Sidetracked to the hospital

I’m home again after an exhausting and unexpected interlude with the hospital.  Still trying to figure out that institution.  You really turn over most aspects of your life to its control.  It has many friendly faces and amenities but there is also a sense of imprisonment. 

WARNING: This post discusses body waste products.  Can you handle that?  If not, skip to lower on the page where you see ***.

It all started with a sense that I have that something is going on in my gut.  I’ve been feeling little twitches in my liver (yep, I know exactly where it resides) and wondering whether cancer is preparing to mess with me again.  I suppose anyone who has ever had cancer suppresses a fear that it could return and the littlest sign of reawakening exposes the hiding place for that fear.  My twitches had me on high alert and therefore I was focused perhaps a little too much on the output of my digestive system.  Is that blood I see or perhaps just the beets I had for dinner two nights ago?  It doesn’t really look like blood and yet it is different from what I’m used to.  I don’t really want to discuss my bowel movements with anyone. I don’t want to talk about this; not with a nurse, not with someone who picks up a phone at a doctor’s office, and not even my wife who has enough to worry about without thinking about my poop too.  I even hope you are not reading this.

Pee, on the other hand, is just slightly easier to talk about.  So when I had two days in a row of urine that was pinkish or maybe orangey, it gave me both concern and courage to call the doctor’s office to see whether that alone was enough to come in early or should I just wait until my regular doctor appointment next Tuesday.  Nurse Jackie checked with Dr. K and asked me to come in to the infusion clinic right away for blood and urine tests.  I got there about 4:00pm on Thursday.

The Lacks Center people are always so wonderful to deal with and there is rarely any kind of hassle and thus it is really a comfort zone for me despite the fact that they typically dump poisonous chemicals directly into my circulatory system.  Since I would need a direct blood draw, when I arrived I asked if Dawn was there today.  She is the best Phlebotomist I have ever encountered.  I have no fear if it is Dawn doing the arm poke.  Dawn was not there. I wondered aloud whether they could do a draw from my port but Nurse Jackie said that they would specifically be doing some clotting tests and the Heparin they use while accessing the port would contaminate the test.  Since my platelet counts have been low and platelets are the clotting agents in blood, the big worry is that there could be internal bleeding. 

So I got the poke from the other Phlebotomist, who on a previous occasion had missed the vein thrice before switching to my other arm.  This time, fortunately, she nailed it right away.  I rendered a orangeish urine sample right afterward (in the bathroom) and then sat around reading the newspaper while the lab tested the samples.

Jackie came back after a bit.  The good news was that there was no blood in the pee sample.  The redness in the urine could mean other things.  The bad news was that the hemoglobin level in my blood sample had taken a dive since the last test.  It was approaching a level where they consider a transfusion.  She asked if I could provide a stool sample.  I gulped a cup of coffee and shortly after, found I was able to oblige.  After more waiting around, the answer came back:  there was indeed blood in the sample.  Jackie said I should report to a hospital room on the fourth floor for intake.  This was not what I had in mind when I made that initial phone call.

*** I slipped into the skimpy hospital uniform and called Mary and then Marlee to let them know they were on their own for dinner and asked brave Mary to bring a few things from the house, including Marlee, so they could pick up my car from the open-air parking lot.  Extra cars can be a hassle when leaving the hospital.

The 4th Floor nurse ran through a huge list of questions, as they must do, and accessed my port for ready access to medicines, saline and blood.  She also sampled my fluids for redundant testing.  Shortly, one of Dr. K’s Physician’s Assistants showed up to help figure out what must come next. She reiterated that the dropping hemoglobin levels were concerning.  The reading from my regular chemo appointment last week had been 11.1.  The reading from the infusion clinic a couple hours ago was 8.6 and the sample that they processed minutes ago was 7.9.  If it hit 7.0, they would give me a transfusion of a couple of units of blood.  She also indicated that they would bring in an upper Gastro-Intestinal Specialist to see if a source for bleeding could be found from the top down.  If nothing could be determined from an endoscopy, then they would likely proceed to a CT Scan.

It was 6:40pm and I was hungry and remembering from before that the kitchen closes at 7:00pm, I requested a menu and ordered enough food to last me until midnight.  The nurse said no food after midnight so I would be properly fasted for a scope in the morning.  She also said I would likely be spending a second night in the hospitl to monitor the blood transfusion.

Then the waiting began.  The food arrived and then Mary and Marlee came up with my iPad and chargers.  The room staff changed. Mary and Marlee left since I was pretty settled and they had not yet eaten. More fluids were taken.  My blood type was tested (O+). I checked out the TV channels but settled on playing with QuizUp, a trivia App on my iPad where you match wits live with other players from all over the world.  I selected the category, “Name the Movie” and played until I was ranked #1 in Michigan, which is about a #238 ranking for that category worldwide.  The nurse popped in to let me know that I would be awoken at 3:00am by a new nurse for more blood tests and so I shut off all electronics and lights and slipped off to sleep easily.

I woke about 2:45am and decided to browse social media until the blood draw.

In the morning at about 7:30am I met a new nurse who reminded me “No food or water”.  She said doctors usually came around sometime in the morning.  She also told me that my particular Type O blood included a rare antibody so they needed to find a couple of pints somewhere that had that same antibodies so my cells would get along nicely with the donor cells.  She said that chemo patients occasionally develop special antibodies.  I wanted to know more about this and she told me she would try to find more info.  But good news… there had been an uptick in my hemoglobin levels. 

Eventually the GI Doc showed up to explain his plans for me.  He thought the blood loss could be coming from an ulcer or a new stomach tumor.  His endoscope could prove or disprove that.  I’ve been through dozens of endoscopies so that was no big deal.  The trouble was, his schedule was already quite full so he could not squeeze me in until sometime in the afternoon.  For me that meant no food or drink for another half day and lots more waiting around.  A different PA colleague of Dr. K came by to say Dr. K would come by after the scoping to let me know what was up.

I downloaded a new book on my iPad and read for a while.  My sister Betsy volunteers at the Lacks Center 3^rd floor (on top of an incredibly busy life schedule) so she stopped by around lunchtime for a visit and conversation. My nurse popped in again to say that the hemoglobin levels were continuing to rise and they would be cancelling the transfusion. Also my pee was now a natural pale yellow.  The reddish color had probably been due to dehydration and all these IV fluids they had given me had corrected this.  Finally at about 1:45, a guy from transport showed up to wheel me to my procedure.  By 2:15 they were ready to proceed.

I’ve had better endoscopies, ones where I did not wake up gagging on an instrument in my throat, but the Versed they give you makes you forget most of the experience.  It just begins and then seemingly immediately, you are all done.  Because of the drugs, I am groggy on the rest but I do know that everything looked fine and dandy from his perspective.  I have a picture to prove it.

Back in the room, I ordered some food and waited for Dr. K.  Mary showed up and we waited together.  Finally Dr. K showed up and pretty much told me that I had managed to self-heal and that he was going to release me.  Yahoo!!  We’d continue with our regular chemo schedule and we would do a CT scan after Mary and I returned from our Florida vacation in just a few weeks.  Irrationally, I had more fear about missing this vacation than I did about the possible return of a tumor so this was really good news.

I do kind of feel better now that I am hydrated but that 24 hours in the hospital sure felt like a big, expensive waste of time just to get my pee the right color.  Once you check in, you just kind of have to ride it to the end, wherever that takes you.