Sunday, August 9, 2015

Days +5 and +6: Recovery & Rashes

Day + 5 (Saturday)

The PICC line was replaced and a new double lumen in the left arm. Dr. Burt thinks the triple lumen was too big and after 11 days just really aggravated the nerve. I'm grateful that it lasted 11 days to begin with.

The new PICC didn't exactly go in smoothly. There was a lot of discomfort when it went in, and an adjustment had to be made after review of the X-ray. It's still a little sore. The right arm is still a LOT of sore, just waiting for it to heal

We switched the daily antibiotic today. I started Cefepime via IV on day 0. On day +2 I developed a rash on my upper back. Originally dr. Burt thought it was folliculitis from wearing the tight tanks with the built in bras. But after three days of topical antibiotics and itch cream, it only got worse and spread to the stomach, thighs etc. Since there is some concern that it is a Cefepime allergy, I am now taking Zosyn via IV. Zosyn runs 4 hours, vs. the 40 minutes for the other. My only hope is that we don't wear out this vein from longer infusions. If this PICC starts to bother me, it's another jugular cath for me.

Otherwise the day was calm. Folks came by with lunch and to visit. Dad walked some laps with me. I got addicted to some show called Catastrophe, Amazon prime only had season one as a teaser.

Today is the day I stopped caring that there is no hair on my head. Didn't wear a cap all day or to bed. How liberating it has been. My mom said I look even more like my little brother now, which is very true. He started shaving his head in his 20's after serving in the Marine Corps. Maybe some bald twin pictures are in order.

Every Saturday at 10:15pm there is a fireworks show.  They were far more amazing than this, my camera has quite a delay.






Day +6  (Sunday)

Today has been a good day. I have lots of energy. My appetite is good. I didn't need fluids or nauseau meds this morning.

Todays counts show I'm still neutropenic. Waiting for WBC to be 1.0 or higher for discharge.






In theory, if all goes well and I am discharged next week, I will be home in 6 days. Last night I dreamt that I went to work my first two days home, forgetting that I was on medical leave. I highly doubt that will happen!

I am on day 3 of Neupogen shots. My bone pain during mobilization started early on day 3, so perhaps already being on a pain management schedule will lessen the bone pain as my stem cells start to engraft. I have noticed a bit of bone aggravation in my skull and spine today. Lots of rocking amd breathing as the next round of pain meds is due.

I've been encouraged with my energy and attitude today. Watched breakfast at Tiffanys with the folks, walked my second set of 6 laps with my dad.








As the day has progressed there are some bone aches: hips, legs, spine, jaw and skull. Lets hope engraftment is beginning and I am just days from discharge.

My friend Jodie comes tomorrow she is here through the finish line to bring me home. Yay!!!
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I was thinking today about all of you.....the people that have helped me get through this. You don't quite know how helpful it is to get an encouraging word when you feel in the dumps and isolated. I find myself wanting to make you proud, so I push through.

One message that has stuck with me was from Rachelle: "encouraging humor: you've survived 100% of your worst days. You'll survive these too". She was another CIDP patient and she went home several weeks ago.

Thanks from the bottom of my heart for your kindness, encouragement and humor.

Friday, August 7, 2015

Days +3 and +4: digging deep for strength

Sorry that my daily posts have ceased. The last two days have been trying. The reason has been unconventional. When I received my IVIG treatments I suffered from phlebitis, a painful inflammation of the veins. This deep vein pain brings me to tears and typically renders that arm useless.

On day +3 (Thursday) phlebitis started in my PICC line. No position is comfortable, feels like my veins are spasming and someone is vice gripping a deep bruise. I had to ask for a strong narcotic to kill the pain and my arm seemed to settle for the day. After that the day included some ups and downs with blood pressure, dizziness and nausea. In general I just felt off. I'll, irritable, uncomfortable...a mix of just plain ick. I managed to get some laps in with OT using just my cane (I had reduced to a walker the last few days due to weakness) to practice balance and it went well. Parents came by with chicken Pho soup, I watched the minion movies to cheer myself up and I had a good rest for the night.

Day +4 (Friday) started out well, had some decent sleep. parents came by with the days laundry and helped me organize some things. Had another icky spell and low BP that required 2 hr of fluids. After that I felt better. More laps with OT and even better balance. Around 5pm it took a turn to the current situation. More phlebitis in the PICC. Allison came by to check on me to find me in tears. Unable to move my arm or find a comfortable position for it. Dr. Burt was called and the suggestion is to remove the PICC and place a new one on the opposite arm for the duration of my stay. This PICC held out 11 days, so the hope is that the new one will last the remaining 6 or so days without issue.

I will discuss with Dr. Burt in am as he placed the order to happen tomorrow. The only other alternative would be a scheduled around the clock  dilaudid drip, which would render me useless the next 6 days. I'm typing this entire post with my left index finger and am wiped. The steroid surf doesn't help with stress coping either so I have gone through way too much Kleenex in the last 80 min.

I'm grateful for no migraines today, no vomiting, increased balance and steadier gait when walking, a decent appetite and so far sleep has not been an issue. Just have to somehow overcome the one thing that brings me to my knees.

Hoping for a better day tomorrow.




Wednesday, August 5, 2015

Day +2 : Nuetropenic

It's official, I am neutropenic today. Vitals every four hours to watch for fevers.

More precaution on the hall laps and bike rides, I now have the added mask. Started to feel tingling in my fingers, only in the morning though. My right foot is still pretty numb and I think my plantar faciitis is acting up so I will be doing some stretching today.
 



I start Neupogen shots in two days to boost my blood counts. So I have asked to start taking Claritin daily, as the antihistamine helps with bone pain. I got it in my jaw and skull during mobilization and it was not fun.

The nurse said this is technically when the "catchup" nauseau kicks in.....so we will keep an eye on it. I have tried to do without the one nausea med that causes headaches (zofran) except on the bad bouts. And have tolerated half size doses of Ativan as needed.

Today has been a day of fatigue. Two very long naps and very little energy to sit up when I'm awake. So we added some fluids and are going to cut back on a med see if it helps.


There may be less updates over the next few days if there isn't much to report. It's a lot like Groundhog Day...and I'm not complaining. My current status quo suits me just fine.

Anytime in the next 6-9 days I can be discharged. Longer if my counts don't boost as they should. But I have a flight booked for the 15th home, so I'm crossing appendages, eyes etc.

 






Tuesday, August 4, 2015

Day +1: Fatigue and Infusions

My fatigue this morning was palpable. Needed to nurse to press the button on the bed to sit me up. So it was no surprise when labs showed low hemoglobin and low potassium. Both were ordered for infusion.







We still haven't don't IVIG, as my hands and feet haven't gotten worse....I even felt some tingling in my fingers today. And some of the numbness in my feet has dissipated in patches.  The nurse walked four laps with me in early evening When I finally had enough stamina.

Also got my final round of Rituxan to really kill any remaining cells. This is the "milder" chemo I had a reaction to on day -6. All transfused without incident, other than a queasy stomach.

There are sudden spells of fatigue with no warning that turn into an hour or two naps. Followed by energy where I catch up on my reading, responding to messages. Then the bouts of queasy that we try to get under control before it becomes nausea. The headache is my content dragon, but so far we have kept it at bay with Tylenol and excedrin rotation.

No real schedule as the days goes by, just depends on the hour and what my body wants to do at that scone. Last week I  took a nap from 2-4:30 pm. Today my nap was earlier in the morning. My day usually starts around 5am and ends around 9 pm..

Thank you blood donors


Nick left today and I cried for a solid half hour. Whether you know him or not, send a nice thought to the universe in his honor. What a guy. At my beckon call while I did chemo, my biggest cheerleader for the finish line, constant reminder of why this is all good, errands to trader joes, laundry runs, soup pickup at Saigon sister almost daily, corn bread muffin runs, my gluten free pancakes from trader joes heated every morning.... I miss him already,

Folks arrive tonight. Hoping for a few more days of mild while the body heals. Will be good to have someone here to get me my favorite soup everyday!!

Shouts outs:
Cards from my team at work and Esther
Care packages from Stacey and Karen




Definitely put a smile on my face.

Monday, August 3, 2015

Day 0: Got my stemmies back

The day started quiet and mild. A little extra time to sleep a shower unattached from IV. Dr. Burt and team poked their heads in and said "stemmies at 10" and briskly left.

Nick got me a corn muffin. There is a phenomenon for some where we taste creamed corn when they infuse them back. I liked his idea to stick with the corn theme.






At 10am the stem cell team, chaplain and Allison came in to start the proceedings. My stem cells were removed from freezing, and placed in a bath at human temperature to thaw within minutes. The chaplain prayed for me, my Brother all the friends and family that supported me and finally the stem cells that they bring healing.










They infused within 20 minutes with no incident. I was overcome with fatigue and took a nice long nap. Managed to walk some laps on the floor with a walker later in the day. Trying to work on strengthening my legs.

But in the late afternoon after dinner I was overcome with not feeling well, and under the weather feeling I couldn't shake. They gave me nauseau and headache meds, and Nick brought the saltines and ginger ale.

Will do my best to ride this out and get some sleep tonight, trying to distract myself with a good Avengers movie. I'm a fan of the Marvel comic characters, what can I say.

Goodnight for now.

Happy birthday immune system. ....go kick some CIDP ass. I will tolerate the physical implications while you make us well.

Sunday, August 2, 2015

Day -1 : toward the healing phase

No more harsh chemo today, no more chemo flushing medication, IV fluids stopped. Just some rATG to further suppress the immune system. It's clearly working by the looks of these numbers.


What that translates to: fatigue. Those of us with CIDP know horrid fatigue anyway but this is even deeper. You need a nap after a shower, after a walk to the bathroom...everything just takes so much energy that one does not have.

The blood counts today:






CIDP knows it's being evicted and has decide to retaliate. My right hand is practically frozen, it's very numb. Writing is comical. Right foot feels like a wood log. Left side still has its standard numbness but the right side is really taking a hit. Hard to hold a toothbrush, phone, anything. I've asked dr. Burt to provide me IVIG tomorrow for my "birthday" (stem cell bday) so we will see if that un freezes my hand and returns some strength. In general these days  my legs are very weak and like to buckle on me.

Had a fun episode this morning, sitting up enjoying a movie, suddenly overcome with dizziness, dry heaves, and my skin felt like it was on fire. All vitals were fine, so we used fans, ice water, cold wet towels and some neck rubs....these nurses and aides are awesome. Dr. Burt was paged and said to give me some more fluids, All resolved after about 45 min.

Got a nice dose of benedryl to help relax me and I got a 1.5 hour nap. Yay!

Taking it easy today. Preparing for the big day tomorrow, there will be lots of pictures. Excited to get the stemmies in my body to start repairing.

The care here is amazing. I can't say enough good things. Dining on call is another story. Thank god for brothers who walk to trader joes or the Galter cafeteria and need I forget grub hub delivery!!

This morning's sunrise was unbelievable. The colors were amazing.


Saturday, August 1, 2015

Day -2 : last heavy chemo day!

Its a beautiful Saturday morning here in Chicago and I completed my last mega dose of chemo (Cytoxan) and rATG today. Which is very emotional. I am over the hump of the intense fluids, steroids and flushing every 6 hours. When Nick fist-bumped me, it hit me.

The chemo is catching up with me. Less energy, weak, poor appetite and a headache. My hands and feet are severely numb and very weak. It has taken quite the effort to type this today. I managed to get on the exercise bike just once today to help with the fluid swelling in my feet.

Its a beautiful boat filled day on Lake Michigan.


Taking it easy and watching movies with my big brother. Seven psychopaths is highly recommended. It sounds bad but it's actually funny. Anchorman 2 had me laughing too. It was actually hard to laugh my body is so tired.

Good news is that the BP and heart issues all ruled out. they cut back on running Lasix and Ativan so close together sine they  both lower blood pressure and everything resolved. Dr. Burt came by today and said "you're doing good". So there's that.

Blood counts are dropping quickly as expected. I'm sure that plays into the fatigue.


Tomorrow I just have rATG (rabbit antibodies) to further suppress the immune system, so a quieter day.

My stem cell birthday is Monday, and I get IVIG as well, which I'm hoping might help boost strength and energy as it usually does.

Thanks for the  calls, emails and texts today. There was a lot of resting today that kept me from keeping up with it all.

More tomorrow.