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| Good morning! |
Yes, it's another early morning wake-up (due to repeated "air-in-line" alarms from my constant kidney-protecting sodium bicarbonate infusion) yet I am dragging less today as I watch colors flood the sky outside my window. Perhaps I enjoyed just another brief 4.5 hours sleep but I am (initially) more refreshed. In addition, my fingers are less tingly and my large muscle groups seem to be fulfilling their lifelong promise to support me upright upon demand. Perhaps the effects of the "odd cycle" Hyper CVAD protocol are being subsumed by the chemistry of this "even round." No mouth sores so far. No nausea. No vomiting. No complaints on my part! I'll take it!
My heart rate is subsiding. It was just measured below 90 compared to 125 when I was first admitted on Tuesday. At that point, I looked at the sweeping and impressive flight of stairs from the VCU Gateway building up to a connecting plaza that I needed to transit to get to Oncology and .... decided to walk up the steps. I took my time, paused as necessary, and still had issues regulating my pulse. Nothing dire but I realized my first set of in-patient vitals would be a bit ... elevated :) Anyway, yesterday the Oncology Fellow detected an ectopic heartbeat or premature ventricular contraction (PVC) during my morning assessment. Joseph and I had both detected this in my pulse a few weeks ago (and reported it) so it was no big surprise. Just something to monitor as it appears to be one way my body is reacting to the chemo. I am feeling no symptoms. Ironically, this time last week, Joe was being monitored for his own physician-detected PVCs but he had felt symptoms that had caused him to see our doctor.
The key element of these "even rounds" is the flushing of my 24 hour methotrexate infusion from my blood stream. When I am admitted on day #1 and as soon as pharmacy can trot the infusion up to the room, the nursing staff accesses my port, I am hooked up to a pump, and methotrexate is poured into my veins over the course of a full day. THEN my blood level is monitored to determine the degree to which the methotrexate is flushed from my body through my kidneys. I can only be discharged when this methotrexate level is "undetectable" - at a level below 0.05. Upon completion of the 24-hour methotrexate infusion, my initial read was .... 14.0 .... so the race is on. Here's hoping I can purge the methotrexate and get home Saturday afternoon as soon as another chemo infusion (my last cytarabine dose) is finished around noon
Another medical issue that is certainly manageable with medication is rearing its head this cycle. My urine pH has been borderline acidic since I arrived on Tuesday indicating that despite LITERS of sodium bicarbonate being pumped into my veins, my kidneys are stressed by the chemo. Supplemental oral sodium bicarbonate can restore me to neutral but we are monitoring and watching many times a day. This simple check reminds me of the tremendous impact the cumulative effect of the chemo is exerting on my body as it does its good work! My job is to eat, rest, relax, and let the meds do their job!
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The anticipation of the canine visit was surpassed by the reality of oh-so-CLEAN-and-SMOOTH coats, eager kisses, furtive exploration, and then quiet sleeping hounds in laps. Sadie and Baxter do not disappoint. CAROLYN never disappoints. Yes, she had prepped the paperwork, gotten doctor's orders, undergone a rules briefing, etc etc but in the end she simply knocked on the (locked) door at the top of the staff stairwell, was quickly let in by a (surprised but smiling) RN, and trotted the hounds down the corridor to my room - no questions asked, no paperwork demanded. Just lots of oohs and aahs from the staff as the pups clickety-clacked down the hall, straining at their leashes, sniffing at the floors.
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