We pulled out of the driveway a little before 9 AM this morning and arrived at NYUCC a little before 11. One of the first things they did was to take Pete's temp. He had taken Advil around 4 AM, so when he awakened he was cool, but on the ride up he knew the fever was returning because his head ached and he started having bad chills. One of the first things they did when we went in was to take his temp; it was 102.3, into the danger zone for cancer patients.
They disconnected the chemo infusion pump; he had only hours left on it to complete the regimen. They started IV fluids because he was dehydrated and then IV antibiotics, Vancomycin and Cefepime, and of course another bolus of Mesna. The normal blood work was drawn, but they also drew some from the port and from his arm for cultures. Today's nurse, T, explained that they draw from 2 places to compare the cultures and determine whether there is an infection at or near one of the sites, in this case they are concerned about the port. Because of the problems he had with the needle coming out they need to check this out. If the port has become infected it will have to be removed and a new port implanted.
Dr R said that if the fever was not gone by 6 PM, Pete would have to be taken to the hospital and admitted for at least over night, as the cancer center closes at 8 PM and has no overnight facilities. The prospect of hospitalization was not something any of us, including Dr R, was looking forward to. Fortunately, Pete did rally and even ate a half of a sandwich around 3 or so. By the time all the IVs finished it was just a little before 7. We pulled into the driveway shortly before 9.
We have to go back in tomorrow for more IV antibiotics, fluids and, since we're there, he'll get the Neulasta shot. His WBC and RBC counts are pretty low because he's at the tail end of the chemo infusion. The Neulasta is the white blood cell booster, but they want to make certain he's got as much help fighting this infection as possible, so he'll also be getting a transfusion of 2 units of whole blood. They want him in between 8:30 and 9 which means we need to leave here around 6:30. It's going to be another long day.
The antibiotics have to be given over 3 days and he'll need more hydration, so we'll be going in again on Saturday. If his fever is still hanging around on Sunday, we'll have no choice but to go to the hospital since the Cancer Center isn't open nights or Sundays. The Costco pharmacy is having their holiday party on Sunday and Pete's been invited. At this point, considering his very precarious state, I don't think that he'll be attending.
Thursday, December 9, 2010
Got Through the Night - December 9, 2010
Pete's fever broke sometime overnight. It was back up to 100.9 at 1 AM so he took another dose of Advil. When I checked him at 4 it was down and he said his headache was gone. He had a toased English muffin with butter a short time ago so he could take his meds, so that tells me he really is feeling better. He's showering now and will be calling the doctor within the next hour to find out whether we'll be going in. I'm thinking we will because he did a bit of sweating last night and sometimes drinking water just isn't really enough to keep hydrated when on chemo.
It's funny how, when he and his sister were little, I would periodically get up to check on them, especially when they were ill and there didn't seem to be any sound or disturbance that would awaken me. It happened less and less as they grew older. When they were young adults and still living at home, I'd sleep through the night and seldom hear them. I guess, though, that I'll always revert back to "mommy-mode", and it doesn't matter whether it's Pete or Bruce or one of the pups. When someone is not feeling well, it seems I sleep very lightly.
It's funny how, when he and his sister were little, I would periodically get up to check on them, especially when they were ill and there didn't seem to be any sound or disturbance that would awaken me. It happened less and less as they grew older. When they were young adults and still living at home, I'd sleep through the night and seldom hear them. I guess, though, that I'll always revert back to "mommy-mode", and it doesn't matter whether it's Pete or Bruce or one of the pups. When someone is not feeling well, it seems I sleep very lightly.
Wednesday, December 8, 2010
Troubling Temperature - December 8, 2010
Last evening, Pete asked for the thermometer because he had a headache and his eyes were burning, the way they do when you've got a fever. It registered 99.8. The critial "chemo therapy" temperature is 100.5; once you hit that it's time call the oncologist, and if you don't get a response quickly get ready to go to an emergency room.
This morning it was 99.2, a slight improvement, but he still had the headache. When he took it around 3 PM it was up to 100.8 at which point he put a call into Dr. R. A took the call and told him she'd check with the doctor, but felt that at this time he should stay put and take it again in about a half hour. If it was up, call back because they'd most likely want us to come in. If it was the same or lower but still over normal, take an OTC NSAID, but be prepared to come in first thing in the morning.
This morning it was 99.2, a slight improvement, but he still had the headache. When he took it around 3 PM it was up to 100.8 at which point he put a call into Dr. R. A took the call and told him she'd check with the doctor, but felt that at this time he should stay put and take it again in about a half hour. If it was up, call back because they'd most likely want us to come in. If it was the same or lower but still over normal, take an OTC NSAID, but be prepared to come in first thing in the morning.
Tuesday, December 7, 2010
Another Unexpected Trip to the City - December 7, 2010
Monday was a fairly normal day, I think. I was going to write about it this morning, but plans seem to have a way of changing at a moment's notice.
Yesterday there were snow flurries most of the day, nothing that you'd call accumulation. There was quite a bit of traffic going in, more than there was on Friday. The visit was unremarkable; blood work, urinalysis and then home. One of Pete's buddies was getting married in the afternoon and he felt well enough to go join in the celebration. Later in the evening he went out with some other friends to watch football.
Pete's prescription for Mesna was supposed to be ready to be picked up in the afternoon, but I just decided that I'd run over Tuesday morning to pick it up and do some food shopping while I was out. I also decided to wait on writing the blog until Tuesday. Best laid plans...
I was up and about to feed the dogs when Pete called and asked me to bring scissors. Somehow that didn't sound good. He was sitting on the edge of his bed and asked me to cut the tape/bandage that covers the needle in his port because he thought that it had come out again. As soon as I got through the adhesive part I could feel that the pad underneath was wet and as I opened it more there was the needle on its side, just the tip poking into the skin next to the port.
It was just about 7 and Pete said that it was fine when he had gotten up around 4. I went back to finish feeding the dogs, knowing we'd be heading to the city shortly. I was getting a cup of coffee when I heard the ominous sound of retching. I ran in to find Pete in his bathroom and the floor between the bed and bathroom doorway pretty splattered. He kept apologizing and said that he had felt fine until he took his sodium bicarbonate and it had just all come back up at breakneck speed and without warning.
I immediately put together a container with lid, a dishpan, towel, roll of paper towels, hand sanitizer, and a few other items that I thought might come in handy on the trip up in case this unexpected nausea should hit again. We were on the road around 8, and it's a good thing we were prepared. He had several more bouts during the drive up. He was able to call the hospital to alert them that we were coming.
He was still feeling nauseous when we got there so they gave him Kytril (IV) to help settle his stomach. Because he hadn't been able to keep any water down he was given IV fluids and because his chemo had been disrupted when the needle dislodged, that meant that the Mesna had also been stopped, so they gave him a dose of IV Mesna. All of that took a good part of the day, so it was after 4 when they finally hooked him back up to the pump. After the 20 minute wait to recheck the pump we were good to go. It was around 4:30.
We had been told on Monday that we didn't have to return until Thursday, when the infusion would be finished. Now that's been changed to Friday to make up for the lost day of infusion between the time the needle came out and when they hooked him up once again.
Traffic was pretty heavy, so it was almost 7 when we got home. I fed the dogs, jumped in the car and drove over to Costco to pick up the Mesna prescription and fill up the car with gas. On the way over I hit what must have been a deep pot hole and winced because it was a hard hit. When I started the car up to head home the tire pressure warning light came on and stayed on. I'm hoping that the hit knocked some air out of the tire but didn't do any serious damage. Guess I'll find out when I check tomorrow morning to see if it's gone flat.
It was a really rough day for Pete. He'd been napping off and on and then just fell sound asleep a while ago so I decided I'd write up our latest adventures before going to bed myself.
Yesterday there were snow flurries most of the day, nothing that you'd call accumulation. There was quite a bit of traffic going in, more than there was on Friday. The visit was unremarkable; blood work, urinalysis and then home. One of Pete's buddies was getting married in the afternoon and he felt well enough to go join in the celebration. Later in the evening he went out with some other friends to watch football.
Pete's prescription for Mesna was supposed to be ready to be picked up in the afternoon, but I just decided that I'd run over Tuesday morning to pick it up and do some food shopping while I was out. I also decided to wait on writing the blog until Tuesday. Best laid plans...
I was up and about to feed the dogs when Pete called and asked me to bring scissors. Somehow that didn't sound good. He was sitting on the edge of his bed and asked me to cut the tape/bandage that covers the needle in his port because he thought that it had come out again. As soon as I got through the adhesive part I could feel that the pad underneath was wet and as I opened it more there was the needle on its side, just the tip poking into the skin next to the port.
It was just about 7 and Pete said that it was fine when he had gotten up around 4. I went back to finish feeding the dogs, knowing we'd be heading to the city shortly. I was getting a cup of coffee when I heard the ominous sound of retching. I ran in to find Pete in his bathroom and the floor between the bed and bathroom doorway pretty splattered. He kept apologizing and said that he had felt fine until he took his sodium bicarbonate and it had just all come back up at breakneck speed and without warning.
I immediately put together a container with lid, a dishpan, towel, roll of paper towels, hand sanitizer, and a few other items that I thought might come in handy on the trip up in case this unexpected nausea should hit again. We were on the road around 8, and it's a good thing we were prepared. He had several more bouts during the drive up. He was able to call the hospital to alert them that we were coming.
He was still feeling nauseous when we got there so they gave him Kytril (IV) to help settle his stomach. Because he hadn't been able to keep any water down he was given IV fluids and because his chemo had been disrupted when the needle dislodged, that meant that the Mesna had also been stopped, so they gave him a dose of IV Mesna. All of that took a good part of the day, so it was after 4 when they finally hooked him back up to the pump. After the 20 minute wait to recheck the pump we were good to go. It was around 4:30.
We had been told on Monday that we didn't have to return until Thursday, when the infusion would be finished. Now that's been changed to Friday to make up for the lost day of infusion between the time the needle came out and when they hooked him up once again.
Traffic was pretty heavy, so it was almost 7 when we got home. I fed the dogs, jumped in the car and drove over to Costco to pick up the Mesna prescription and fill up the car with gas. On the way over I hit what must have been a deep pot hole and winced because it was a hard hit. When I started the car up to head home the tire pressure warning light came on and stayed on. I'm hoping that the hit knocked some air out of the tire but didn't do any serious damage. Guess I'll find out when I check tomorrow morning to see if it's gone flat.
It was a really rough day for Pete. He'd been napping off and on and then just fell sound asleep a while ago so I decided I'd write up our latest adventures before going to bed myself.
Saturday, December 4, 2010
I Forgot One Thing - December 4, 2010
I have found this blog to be very useful as I have referred to it a number of times when Pete and I have been trying to recall when some event relevant to his treatment took place. Yesterday, the needle into his port was changed. I had forgotten to include that until I was talking with my daughter and she asked me something about the needle and I suddenly remembered.
Friday, December 3, 2010
Numbers Still In the OK Range - December 3, 2010
10 AM appointment this morning, so most of the rush hour traffic had already gone through but the traffic on the city streets was pretty heavy. No blood return from his port again, but that's nothing new.
The past 2-3 days have not been very good for Pete. He's had headaches and has complained of that "watery mouth" that precedes an attack of nausea, but that's as far as it went. He was hungry, but wasn't in the mood to eat, though he did manage to have a few small, light meals these past few days. And he's really been feeling fatigued.
This morning I mentioned to him that he was looking better. I can't quite put my finger on it; it's a rather subtle difference and I don't know if anyone else would detect it. He did say that he was feeling a bit better today.
Pete's blood work numbers were okay, well, they're okay for someone in the midst of chemo (WBC 4.1, RBC 3.47, both lower than the normal range as expected) but he did have some blood in his urine. The chemo he is currently getting, Ifosfomide, is given along with another drug, Mesna, which helps protect the bladder from the damaging effects of the Ifos. He has to stay hydrated to assist the Mesna in flushing the bad stuff out but sometimes the amount of water he's supposed to drink is tough to get down. The remedy is to give him a bolus of fluid to rehydrate him, so our hoped-for short stay turned into a longer one.
This isn't the first time for the blood in the urine (it was there last Friday as well) but the nurse assured us that it just a trace and nothing to be alarmed about. Last week, they did a second urinalysis after he finished his bag of hydration and it was clear.
By the time we were heading home, the rush hour had begun; traffic was getting heavy. His next appointment is Monday at 10. A had stopped in and we figured out that Thursday will be Day 8, the day the pump will be removed. At least 24 hours after the chemo ends he'll get his Neulasta shot and then 2 weeks later he'll be going for the scans and stress echo cardiogram. Looking at my calendar, that takes us to the week leading up to Christmas. Gina is coming in from CA on Dec 28 and flying back on New Year's Day. Short visit but the airfares were quite high and this particular itinerary was a bargain so she took it.
The past 2-3 days have not been very good for Pete. He's had headaches and has complained of that "watery mouth" that precedes an attack of nausea, but that's as far as it went. He was hungry, but wasn't in the mood to eat, though he did manage to have a few small, light meals these past few days. And he's really been feeling fatigued.
This morning I mentioned to him that he was looking better. I can't quite put my finger on it; it's a rather subtle difference and I don't know if anyone else would detect it. He did say that he was feeling a bit better today.
Pete's blood work numbers were okay, well, they're okay for someone in the midst of chemo (WBC 4.1, RBC 3.47, both lower than the normal range as expected) but he did have some blood in his urine. The chemo he is currently getting, Ifosfomide, is given along with another drug, Mesna, which helps protect the bladder from the damaging effects of the Ifos. He has to stay hydrated to assist the Mesna in flushing the bad stuff out but sometimes the amount of water he's supposed to drink is tough to get down. The remedy is to give him a bolus of fluid to rehydrate him, so our hoped-for short stay turned into a longer one.
This isn't the first time for the blood in the urine (it was there last Friday as well) but the nurse assured us that it just a trace and nothing to be alarmed about. Last week, they did a second urinalysis after he finished his bag of hydration and it was clear.
By the time we were heading home, the rush hour had begun; traffic was getting heavy. His next appointment is Monday at 10. A had stopped in and we figured out that Thursday will be Day 8, the day the pump will be removed. At least 24 hours after the chemo ends he'll get his Neulasta shot and then 2 weeks later he'll be going for the scans and stress echo cardiogram. Looking at my calendar, that takes us to the week leading up to Christmas. Gina is coming in from CA on Dec 28 and flying back on New Year's Day. Short visit but the airfares were quite high and this particular itinerary was a bargain so she took it.
Wednesday, December 1, 2010
New Pump - December 1, 2010
Late appointment in the city today, so the traffic going in wasn't too bad. The ride in would have been better if we did not have to deal with pouring rain and 50 mph gusts of wind.
The port did not cooperate with a blood return today, so Pete got stuck in the back of his hand. We sat around waiting for the results so that he could get his new pump with the new supply of chemo. All his blood work looked fine. This pump will run 8 days to complete the full 16 day regimen. The nurse secured the needle and the loose end so it shouldn't come out like the first one did. That means it should be done next Thursday (or Friday) and he'll get his Neulasta shot on Friday (or Saturday).
Dr R stopped by and told him he'll be having the scans about 2 weeks after the Neulasta shot and the results will determine the next course of treatment: more chemo, radiation, surgery or some combination of these.
We came home in the early part of rush hour traffic. The next appointment is Friday.
The port did not cooperate with a blood return today, so Pete got stuck in the back of his hand. We sat around waiting for the results so that he could get his new pump with the new supply of chemo. All his blood work looked fine. This pump will run 8 days to complete the full 16 day regimen. The nurse secured the needle and the loose end so it shouldn't come out like the first one did. That means it should be done next Thursday (or Friday) and he'll get his Neulasta shot on Friday (or Saturday).
Dr R stopped by and told him he'll be having the scans about 2 weeks after the Neulasta shot and the results will determine the next course of treatment: more chemo, radiation, surgery or some combination of these.
We came home in the early part of rush hour traffic. The next appointment is Friday.
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