Cindys update for 4-1 at 9:00 pm: Well, it seems to me that todays update is brought to you by Roseanne Roseannadanna: Its ALWAYS something; if its not one thing, its another! First things first: the very important trend that first appeared on Friday and Saturday has continued through the weekend and into the first part of the week. Those white cell counts that were causing such trouble have now declined from a high of 115,000 on Wednesday to 66,000 on Friday to 15,000 on Saturday to 7,500 on Sunday--or, in other words, a count within normal tolerances. While there are still, as of this morning, some of the T-lymphocytes (bad guys in the lingo of Drs. Taylor and Buggy) in the peripheral blood, the blood work looks pretty good (Dr. Taylor). These changes have has had two salutary effects: First, the decrease in the volume of malignancies in the blood has brought considerable relief from fluid in the lungs; second, the acute fatigue that Cindy felt for much of the past week has subsided very noticeably. Together, these changes have vastly improved the patients humor, appearance, and energy level. Shes getting around much better--showing off the leg (now finally in good trim after the multiple adverse effects of her long stay in December and January) by motating on her own to the bathroom and for short walks. Shes also able to sit in a recliner and scootch herself around in bed, and is quite a bit more comfortable as a result. On the its always something side of the ledger, though, the patients blood pressure dipped down pretty well throughout Sunday and yesterday. Worried about low pressure, some of the heart meds shes been on since December were withdrawn. Unfortunately, she started an arrhythmic heartbeat again about the same time. Dr. Taylor shored up the BP with a transfusion yesterday, however, and the electrophysiologists on the team (Dr. Bhatia, et al.) are watching closely, reintroducing Amiodarone and adding Digoxin to control the atrial fibrillation and rapid pulse. Meanwhile, the question currently in the wings is how far the pendulum will swing through the range of normal white cell counts and into the other extreme of immunosuppression. Dr. Buggy has been regularly on hand to administer prophylactic doses of antibiotics since the new chemotherapy started this past Tuesday. In chatting today, though, he made clear that, during the course of any successful treatment, some nasty thing or other will find a home where it shouldnt--and thus that the odds of passing, say, 30 days without at least a brief hospital stay for more aggressive treatment of some bug or infection are pretty long. So we wont be running short of frequent flier miles at St. Lukes anytime soon. Which is nice. All in all, however, it appears that progress is being made, and its awfully good to see my lovely bride feeling better. Many, many thanks to all for the many cards and notes. Theyre great medicine, too.
Posted on: Wed, 02 Apr 2014 03:02:22 +0000
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