Early morning woes

Although we have an answer to the ongoing ailments, Dale's needs are intensive. Early yesterday morning, I heard a thud and found that Dale had passed out. He bumped the biopsy wound on his elbow, broke the stitches, and was bleeding. What a mess. Good Morning!!

It stopped bleeding enough to clean around the wound so I could bandage it. Later, we had the doctor look at it since it began bleeding again, had "heated up," and was painful. They cleaned it, examined and bandaged again. Should be fine.

I am tired.

I am not a nurse, but have to be one.

Not tuberculosis

It is not tuberculosis. It is erythema nodosum.

The bumps on Dale's arms and legs became troublesome and painful. They grew in new places and the discomfort and  pain increased. Off to the ER we go. The ER physician that remembers us was just leaving but came in to see us anyway. He looked at the bumps and made a diagnosis he shared with the incoming ER physician, who added in more information, and then called Huntsman Hospital's hematologist for further care. Huntsman said, "Come on in!" After all, Dale has had issues for several weeks and there have not been answers.

Dale was given a room in the BMT (bone marrow transplant) wing which gave me the indication that he needed a sterile room. When the University sent the infectious disease doctor in, tuberculosis was being ruled out. He has many of the same symptoms. With his compromised immune system, Dale is susceptible to infections most of us are vaccinated for.

There were teams of doctors and doctors-in-the-making checking on Dale, as erythema nodosum is rare. His stay was less than 24 hours, but they found the answer.  Another biopsy of one the larger bumps on his elbow was taken. It is likely to be the same as the lung biopsy mass was, just on his shins, ankles, and forearms.

When they took the biopsies in the lungs, the erythema nodosum began to develop, a side affect. No treatment, just occasional ibuprofen. Dale will have painful joints, fevers, and will feel sick for 2 to 8 weeks. Weakness and other flu-like symptoms will continue.

An answer to the last several weeks.

2:45 AM Room window view, when Dale was admitted.

Rest is best

Antibiotics have one more day to magically work. Then what? Dale's red eyes turned pink for the weekend, and are slightly whiter today. Weakness, shortness in breath, loss of appetite. Loss of hope. Sick and tired of being sick and tired. Coughing has its intensive moments, but a calm from coughing is increasing. Diarrhea is back. I believe he needs a weekly follow up with primary care physician for several weeks at least. Next one is Wednesday. Lumps on arms and legs are increasing, which I believe is a cancer--a foreign object out of control. Maybe not cancerous, but a cancer, nevertheless.

Dale is doing all he can to maintain through a day. Rest is best.

Bad news today of a good friend's wife. Her cancer has come back after about 10 years of remission. Radiation and chemo, and fast. My heart sank when I heard about it this morning :( They have a young family who need both Mom and Dad.  Cancer is cruel.

Pneumonia coughs

I was right. Dale was sent home from hospital yesterday with prescriptions of antibiotics and orders to rest. His persistent cough is annoying for both of us. He coughs & spits frequently. His blood pressure and temperature increases during the coughing spells. That can't be good on his total well-being. He complained of chilling, but was in the basement where it is colder, so I gave him another blanket layer, which seemed to help. His energy level is low, balance is off, and he is faintish.

Appetite is minimal and if he does eat, nausea sets in and he feels he will vomit. A pan for spit and vomit surround him. Liter bottles of fluids are within reach. Washable towels lay besides him and the TV remote is in his hand. Should be fine for the day.

It is lousy being sick.

The Hospitalists

Appointment with primary care doctor was quick. He listened and asked questions. He prescribed updated blood labs, chest x-rays, and antibiotic infusion for next several days. He understands Dale's fragile health history and wants to prevent pneumonia from taking over. 

Unfortunately. It already had done so.

By the time we left doctor's office and began blood labs, about 15 minutes, his temperature began to rise. Then on to radiology and his temperature felt warmer. By the time we were in the infusion room, nurse took temperature, called his doctor, and they determined he should go to the ER for respiratory treatments, antibiotics, hydration, and probably admission to hospital. By then they found the pneumonia. 

ER took more blood culture samples for infections. Respiratory treatments had to be done twice and they put hydration and antibiotics into his veins. 

In the next couple of hours, the hospital had to decide if he really needed to stay or not. Outpatient care for pneumonia seems to be the popular insurance's coverage request now. 

Apparently, doctors have to submit patient information to a "Hospitalist" panel of physicians for review and admissions. Primary care and ER physicians don't have the authority to do so any more. That took a couple of hours. 

I suspect, he will get the medications this morning, they will see he is doing okay, and send him home as outpatient. When he is home constant care and transportation for treatments is necessary.

Dale's reflection in hospital room window.

Nothing looked good

Dale did not progress well enough, in my mind, through the day Monday, so off to the ER we went. Insta-care places will not service him because of his cancer history. We had visited the ER one week ago for another acute health condition and the ER physician recognized us and Dale's health history, which says much about the doctor and the ER. 

Eight hours later, they sent us home with an oxygen tank and eye drops. Not pneumonia, yet. Go to your primary care for follow-up. That is what we are doing today. 

I am emotionally exhausted, and physically beat. I worked yesterday on 2 hours of sleep with no down time, (if I stopped, I probably would not be able to get going again) picked up a prescription for Dale, and wondered around the store for 15 minutes trying to find something for dinner. My mind was not able to function and make a plan. All I knew, dinner would have to require minimal effort in preparation. Nothing looked good. I found a prepared dinner that seemed reasonable and headed safely home. 

Bedtime for me was 5:00 PM. But I had to stay up another 1 1/2 hours, because the dinner needed that long to cook.  

The emotional roller coaster is on the rise again.

Cancer may not be the greatest concern here. Look at that pathetic face! 

Dale has been sick with something for over 10 days now. One night-morning in the ER did nothing but confirm, yes, you aren't well. Get some rest and drink plenty of fluids. Dale coughs all day and night spitting yucky stuff. He is weak, nauseated, and miserable. He fevers occasionally and chills frequently. He reports that his joints ache and his body is in pain most of the time. The lumps on his arms and legs are returning. Depression setting in. 

The only explanation I can come up with is that Dale's immune system was not so great before bone marrow transfer, and now it is even weaker. A cold will last several months with him. This flu/cold/pink-eye??? will also last several months with him. 

The emotional roller coaster is on the rise again.