In the Warmth of the Fireplace ...

Sunday - October 7, 2012

... the hounds curl up in their dog beds and BASK!  A happy Italian Greyhound is a warm / hot / cooked Italian Greyhound....  On this first truly nippy morning of autumn, the fireplace is a welcome spot for both dogs and humans.  Joe and I are both on our iPads enjoying the warmth and the peace of a quiet morning at home.  After awakening to the comfort of the sound of rain and a cool crisp breeze through the open windows, I am preparing for my last day before tomorrow's expected (11th) hospitalization.  I will miss my access to fresh air!  Today's agenda (because I do indeed love a good to-do list) includes finishing up a Coursera class paper on the effects of the 14th century plague pandemic, tackling Megan's* closet (part 5?), enjoying some sewing machine time while watching football, and meeting Gina downtown for lunch.

So today is my last day for a while to revel in feeling perfectly, absolutely, blissfully fine!  A good starting point for an infusion of high-dose methotrexate?  Lest we all forget the toxicity of this poison ....

"Methotrexate is eliminated primarily unchanged in the urine.  This means that a patient’s renal function is a critical factor in predicting the magnitude and duration of methotrexate levels following high-dose administration. Very high levels of methotrexate may lead to precipitation of the drug in the renal tubules.  This can cause methotrexate-induced nephrotoxicity, with increased serum creatinine and the potential for acute renal failure. Once methotrexate-induced nephrotoxicity occurs, a vicious cycle is initiated.  Nephrotoxicity with impaired renal function leads to even more delayed clearance of methotrexate, with further impairment of renal function and high sustained methotrexate levels in the blood."

My kidneys have performed admirably and with gusto in the past.  Let's all wish them well as they take on the challenge of a higher dose of this powerful chemo drug.  Side note: "vicious cycle" is not a phrase I come across often in medical articles. Hmmmm.... Not sure I like it ....

* For the record, "Megan's closet" is generally a storage area and not filled with the detritus of M's pre-Davis, CA living.