots of on-demand videos available. A few of my favorite titles are "How Your Bowel Works," "Cancer and the Hispanic Woman: Her Experiences in Sexuality" (en Espanol), and "Scarves: A Fashionable Alternative."
Dad just informed me that he is hungry, which I think is also a good thing, so we ordered milk shakes. Jerry is having vanilla and Nolie and I are having chocolate, which is weird, because Nolie is usually the vanilla one and Jerry is usually chocolate. Sometimes, Nolie is strawberry, but never chocolate. Anyway, Jerry's is free and Nolie's and mine are $3.00 each. How cool is that? They are real milkshakes too. Not those fake ones like at McDonalds, they're real, like at Earl's in Leaky, which is a restaurant we used to eat at when I was younger, and is also an Exxon station. The room service menu here is quite extensive. You can check it out here.
Hazel just arrived to begin another bag of medicine. Hazel is our R. N. today until 7:00 p.m. If I were Hazel, I would draw a little smile on my Cancer Mask. I am not Hazel though, and do not wear a Cancer Mask.
Saturday, March 10, 2007
Getting Around Slowly, But Getting Around
I tried to post a new video interview with Jerry, but it's taking a long time to process through Youtube, so for now, I'll just recap the latest events. I may have to publish the interview in multiple installments.
Jerry had a couple of rough days right after coming home from his platelet transfusion at Arlington Memorial. His arthritis really flared up and he stayed in bed a couple of days. He started getting up and around yesterday with his new wheel chair, and today is getting around on his own with no wheelchair or walker. The last time he had a transfusion his arthritis also flared up, so there seems to be some kind of connection. The transfusion at Arlington Memorial took 43 hours and the transfusion he received at M. D. Anderson took 5, so Mom and Dad are headed back to Houston tomorrow just to be close, just in case. Also, Arlington Memorial doesn't have high speed wireless, which really irritated Nolie, and I think that's funny. Who would have ever thought that my mother would care about having high speed wireless.
I have learned a couple of things in the last couple of days. One, is that it is much more difficult
to put socks onto a person other than yourself than it looks. I have also learned that when helping someone put on a button down shirt, it is much easier to do both arms at once from behind, like when you try on suits, instead of one arm at a time from the front. I know the "help from behind" thing also applies to recent college graduates who check into a hotel for their first big job interview, then realize on the morning of the interview that they do not know how to tie a tie. Believe me, I see this more often than I should. How do you graduate from college and not know how to tie a tie? I digress.
There was a traffic jam this morning in the hall as I was on my way to the kitchen to get coffee. I think I'm going to get Jerry an orange triangle for his new chair, like the ones the Amish people have on their buggies.
Jerry had a couple of rough days right after coming home from his platelet transfusion at Arlington Memorial. His arthritis really flared up and he stayed in bed a couple of days. He started getting up and around yesterday with his new wheel chair, and today is getting around on his own with no wheelchair or walker. The last time he had a transfusion his arthritis also flared up, so there seems to be some kind of connection. The transfusion at Arlington Memorial took 43 hours and the transfusion he received at M. D. Anderson took 5, so Mom and Dad are headed back to Houston tomorrow just to be close, just in case. Also, Arlington Memorial doesn't have high speed wireless, which really irritated Nolie, and I think that's funny. Who would have ever thought that my mother would care about having high speed wireless.
I have learned a couple of things in the last couple of days. One, is that it is much more difficult
to put socks onto a person other than yourself than it looks. I have also learned that when helping someone put on a button down shirt, it is much easier to do both arms at once from behind, like when you try on suits, instead of one arm at a time from the front. I know the "help from behind" thing also applies to recent college graduates who check into a hotel for their first big job interview, then realize on the morning of the interview that they do not know how to tie a tie. Believe me, I see this more often than I should. How do you graduate from college and not know how to tie a tie? I digress.
There was a traffic jam this morning in the hall as I was on my way to the kitchen to get coffee. I think I'm going to get Jerry an orange triangle for his new chair, like the ones the Amish people have on their buggies.
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