Tuesday, April 29, 2008

Manda's Sick - OMG WTF?

Are you sitting down? Amanda might get to come home on Friday!

The results of the 3rd biopsy are still inconclusive, but her numbers are coming up to where the average patient would be sent home if in remission. So they're going to schedule another biopsy for Friday (#4!) and, if her numbers are where they need to be, she'll probably get sent home.

The respite may be brief, as negative biopsy results would mean she'd go right back in for more chemo, but the prospect of having Amanda home, sleeping in her own bed, having breakfast and playing with Alastair, is more than I can wrap my mind around right now.

I'm trying not to get too excited, though: the doctors have yet to render a final word.

Cross your fingers, and keep up the prayers and love!

Saturday, April 26, 2008

Manda's Sick - Upgrades

Sinusitis is the order of the day, and for the pain she started with percocet. Now she's on oxycodone. Oh, yeah: hillbilly heroine!
I spent about 3 hours with her tonight, or maybe I should say I spent about 3 hours near her. She'd be in the middle of flipping through the channels and drift off for a minute. Toward the end of the evening she was more off than on, so I figured I'd let the drugs do their job and head home to fold laundry.
I got to see my dear college friends Maureen and Kate. Maureen flew in from NY to see Amanda, and Kate drove her to town. I wouldn't have recognized Kate at all, had she not stepped out of the same car as Maureen (who hasn't changed one iota!). It was great to see them, and I wish they could have stayed longer.

Friday, April 25, 2008

Manda's Sick - Biopsy #3 in the Series--Collect them all!

Today was the big test. The one that determines the next phase of treatment for my darling wife. The one for which the church elders came and prayed over her last night. The Big One.
I showed up just as the doctor was rolling her back onto her back in the bed and the nurse was cleaning up: as usual, I missed a biggie (to be fair, though, I wasn't expected to be there; it was coincidence that I showed up during the time of the procedure at all).
Almost immediately after the doctor left, a pair of Radiology Transportation folks showed up to cart her downstairs for another head CT. She had noticed a lump in her neck, reported it to her doctor, and he had called for a CT. He suspects it's a swollen lymph node, which is a little weird, as that's generally evidence of the immune system functioning. Amanda's not supposed to have a functional immune system.
Anyway, almost as soon as she got back to her room from that, they came back with results from the biopsy. The results?

Drum roll please....

Inconclusive! Yes, while the leukemia cells seem to be "almost entirely" gone, there are some curious blast cells that need further examination. They're either the remaining undead that Zombie Warrior missed on her last rounds, or they're regular white blood cells that simply haven't had time to finish developing.
Obviously we're hoping for the latter, but we won't know for sure until Monday, when the additional results are expected. If we get bad news, it's back to the chemo for a bit.
Meanwhile, Amanda's thunderdouche* GP sent us an non-itemized bill for $200. Apparently he thinks he should get paid for failing to order even the simplest of blood tests that could have revealed Amanda's disease almost a full month prior to her ER visit.
*Thanks, Pajiba!

Thursday, April 24, 2008

Like a giant dildo crushing the sun

So, yeah, if you read about it on Manda's blog, you already know that I've been sick the last couple of days. I spiked a fever of 103.4 on her birthday and watched the entire Matrix trilogy on Wednesday.
I took the opportunity of being unwell yesterday to finally get some blood-work done (that I'd been putting off since October). I think there's a reasonable chance they might find something interesting. I've had 5 fevers in 2008, which is about 4 more than I usually have in a year, and for the past year or so, it's taken up to two months for simple scrapes to fully heal. We'll see.
The fever broke mid-afternoon, and I went down to the hospital and spent the evening with my darling wife. We did nothing in particular, and it was great. I helped her wash her hair in the shower, and supervised the whole shower process lest she should have another orthostatic hypotension episode.

Tuesday, April 22, 2008

Manda's Sick - Hospital Birthday Blues

Yeah, so the first person to call and wish Amanda a happy birthday was my mother. Great. Mom regaled her with tales of an amazing root called bloodroot. Read about it here! Nothing hotter than disfigurement!
Anyway, it's Amanda's 33rd birthday. She just got platelets yesterday, and now has a platelet count ~18,000, up from 48 when she first entered the hospital, and 38 a few days ago. That's a pretty dramatic difference.
I spent some time yesterday afternoon getting our new wireless camera installed, so now she can watch Alastair whenever he's in our den. Now I just have to get her a camera so that we can video-conference at night, and blow mommy kisses!

Monday, April 21, 2008

Manda's Sick - Post Chemo Recovery

I just published 6 comments on Amanda's blog. She's not really up to browsing the webs at the moment.

Amanda's chemo ended unceremoniously on Saturday. She'd felt great through Friday afternoon, with the exception of a mild intermittent cough.
Saturday, she felt crummy. She had a fever of about 101 and just felt puny. I took Alastair to see her in the morning, and she looked terrified when he coughed (he's been struggling with allergies at Casa Amos). We left, and I talked to her a couple of times throughout the day, culminating in our Date Night. At some point during the day, the good doctors came and performed a chest X-ray and took blood to see if antibiotics were necessary.
Our date consisted of watching an episode of Battlestar Galactica (we're half-way through Season 2) and me watching her sleep. She just had no energy at all.
Sunday we didn't see her at all, but apparently her fever broke in the night.
Today the fever is back, and she's on antibiotics. She's reading, resting, and trying like crazy to avoid my mother, who's been persistent in nagging us to death. If you Pajibans want to fire up the MT, I've got the ideal target. Mom likes to make every problem relate to her absurd life, comparing Amanda's leukemia to her divorce from my father over 30 years ago--a divorce that she lies about at every opportunity.
Enough about Wacko-Mom: keep the love flowing with all the positive vibes you can muster. Amanda's in the "side-effect" stage of things now, and she'll feel like absolute crap for about 2 weeks.

Thursday, April 17, 2008

I, Criminal

I got home late(ish) last night to find two pamphlets in my door. Both were from Henrico County's Community Revitalization department, and were left by a neighborhood inspector. One pertained to trucks, trailers, and other commercial vehicles, while the other was dedicated to "inoperable vehicles" and their storage. A handwritten note on the commercial vehicle pamphlet suggested I read the section on trailers and "other pamphlet".
Here's what he was after:
Sec. 24-102. Trailers and trailer parks.
No trailer of any kind shall be parked or stored in any district except as follows:
(2) In any district used for residential purposes, one travel, utility and/or boat trailer, as an accessory use, may be parked or stored in the rear, side yard or in a carport or garage on the same lot with the principal use, provided it shall not be occupied for living or business purposes. The wheels or other transporting devices shall not be removed, except for repairs, nor shall the trailer be connected to any utility service or to the ground or other structure in any manner that would prevent its ready removal.
Cute. The fines for this curiously-defined crime are steep:
Sec. 24-110. Violations and penalties.
Any person who violates any of the provisions of this chapter shall be deemed guilty of a misdemeanor and upon conviction thereof shall be fined not less than $10.00 and not more than $100.00 if the offense be not willful; or not more than $250.00 if the offense be willful. If the violation is uncorrected at the time of conviction, the court shall order the violator to abate or remedy the violation in compliance with the zoning ordinance, within a time period established by the court. Failure to remove or abate a zoning violation within the specified time period shall constitute a separate misdemeanor offense punishable by a fine or not less than $10.00 nor more than $250.00, and any failure during any succeeding 30-day period shall constitute a separate misdemeanor offense for each 30-day period punishable by a fine of not less than $10.00 nor more than $1,000.00.

As provided in Code of Virginia, § 15.2-2286(A)(4), a notice of violation involving temporary or seasonal commercial uses, parking of commercial trucks in residential zoning districts, or similar short-term, recurring violations may be appealed within ten days. If no appeal has been filed within ten days, the notice shall be deemed final and unappealable.

(Code 1980, § 22-110; Ord. No. 954, § 1, 7-23-97; Ord. No. 1005, § 1, 10-10-00)
So I could be looking at thousands of dollars in fines. But wait: there's that little clause about temporary or seasonal commercial uses, which is exactly what I'm doing. The trailer is out front because it is a seasonal use vehicle. The racing season is in full swing. But ok, sure, whatever: I'll move the trailer into the driveway as soon as the Miata's upgrades / repairs are complete. (I hope it's enough, because I'd hate to see the guy behind us get similarly fined for the big boat parked in his driveway, or the person who owns the little utility trailer around the corner.) Which brings us to the law governing inoperable vehicles:
Sec. 10-3. Inoperable motor vehicles.
(a) Restrictions on inoperable motor vehicles. It shall be unlawful to keep more than one inoperable motor vehicle outside a fully enclosed building or structure on property zoned or used for residential purposes, or any property zoned for, commercial or agricultural purposes. For purposes of this section, "inoperable motor vehicle" means any motor vehicle, trailer or semitrailer, as defined in Code of Virginia, § 46.2-100, which:
(1) Is not in operating condition; or
(2) Does not display valid license plates; or
(3) Does not display an inspection decal that is valid; or
(4) Displays an inspection decal that has been expired for more than 60 days.
(b) Shielding or screening required. One inoperable motor vehicle may be kept outside a fully enclosed building or structure if it is shielded or screened from view. As used in this section, "shielded or screened from view" means not visible to someone standing at ground level from outside of the property on which the subject vehicle is located.
(c) Exceptions. This section shall not apply to a licensed business which is regularly engaged in business as an automobile dealer, salvage dealer or scrap processor.
(d) Enforcement. The director of community revitalization shall enforce this section.
(Ord. No. 922, § 1, 5-22-96; Ord. No. 945, § 1, 5-14-97; Ord. No. 986, § 1, 7-13-99; Ord. No. 1069, § 1, 8-10-04)
State law references: Authority of Henrico County to restrict keeping of inoperable motor vehicles on residential or commercial property, Code of Virginia, § 15.2-905.
Ok, the car runs, and runs very well. It's inspected, licensed, and current for all its immunizations. It's just up on jacks. The race tires we bought for the 2008 season are so soft that they'll get flat spots just from sitting. It's also fairly common practice with race cars to get them off the tires to relax the suspension: no sense wearing out 700 in/lb springs just sitting in the driveway. The tires could be mounted and the car driven in under 10 minutes. Probably 5 minutes.
I have an old set of racing tires that I could (and probably will) mount just for "storage" purposes, but I see no law being broken here.
Granted, I have no intention of re-inspecting the car this year, or for paying to keep the plates on the car, but putting the cover on the car would prevent any of those details from being known. The pamphlet, however, over-steps the legal bounds outlined in the County Code, and adds:
Solid wood fences, walls and dense evergreen plantings of a sufficient height to screen the vehicle, are acceptable methods of shielding of screening when located in side or rear yards. Covering inoperable motor vehicles with tarps or car covers does not meet the requirements of the ordinance.
Yeah, ok, but how the hell are you going to know it's not licensed when there's a cover on it? And wait: where does the authority come from to make that determination? It's not in the code at all!
So now I have a question. What happens when you decide on a beautiful sunny day to change your oil in the driveway? The moment you pull the oil-drain plug, you have an inoperable vehicle. You are a criminal. To get really pedantic and focus on the semantics of the word "inoperable", I'd say even opening the car door makes the car inoperable. Certainly popping the hood, having a flat tire, or checking the oil would qualify. Adding washer fluid. You name it: the moment you place the car into a condition that renders it momentarily undrivable, you have an inoperable vehicle. Part of the reason the car is on jacks is also because we're changing brake pads, rotors, and fluid. Normal standard maintenance, no more or less involved than an oil-change. Criminal.
So here's my plan: I've scoured through the laws, and can't find any reference to it being illegal to store my "inoperable vehicle" on my trailer. I mean, what makes the Miata any different from a lawnmower at that point? So I'm going to just put the old race tires on, drive it up on the trailer, and park the whole rig in the driveway. It sat in the driveway for weeks like that before, and now it can live there. And you'd best believe I'm going to incorporate ahamos racing, LLC to qualify for the seasonal commercial use clause.

After getting all fired up about this crap, I did some more research into the County Code of Henrico. The ice cream man, whom I famously "threatened" by speaking sternly to him while wearing my .45 holstered to my hip, is also a criminal:
Sec. 22-39. Unnecessary noise in operation of vehicle.
(a) Generally. No vehicle shall be loaded with materials likely to create loud noises by striking together, without using every reasonable effort to deaden the noise. The use in, upon or attached to any motor vehicle operating on any street of the county, of any radio, phonograph, musical instrument, bell, whistle, loudspeaker, amplifier or device of any kind whatsoever whereby sound therefrom is cast upon any street to promote or advertise the sale of goods, wares or merchandise, or for the purpose of advertising auction sales, sporting events or other business or things advertised thereby, is prohibited.
I'm actually pretty jazzed about being able to call the cops on this jackass. He only drives down our street when Alastair is napping, and seemingly only when school is open. WTF? Who's buying the ice cream? Is it a front for a drug operation, like we saw in Athens, GA? The ice cream man there used the truck to vend heroin and crack.

Keep your kids away from my house: I'm a big bad criminal.

Wednesday, April 16, 2008

Manda's Sick - Date Night!

Yesterday afternoon, I left work and went straight to my darling wife. We spent the whole evening together, and I got to tuck her in at 11:00pm before going home. It was wonderful.
We curled up (as much as we could) in her bed and watched Sweeney Todd on the iBook. Manda passed out about 10 minutes from the end. I hadn't gotten to watch her sleep in what seems like forever.
Jamiesmitten came to visit, and I got to hear all about her dad's wild ride through life.
I ate overpriced food from Blimpie, prepared by a curious fellow who seemed to be scoping out every single breathing female in the cafeteria. I overheard him expressing his lack of concern about body-shape, hair, or basically any other distinguishing traits other than sex. Very curious indeed. And the woman who took my money might well have been blind, since she reached well past my hand with my change.
But it was a fabulous night. Best I've had in weeks. And I get to do it again on Saturday!

I love my wife.

Monday, April 14, 2008

Manda's Sick - Hey, can I get some of that tasty sickness?

I haven't updated like I said I would. ("Really?", you say? "Hadn't noticed...")

I was coming home to update the blog Friday night when I was stricken with a strange combination of belly cramps and hunger. I wolfed down a whole diGiorno personal pizza (900 calories, thank you very much), did a little work on the Miata, and went to bed.
At 3:30am, I was up with a belly that was distended and hard. At 3:50am, I realized there was no holding the pizza down.
I lost the second round of belly-warfare at 5:30am, and the 3rd round around 6:15. Round 4 was unceremonious at around 7am, and my stomach declared total victory.
Then came the fever. It climbed and climbed throughout the day, peaking at 102.6 by 7pm.
Does it help to mention that I felt like hell? I watched, and in my feverish, sleepless state actually really enjoyed Night at the Museum, and while waiting for the NASCAR race to start at 8:45pm (we don't have the cable, and I felt too crappy to move over to the DVD shelf), I actually watched about half of a hockey game, a few innings of baseball, and even a single hole of golf, interspersed with random cooking and home-improvement shows on PBS. Even NOVA sucked on Saturday.
What's my point? Certainly not to detract from Amanda's illness, but I missed the beginning of her chemo. It felt like missing the birth of my child. I broke down and sobbed several times throughout the day, but there was just nothing I could do about it.

The event, as I understand it, was anti-climactic.

Amanda is still doing and feeling well on her 3rd day of chemo. I've been by twice to see her, but I don't feel like I get to spend nearly enough time with her. Each time has been less than an hour, and I'm running around after Alastair to keep him out of trouble. I so didn't see this week working out like this.
But, on the bright side, I am finally getting some time with him. I didn't see him from Friday morning until noon on Sunday, when he (and my dad and fantabulous stepmother) showed up at the autocross for my last run.
I got to work from home today so that I could give him some semblance of normalcy.
Tomorrow he's back to his grandparents' house, and I'm back to work, further lamenting my separation from the most wonderful woman in my life.
Woe is me, right?

Friday, April 11, 2008

Brief Update

Chemo will now start Monday. Apparently the good doctors have found several markers for AML, but they've also found one confusing marker for ALL. They want to take the weekend to figure out where that marker came from before proceeding.

The next two days should be pretty uneventful for her: no bi-carb, maybe a transfusion or two (hemoglobin has gone back down to 8.3, white blood-cells to 2.4, and platelets at 48).

Call or come by if you can.

Unless something medically interesting happens, there probably won't be any more updates over the weekend.

Thursday, April 10, 2008

Manda's Sick - MCV Day 2

My wife is a smurf. I didn't think to ask why they painted her blue, but blue she is, and covered in painfully sticky saran-wrap-looking tape with a bloody mess of a hickman line.
She was ordered not to eat after midnight (or get wet, or exposed to water) since she was scheduled for catheterization and another bone marrow biopsy today. The hope was that these things would happen early in the morning so that she could eat.
Both occurred after lunch, the catheter some time after 3pm.
I got to the hospital around 4:30 to find her in good spirits and recently fed (Chick-Fil-A, courtesy of my stepmother and SuperWoman, Randy - a cancer survivor and tremendous support). She's online, as some of her beloved readers know, but might be a bit loopy from the percocet.
After Randy left, Amanda was really really ready for a shower. She got in, washed, and nearly collapsed. After squatting for about 2 minutes in the shower from lightheadedness (and refusing to let me get a nurse), sitting in the chair beside the shower for another 3 or 4 minutes (and refusing to let me get a nurse), and finally having me dress her and comb her hair, I was allowed to go get a nurse.
So now we have new terms to add, along with new restrictions. Orthostatic hypotension, a fancy term for a head rush, caused her blood pressure to drop to about 82/42, with a pulse of 60. Crazy Pants was put into a wheel chair for the 10' ride back to the bed (seriously: she couldn't move on her own), and had her recently-granted ambulatory rights revoked.
Instead she gets a fancy pumping machine that wraps around her legs and massages her to prevent Deep Vein Thrombosis. She looks like a Storm Trooper.
To top it all off, she was in pretty serious pain from the surgery and biopsy, hence the percocet.
But, she did get to spend some good romp time with Alastair this evening. He came down and climbed all over her, only reaching for the hickman line a couple of times. Both Mommy and Boy were having a great time before I had to bring him home.

Edit: Forgot to add that an ophthalmologist came by and assessed her vision issues. She found leukemic retinopathy to be the cause of her grayed vision, and described it as being similar to bruising, that it will come and go, and that it's very common (in leukemia patients).

Manda's Sick - MCV Day 1

We got the big spiel last night from 8 to 9pm. Special thanks to Dr. Kate Kimmelshue (our inside man) for sticking around and helping explain some of the pathology stuff.

We met our team of doctors:

Faculty (Attending): Dr. Shaw - jovial 50-yr-old with the answers
Fellow: Dr. Rome
Resident: Dr. Appert - reminds me of my cousin Cory, except with big red curly hair. And an MD.
Intern: Dr. Hoffman - youngest of the bunch; has an 18-month-old and an 8-month-old. Do the math.

Amanda's under the knife right now, getting her hickman line. She had her second bone marrow biopsy this morning (this time heavily anesthetized), and hasn't yet been allowed to eat since midnight. But she seems to be in pretty good spirits, and you can expect to see her online this afternoon, as my stepmother took her a laptop.

Pajiba at large: you guys rock! (But no marijuana, please)

So, anyway, the gist:

Amanda suffers from Acute Myelogenous Leukemia, and until further differentials are complete, is being treated as having M0: Undifferentiated. Untreated, she would have been dead within 4 months.
7 days of chemotherapy, starting today. 3 days of cytarabine and idarubicin, 4 additional days of cytarabine. The following 18 - 22 days will be recovery. She will lose her hair, have mouth sores, feel crummy, and probably not be very good company. She will lose her appetite. Her birthday (the 22nd) will suck.
After the 2nd week (can't remember whether it was 2nd week of hospitalization or recovery), she will have another biopsy to see if the cancerous cells are gone. If so, she is considered to be in remission. If not, "we'll go from there".

Amanda is a strong and beautiful woman, but she's going to be tested.

Wednesday, April 09, 2008

Manda's Sick - Interlude

Thanks, everyone, for the well-wishes, the gifts, treats, visits, care, love, and concern you've shown over the last few days. This has been a real challenge, and we feel absolutely bathed in love.

Amanda got a brief respite from hospitalization today: her transfer from St. Mary's to MCV came by way of our house. She got a hot shower, time to play and build towers with Alastair, and an opportunity to love on the kitties before I had to take her back.

It was the worst car ride of my whole life. Having her home felt, even just for a moment, like everything was ok. She looked great (hemoglobin was back at 9.7 after 6 units of blood), too, and when she went up the stairs, she had no palpitations. For a little while, at least, our life was normal.

I'll get into her care at MCV tomorrow. Right now I'm emotionally spent. She's getting started on chemo tomorrow, and aside from new names and faces, there's not too much to report.

Tuesday, April 08, 2008

Manda's Sick - Chapter 4: The St. Mary's Conclusion

Acute leukemia.

She's being transferred tomorrow to MCV, where she'll spend the next month undergoing chemotherapy, losing her hair (she's planning on shaving it anyway, since she hasn't been able to wash it for the last 3 days), and getting matched for a bone marrow transplant.

Pray pray pray.

Monday, April 07, 2008

Manda's Sick - Chapter 3: Room 618

Late Sunday afternoon, we gathered Manda's worldly hospital possessions and trucked upstairs to the Oncology ward. There was a patient wailing two doors down. I heard more wailing and a fellow bellowing for a nurse later in the day. But at least she got a single-occupancy room with a great view.

No sooner had we gotten into the room when a doctor knocked on the door. He was the on-call eye doctor and did a curious super-voodoo looking dance in front of Amanda's face for about 5 minutes. His gadgetry required him to physically zoom in and out rapidly, but at the end of it (and after anesthetic had been applied to her eyes) he could find no sign of a detached retina, which was a concern when the vision started failing. He found no major problems of any kind, but suggested that -- at her convenience -- she could come downstairs and do it all again with the big machines.

He left. Blood came. More blood came. More doctors came and went. Fabulous nursing staff. Friends and family began to visit with more regularity (love you guys -- all of you).

Hey, it's a Sunday: what're ya gonna do?

I came and went as Alastair required. He got to see his mommy, which was great for both of them.

By the end of the day, she'd received another 2 units of red blood cells, a slightly wavering temperature had settled back to non-feverish levels, and she was allowed to sleep without her IV.

Then came Monday, the day of The Biopsy...

She started the day with a bit of good(ish) news: her hemoglobin count was up to 7. We're targeting 9 for dismissal. She was also told that she didn't have to wear a hospital gown if she didn't want to (who exactly wants to wear them?)!

The biopsy came shortly after noon. Amanda described it to me as feeling like being kicked in the back, only from inside. They numbed her up and extracted marrow and a core-sample of something very technical and complicated sounding. A pathologist friend later explained it with no better success. They also took the opportunity to biopsy a small hardened spot on the back of her leg (forgot to mention that in the original symptom list, sorry).

The echocardiogram was done, and really nothing else has happened.

We're waiting on pathology now. We've been told to expect somewhere between 24 and 48 hours for preliminary results, but there's to be a "family meeting" with the hematologist to discuss treatment options once the results are back.

I'm home with Alastair. His grandparents have been great, watching him, entertaining him, and keeping his spirits up.

We're hoping to have Mommy home by tomorrow or Wednesday, but I don't think they gave her any blood today, so I'm not sure.

Manda's Sick - Chapter 2: Room 419

So Saturday night at 11:30 or so we got settled in to our new environs, the Progressive Telemetry Unit.

I came home briefly to feed the cats, but when I got back, Amanda was on her second bag of blood and had just consulted with the first (of 3) hematologist. The woman was very intrigued with Amanda's symptoms, and thought there was somewhat consistent evidence of Leukemia, but that some things didn't really add up.

I stayed with Amanda until nearly 2am before heading home for the night.

By Sunday morning her hemoglobin count was only up to 5, and shortly after I arrived I was told by her nurse that "Neutropenic Precautions" needed to be taken: anyone entering the room would need to wear a gown, gloves, and mask. Her white blood cell count was also very low, and the risk (to her) of infection was too great.

Sadly, I was the only one to wear the space-alien get-up, because Hematologist #2 came in about an hour later and rescinded that order: only thorough hand-washing would be necessary.

He told us that Amanda needed a bone-marrow biopsy, to be scheduled for Monday, along with an echocardiogram, blood-cultures to rule out virus, and a visit from an eye doctor. He told us that he felt her bone marrow was not functioning: no deficiencies (B-12, iron, etc) were causing the blood issues, it simply wasn't being produced. Either the marrow was suppressed, diseased, or had died. He actually (pre-diagnosis) began discussing chemotherapy and transplant considerations.

He also felt that the PTU was not the right place for a patient with Neutropenic issues, so he had her shipped upstairs, to ONCOLOGY. Oh, yeah: that's the kind of thing that helps you sleep at night...

Her nurse was very sad to see her go. Apparently Amanda's a very good patient.

Manda's Sick - Chapter 1: The ER

Saturday afternoon, shortly after 2pm, we strolled in to the ER. Amanda wasn't thrilled about the prospect of being there, of having to leave Alastair, of the potential for being sent home with no real progress or resolution. Her vision was terrible, her color non-existent.

We went through triage fairly quickly. When you come complaining of heart problems and loss of vision, they try to get to you quickly. Nobody wants a dead body in the lobby.

We were called frequently during the first 30 minutes, but then we sat. And waited. And got frustrated. For 3 hours. The ER was so busy they had been closed to ambulances.

The only interruption to our wait was one final call back to the triage area where a nurse drew blood in anticipation of a lengthy set of procedures.

Finally, at 5:20pm, we were called back into the "Major ER". Here we were immediately informed of Amanda's low hemoglobin count, and a doctor came and asked curious questions like, "Do you have Scandanavian in you?" (Seriously: evidently Amanda's got large red blood cells, which is common in the Nordic folks).

This nice doctor informed us that her hemoglobin count was almost certainly the cause of all her other symptoms. He ordered a blood transfusion, told us that he needed to consult with Amanda's PCP before admitting her, and vanished.

Some time around 8pm, a very nice doctor named Iraj Mishrahi came and asked the same battery of questions we'd now heard a few times, expressed the same shock over the lack of prior blood-work, ran her through all her symptoms, poked and prodded her, and informed us that she was being admitted to the Progressive Telemetry Unit.

At 9, we got our first visitors (and dinner!) while still in the ER. By 10 (or maybe earlier, it's getting a bit fuzzy after a couple of days), Amanda was getting her first bag of blood.

We were told that it would take a long time for the admissions process: supervisors had to be notified, departments had to look for empty beds, rooms had to be cleaned, more supervisors notified, and transporters located. It's almost as complicated as some of the procedures, but by 11:30pm (9 hours after arriving at the hospital), she was in the PTU, Room 419.

Sunday, April 06, 2008

Manda's Sick - Prologue

For about the past 7 weeks, Amanda has been unwell. No, back up: for about the past 8 months, Amanda's been feeling strange.

It began early last Fall with her hearing a curious whooshing sound whenever the house was quiet. She dealt with it for a while, then got irritated and did some research. We found some interesting candidates, like Eustachian Tube Disorder, all sorts of ear infections, and simple allergies. This last, being the easiest to "fix", became the subject of her great interest. She embarked on a thorough cleaning of the house. Grandma clean.

Things seemed to get better, but she occasionally would still complain that she could feel her pulse strongly.

Then in either January or February, she started having more "allergy" symptoms, so she started taking decongestants. Daily. For 3 weeks. I can't take 'em: they make me feel like I'm looking down at the world from about 5 feet above my head. They raise her mother's heart-rate. And she was starting to feel the same way. So she stopped.

A couple of days after coming off the decongestants, we got our first real clue that something was WRONG. The light palpitations and light-headedness continued. After a couple of weeks of this, Amanda was convinced that the 21-day fusillade of decongestants had permanently damaged her. Then came a reasonably warm day: warm enough to go for a nice outdoor run. 10 minutes after heading out the door, she was back, and looking horrible. She said that her heart felt like it was going to burst from her chest, and you could watch the veins pulse in her neck. When asked how far she'd run, she said "two blocks". Bear in mind that she'd been doing 30 - 45 minutes per night on the elliptical up to just a few days prior.

Then she started having more serious palpitations. She couldn't go up the stairs without getting them.

Finally she made an appointment to see a doctor. Her GP referred her to a cardiologist who performed a Nuclear Stress Test and made her wear a Holter Monitor. She then went back to her GP, who said the results showed nothing interesting. He then sent her back to the cardiologist, who scheduled her for an echocardiogram. During all this time (3 weeks of Dr. Tennis Match), nobody ever took any blood.

Last week, she had a fun list of bizarre symptoms: a toe-nail fell off. Just fell off. (Yuck!) We were watching BSG and she started complaining that she couldn't see the action all that well: made me turn down the lights in the room and told me that the show was strangely lighted. Then her left hand started tingling (I made her go take an aspirin immediately!). She got cold sweats. Shivers. Then a 3-day fever.

Finally she began to lose her vision. She'd had a floater for a few days, then a big gray haze settled in on her right eye.

On Friday night she went ghost-gray pale, and her ankles were badly swollen.

Saturday she nearly passed out in the shower, and throughout the day her haze-gray blindness engulfed more of her right eye.

Even so, it took much cajoling to get her to the hospital.