T minus two
Karl is back on 4 North A at the Health Sciences Complex in St. John’s, so I’m back to the blogging. The title says it all once I interpret it for you. Karl will get his transplant, or the previously extracted young stem cells reinserted, in two days. So today we are T - 2. Thursday will be called Day Zero.
Yesterday Karl went to Ambulatory Care for his pre-admission medical and a meeting with Charlene and Dr. Jones while I flew across the continent from a 5 day Black Friday shopping trip. Karl picked me up at the airport at 430, and we got the call at 5 that a bed would be available for his admission later in the evening.
The data gathered during the pre-admission check was all very positive. His hemoglobin was up to 122 from 99 when he was released from hospital on October 30. His white cells were 4.2 and neutrophils were 2.1, which is both normal. Best of all, his creatinine was 112, and his magic number was 113. Remember that his creatinine rose to a high of 553, and it has been slowly dropping back to normal levels over the past month. Last Tuesday it was measured in Clarenville at 147, so this is the first normal reading since it started to rise.
Last Friday Karl had an EKG completed in Clarenville. Yesterday he was told that his EKG was borderline because his heart rate was 58, and 60 is considered normal. But Dr. Jones said not to worry about that. So we won’t because we are going to pick our worry battles.
After the initial call at 5pm we waited for the next call to go back to the hospital. And we waited. And waited some more. Karl fell asleep on the sofa. Then at ten he woke and said he was going to bed. Naturally as soon as we got settled in bed the hospital called. It was 1030 and his room was finally ready for check in. Karl asked if he could stay where he was and was told he could if he came in early this morning. We were here before the breakfast trays.
After breakfast, which he didn’t eat, he went downstairs to Diagnostic Imaging where radiologist Dr. Bartlett inserted a Hickman Catheter in his shoulder. This catheter will be used to give his chemo, to reinsert his stem cells, to give iv fluids, and to take blood tests. It replaces the perma cath he had a month ago which had to be removed because of the infection. If there hadn’t been an infection the perma cath would still be there and would be used for this round too. But now he has another. We pray no infection this time. On a side note, remember that when he got the infection he was given Vancomycin to treat it, and it was the Vancomycin which caused the kidney issues. Apparently Karl’s reaction to the Vancomycin has been a topic at their weekly hematology meetings several times because he went from normal creatinine one day to drastically high the next day with no warning. While there was no rash or other signs of an allergy, they have decided to treat Karl as if he has an allergy to Vancomycin. While it is not unexpected for Vancomycin to cause some kidney issues, apparently there are usually signs and the creatinine levels start to rise slowly. Karl didn’t fit any regular pattern. So, while we can’t be sure he is allergic to Vancomycin, and not all members of their team are comfortable that Karl’s reaction was an allergic reaction, no one is comfortable saying that it wasn’t either. So from now on when we are asked about an allergy, we have to list Vancomycin.
Right now Karl is surfing on his iPad while some morphine courses through his veins to combat the discomfort from the catheter insertion. Later this afternoon he will be started on iv fluids because they want to make sure he is well hydrated before he is started on high dose chemo tomorrow. But that’s tomorrow’s news.
Yesterday Karl went to Ambulatory Care for his pre-admission medical and a meeting with Charlene and Dr. Jones while I flew across the continent from a 5 day Black Friday shopping trip. Karl picked me up at the airport at 430, and we got the call at 5 that a bed would be available for his admission later in the evening.
The data gathered during the pre-admission check was all very positive. His hemoglobin was up to 122 from 99 when he was released from hospital on October 30. His white cells were 4.2 and neutrophils were 2.1, which is both normal. Best of all, his creatinine was 112, and his magic number was 113. Remember that his creatinine rose to a high of 553, and it has been slowly dropping back to normal levels over the past month. Last Tuesday it was measured in Clarenville at 147, so this is the first normal reading since it started to rise.
Last Friday Karl had an EKG completed in Clarenville. Yesterday he was told that his EKG was borderline because his heart rate was 58, and 60 is considered normal. But Dr. Jones said not to worry about that. So we won’t because we are going to pick our worry battles.
After the initial call at 5pm we waited for the next call to go back to the hospital. And we waited. And waited some more. Karl fell asleep on the sofa. Then at ten he woke and said he was going to bed. Naturally as soon as we got settled in bed the hospital called. It was 1030 and his room was finally ready for check in. Karl asked if he could stay where he was and was told he could if he came in early this morning. We were here before the breakfast trays.
After breakfast, which he didn’t eat, he went downstairs to Diagnostic Imaging where radiologist Dr. Bartlett inserted a Hickman Catheter in his shoulder. This catheter will be used to give his chemo, to reinsert his stem cells, to give iv fluids, and to take blood tests. It replaces the perma cath he had a month ago which had to be removed because of the infection. If there hadn’t been an infection the perma cath would still be there and would be used for this round too. But now he has another. We pray no infection this time. On a side note, remember that when he got the infection he was given Vancomycin to treat it, and it was the Vancomycin which caused the kidney issues. Apparently Karl’s reaction to the Vancomycin has been a topic at their weekly hematology meetings several times because he went from normal creatinine one day to drastically high the next day with no warning. While there was no rash or other signs of an allergy, they have decided to treat Karl as if he has an allergy to Vancomycin. While it is not unexpected for Vancomycin to cause some kidney issues, apparently there are usually signs and the creatinine levels start to rise slowly. Karl didn’t fit any regular pattern. So, while we can’t be sure he is allergic to Vancomycin, and not all members of their team are comfortable that Karl’s reaction was an allergic reaction, no one is comfortable saying that it wasn’t either. So from now on when we are asked about an allergy, we have to list Vancomycin.
Right now Karl is surfing on his iPad while some morphine courses through his veins to combat the discomfort from the catheter insertion. Later this afternoon he will be started on iv fluids because they want to make sure he is well hydrated before he is started on high dose chemo tomorrow. But that’s tomorrow’s news.
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