Showing posts with label Ultrasound. Show all posts
Showing posts with label Ultrasound. Show all posts

Saturday, June 8, 2013

Hospitalization and the 9 Diagnoses

Here I am, sound asleep, receiving a blood transfusion and antibiotics.

My first chemo didn't go well. This was as bad as it would get.

Because I was so symptomatic, I was admitted to the hospital and the first R-CHOP was done there. I was discharged home on the 5th day. Four days later, I went to Dr. V's office for labs. My blood counts were very low--red, white, platelets--everything. Nothing was even close to the normal range.  And I had fever, so back to the hospital we went. Did I mention I felt miserable?

While we waited for a hospital room, I received, at Dr. V's office,  IV fluids, antibiotics, and a Neulasta shot to stimulate my bone marrow into making more white blood cells. I progressively felt worse and worse and left Dr. V's office in a wheelchair.

I remember getting to my hospital room and changing into one of their lovely gowns. I remember meeting my nurse. I remember pain setting in. I have tiny fragments of memory of several days. I remember being surprised one morning to learn that I had been in the hospital for over a week!

This is why I was hospitalized:

Neutropenic Fever
MSSA Port Infection s/p removal
SIADH
Stage III transformed Marginal Zone Lymphoma
Left pleural effusion s/p Thoracentsis
Pancytopenia
Anemia s/p PRBC transfusion
Hypophosphetemia and Hypokalemia
Deconditioning

Needless to say, we had to look up most of those words.

Things I know from my husband and his notes:

Day 1: Fever, shaking chills, temp up to 103.9; finally got hydrocodone for pain; Ativan; Clonodine after a tough round of fever with high BP and heart rate; by 1AM, vitals back to normal, temp to 100.

Day 2: (Pictured above) Hemoglobin down, transfusions ordered; Oxycodone and Morphine added for pain; 4PM CT scan and ultrasound done, more fluids, antibiotics, Albuterol for Wheeze (new today).

Day 3: Fluid in left lung, will see lung Doctor; lymph nodes shrunk somewhat; white count still way down. platelets about the same, hemoglobin up; Pulmonologist  says left lung less than 1/2 aerated; when platelets and blood count go up enough, will use needle to remove fluid from around lung and test to see if it is from the lymphoma; platelets are at 30, he wants a count of 60 to do procedure.

Day 4: Platelets 50; red cell improved; white not yet--still at 0.0; port must come out, Staph Aureus;
sodium down, limit fluids; 1 PM port removed.

Day 5: Platelets 75, still low; white count not up; sodium level 118, low, salt tablets ordered; Cipro and Unasyn ordered. Nephrologist ordered 3% sodium infusion, 100 ml. to raise sodium without adding water; kidney function good, but R is seriously retaining water and this dilates her sodium level and causes confusion, etc; water intoxication; sodium at 115; if it drops after infusion to 113 then it's off to ICU; 11PM Good News! R's sodium back to 118.

Day 6: Sodium up to 124; Platelets 123; white counts and Neutrophils up; all good news; may get PT today; may get lung procedure today or tomorrow.

Day 7: Thoracentesis done using a needle to draw off 1200 ml. fluid; fluid was bloody but no sign of infection; 1200 ml about 1/2 of fluid present but stopped due to pain and coughing from pleurisy which should subside in a few hours; 1PM chest x-ray showed normal but 02 saturation went down to 86%; got 2 lpm  02; level went quickly back up.

Day 8: Blood good; electrolytes good; sodium 124; phosphorus still low; no infection from lung fluid, will know more tomorrow; will add hydrocodone and d/c morphine; wound care nurse teaching.

Day 9 through 11, I can remember!  I started getting physical therapy; the fluid from my lung was negative for lymphoma; blood counts good. I was discharged on Day 11 with 11 prescriptions, a walker, orders for home health physical therapy, and a 1 week delay in Chemo #2.

View from my Hospital Room

Thursday, May 30, 2013

I am going to an Oncologist (c-a-n-c-e-r d-o-c-t-o-r)

Asheville Hematology & Oncology
 
The first day we met Dr. V, he got right down to business. I truly don't remember too much about what we talked about that day. My husband probably remembers more than I do and he probably took notes; he has been very meticulous about that. And I felt like hell--still running fever, still short of breath, getting weaker by the day.

One of the things I do remember is the Bone Marrow Biopsy. Oh yeah. The very first day we met! I didn't think he had even gotten to first base and here is was going all the way for the home run. Yep, we marched to another room where I got onto a table on my side with one leg pulled up. My husband was there, Dr. V's assistant, and someone from the lab who was dressed in full protective gear, face mask and all. I couldn't tell  what was going on in the room once I was in the position.

What I remember is feeling a lot of pressure. Then a lot of pain. A lot of pain. And I started crying. They let my husband come and hold my hand.

On my way to get the bone marrow biopsy, I went by the lab where 11 vials of blood were drawn.

Afterwards, I walked to the other side of the building to meet another doctor, an oncology surgeon, who would be placing a port-a-cath into my chest and excising a lymph node from my armpit for biopsy. I had an ultrasound of said armpit in order to mark which node would be excised.  That doctor seemed very nice that day, but my husband and I both would develop very bad feelings about him over time.

I also got orders, that day, to go to the heart tower at the hospital for an echo cardiogram, and also to get a PET scan.

What a day! I barely remember crawling to the car to drive home and nothing of that evening.


I don't know if Dr. V used the blue handled or green handled awl (or both) to drive into my hip bone. My husband said he was straining, shaking, sweating, and working hard to get into the bone.