Monday, November 26, 2012

There’s No Place Like Home (Dorothy)

I am writing this blog post from home!  I met with Dr Levine today, and he said it was OK for me to leave Jamaica Plain and return to Stow.  That does make me farther away from the hospital, and if I were to get a sudden fever or infection, it would take longer to get into Beth Israel.  But my blood counts are good, and the risk of something bad happening can be mitigated by being careful.  In effect, I am OK, so long as I don’t do anything stupid.

I really am feeling much better.  I had a pattern of morning and afternoon walks while staying at Brian & Bridget’s, and gradually I got so I could walk faster (a more normal speed) and longer.  On Saturday Barbie & I walked around Jamaica Pond, a walk of 2 miles.  Yes, I sat on the benches every 20 minutes or so, but it was great to be out in the sunshine and the crisp breeze.  I wore a mask while walking, and if it was cold my nose would run and make the inside of the mask a mess.  After the long walk, I did take a significant nap, but gradually the feeling of fatigue has been receding.

A big thank-you to Brian and Bridget for hosting me in their home for the last 10 days.  Or the portion of the last 10 days that I have been out of the hospital.  My things and mess were still in their house while I was back in the hospital Sunday – Tuesday, so they were still putting up with me.  I have to admit that I was not a very entertaining guest, as I had my own issues to deal with.  They certainly fed me very nicely, and the private quarters on the 3rd floor were perfect.  At first just climbing the stairs to the 3rd floor would exhaust me, but by the end I had almost gotten used to it.  They hosted a small party (6) for Thanksgiving, and it was perfect.  I claimed saying the grace, and pointed out that 2 weeks prior to Thanksgiving was the nadir for me.  November 8th + 9th were when I had the blood infection, and I was wracked with shivering or sweats and totally overwhelmed.  Once again my eyes leaked while I said I personally had lots to be thankful for, and that I appreciated all the help – both from family and from the professional staff at the hospital – that pulled me through.

I am now on an antibiotic regimen of Vancomycin every 12 hours.  Instead of a pump to deliver the medicine, there is a small bottle with a rubber balloon inside of it.  The bottle resembles a baby bottle, just shorter.  Here is a full one, before it is infused:

I hook the tube to the left that has a blue thing at the end up to a tube coming off my PICC line.  The bulge at the top of the bottle slowly deflates over the course of an hour, and the medicine ends up inside me.  Just think about it: a balloon as a medical delivery device.
One of the reasons Dr Levine gave for allowing me to return home is that my blood counts look very good.  He stressed that I still need to be careful because my immune system lacks antibodies to most diseases.  Some of those will be reintroduced by vaccines, but others just have to be built up over time by exposure to real life.  But I certainly need to be careful early on while the immune system is still finding its legs.  Here are the latest blood counts:




The first two graphs bounce around quite a bit after November 11.  That is because they gave me injections of Neupogen to stimulate the production of white blood cells.  That is the same drug they had me inject myself with leading up to the harvesting of my stem cells in October.  Clearly I respond quite well to Neupogen.  Once, they saw a positive response, they eliminated the shots.  The result was a drop in the white blood count.  Then when I came back in the hospital on Sunday, 11/18, they decided to boost my numbers by another Neupogen shot.  Hence another spike up.  My final numbers are my own cells, without any help.  Not as spectacular as the Neupogen-enhanced numbers, but solid enough to come home.

They train you to administer your own drugs while you are in the hospital, but they don’t really trust you to do it right.  So part of the home-dosage process is a visiting nurse who checks that you are doing it right.  She also checks your vital signs and replaces any dressings that have gotten dirty or messy.  My visiting nurse while I was at Brian & Bridget’s was Kathleen McCarthy.  Could that be a Boston Irish name?  Here is Kathleen getting ready to change the dressing on my PICC line.  I must roll over on my PICC line is a bad way when I am sleeping, because frequently it becomes covered in blood overnight.

A different nurse from a different visiting nurse company will perform the same functions here in Stow, since Kathleen’s company does not extend out to Stow.

The 3 rooms I will inhabit on the second floor here at home are incredibly clean.  A LotsaHelpingHands crew of Madge Evans, Tricia Woods, Jane Epstein, and Barbie went to town on Sunday.  My office has never been as dust-free as it is now.  The boys’ bathroom has been thoroughly scrubbed and disinfected.  Andrew’s bedroom, which will be my bedroom until further notice, was cleaned to a fare-thee-well.  They removed the mattress and box spring from the bed frame, which revealed YEARS of accumulated junk and dust.  All that was vacuumed out, swabbed down with antiseptic Clorox wipes, and put back together with specially cleaned linens.  The plan is to put a gate on the end of the corridor that connects to the rest of the house so that the dogs stay out of my area.  I can be in the same house as the dogs, but I am to keep my distance.

Once again, I am incredibly thankful to be home.  I am blessed to be feeling well.  Clearly I am lucky enough to be on the mend.  Furthermore, I have a good prognosis.  I feel like I am coming to the end of the tunnel, and the sun is shining out there.  I hope that I have very little news to share in the next few weeks.  As Dr Levine likes to say, boring is good in the Stem Cell Transplant business.  I hope I have no setbacks or attacks of idiocy to report.  But quiet times on the blog should not mask the fact that I am incredibly grateful to have made it through the Stem Cell Transplant.  It was a near-death experience, and it makes me appreciate the life that I have all the more.

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