Wednesday, July 18, 2007

July 17 2007

I went to the gym for the first time today. It felt so good to do a workout.

June 18, 2007

Dr. Brodsky switched me to the anti-biotic Dapsone to take Monday, Wednesday and Friday for 2 months instead of Bactrim. I tried my first dose and did not have any side effects. Also, I called to schedule my 3 month follow-up with Dr. Kerr for late September. Dr. Hammond will mail me the list of follow-up tests to do locally and the long term protocol follow-up schedule so I'll know what to plan for. Also (as an FYI for future patients), I did not lose 100% of the hair on my head maybe because I had very thick hair to start with. As a result, I can do a Donald-style comb-over and have little bangs to show under a hat. Plus I have a bit of hair in front of my ears and the lowest part behind my head, and with a hat, I can be more comfortable without a wig. So, the free hair buzz (to baldness) that is offered at the Image Recovery Center may not be so helpful in the long run. My lint roller kept up with the very quick hair loss that only lasted 5 days.

I got a delivery of hats and a gorgeous wig from the American Cancer Society's TLC Catalog. The wig is better looking than my original hair was and it doesn't frizz in the summer heat.

Sunday, June 24, 2007

June 17, 2007

I'm feeling a little stronger today. After getting up at 8 am, I felt good enough to do more organizing of my kitchen and family room. It is so nice to feel that my home is back under control again. The boys went up to the cottage in Maine to get it opened for the season. Jessica stayed home to keep me company, since I didn't feel ready for a weekend away (my first weekend after finishing my protocol). In the afternoon (after a long break reading a magazine), I felt good enough to do yoga stretches and some of the exercises that the hospital Physical Therapist taught me. I used 5 lb weights to work on my biceps and triceps, plus I did balance exercises that focused on strengthening the calf and thigh muscles. More good news: my stomach and intestines are back to normal. I enjoyed pizza for lunch with Jess. I did have to make a call to the IPOP today because I developed a rash last night after my first dose of Bactrim. The doctor (available whose name I don't remember) said it sounded like a reaction to the drug and not to take today's dose, but to use Benedryl if it got too itchy. He also said to check in with Dr. Brodsky to see what he'd like me to switch to. So, I left him a message. It is about 90 degrees outside, so I'm blasting the air conditioning and taking it easy for the rest of the day.

Friday, June 15, 2007

Thursday, June 14, 2007

Now, I'm back home hanging out with my dog, Teddy. I slept late, then we went downstairs to survey the "tornado" that hit while I was gone. After tossing out some of the junk mail and organizing some of the mess, I realized how exhausted I really am and that I need to take my time recouperating and resting.



The thing that really seems to be slowing down my recovery is the continuation of the major stomach and intestinal cramps. Unfortunately, the severity of the intestinal distress is due to the combination of the HiCy, IV antibiotics given during the rehospitalization for 6 days of fever of unknown origin and the MISTAKE where the MD intern gave me a magnesium citrate drink before starting the Zocyn and Vancomycin to cover anything that might be causing the fever. As I mentioned in earlier posts, my fever was not tied to anything except the classic neutropenic state and as the Infectious Disease doctors speculated, possibly induced by the necessary growth factor injection of neupogen (started on the day I first developed a fever). The lesson that I learned the "hard way" is that just because a doctor is in a white lab coat (with his name followed by MD), it doesn't mean that he has much knowledge or experience with this specialized HiCy protocol.



A nurse with lots of HiCy experience (that worked day 3-5 of my 6 day hospital stay) told me that the magnesium citrate should never have been given to me. I unfortunately was re-admitted on a Saturday, which is as bad as being admitted at night, because the staffing is severely limited and in my case, the nurses and MDs seemed to know less about the HiCy protocol than me. Also when I would buzz the night nurse to ask for even just a glass of water, it would often take them up to an hour to show up.



This should change over time as Dr. Brodsky takes over more beds on the fourth floor and uses more of his HiCy trained nurses for weekday, weekend and nightly coverage. My advice to anyone who goes through this protocol is to always have a close friend or family member with you (in and out of the hospital). They can even get you a drink. When you go for the IPOP visits, the nurses are well qualified, so in general, you can trust their judgement and decisions. But, in the hospital you must not be intimidated by MDs or any staff. Also, it's ok to ask how much experience they have with the HiCy protocol. It can't hurt to have someone you trust "google" the drug or treatment (you will get during a rehospitalization to check whether the doctor actually made a good choice). "Hindsight is 20/20". Had I known the magnesium citrate would dramatically increase the intestinal damage (already slated to begin from the HiCy and IV antibiotics), I would have refused to drink it. Another FYI, that I learned (from the rehospitalization experience) is that the lowest level MD, with the least amount of experience/closest to graduation from medical school is the MD that the higher level doctors let make the decisions (maybe to help them to learn from their mistakes) including ordering meds and doing discharge orders. An example of how alert you (and your caregiver) must be is checking discharge orders. When I was discharged with severe intestinal cramps (and diarrhea), my discharge orders included prescriptions for two laxatives. That seemed incredibly negligent to me (and made me question, the safety and intelligence of anything else on the discharge orders) and it made me wonder why the higher level attending physicians didn't catch that or the magnesium citrate.



The bottom line is that the HiCy protocol has been shown to be an amazing, life improving treatment, like no other available. It's just that a patient has to be completely knowledgable about everything that is supposed to happen for whatever scenario may occur.

Wednesday - June 13, 2007

Today was an exciting day. At approximately 8:15am, I went to the IPOP to have blood drawn and was given IV fluids (due to an increased heart rate). Then Dr. Brodsky came by to see me to check how I was doing, watch me walk and check my balance. He gave me a big hug, too. I like the way he seemed so proud of me for finishing.



Next Marilyn and I went to the lab where my central line was removed. The removal was quite different from the placement, because I was awake the whole time (with 2 numbing injections). The PA's who removed my line were so comforting and wonderful, so it only hurt while the 2 needles for numbing were used. During the process, I agreed to have them cut enough to remove all of the line parts - to leave nothing behind. I didn't want the piece that held the catheter in place left in my body.



I was told that I could shower and change the bandage the next day. After a quick lunch, Marilyn and I went to the Outpatient Center to see Dr. Kerr. Dr. Edward Hammond stopped by (since he has been helping me from day one). Marilyn took our picture together and he gave me a list of what blood tests to have done each month until my first follow up appointment 3 months from nowand a proud hug. Also, Dr. Kerr came by to answer questions about my medications and the HiCy recovery process. He said if I had any questions or concerns after returning home that I should feel free to email him or call him. It feels great knowing that he will continue to follow me along and be there for me for whatever I need. He gave me a big hug and was happy to let Marilyn take our picture together. I can't imagine having any better doctors for this than Drs. Kerr and Brodsky. They are the absolute best in every way.



I'm so happy about going home to see my family and my dog, Teddy. Jessica is changing her plans after school tomorrow, just to be with me! I know my being away has been hard on everyone, especially Jess. During one of her weekend visits to Baltimore when she saw how much hair I had lost, she cried because I think she felt so sorry for me (since the hair loss made me look so ill). For now, I plan to always wear a hat or a wig so I look healthier, until the hair grows back.

Tuesday, June 12, 2007

June 12, 2007

I am scheduled to have my central line removed on Wednesday, June 13th. I've been in this protocol for three weeks but it feels more like 3 years.

Wednesday at 8 am I'm supposed to report to the IPOP for pre-op tests. Then at 10 am, I am scheduled for the central line to be removed. At 12 noon, I'm scheduled to see Dr. Kerr and hopefully Dr. Hammond too. Well need to go over future plans for follow-up as well as medication adjustments. Marilyn and I are scheduled to fly back together Wednesday evening. When I return home, Doctor"s orders are for at least one month for recuperation (lots of rest) in order to get stronger.

I was given permission to have my first outing away from the hotel and hospital tonight. So Marilyn and I went to Phillips on the inner harbor outdoors. It felt surreal, almost like a dream, to be acting like a "normal" person in the real world.

I feel like I've been away forever.

June 11, 2007

My white blood cell count, platelets, h/h are in the normal range! Dr. Brodsky came by the IPOP to see me to say that I was all set to plan for a discharge from the protocol. Through a waterfall of tears, I thanked him for everything he's done for me. I could barely get the words out (I was so emotional) but I wanted him to know how grateful I was to have had him put me through the protocol. Through the tears, I tried to say that I couldn't possibly thank him enough for giving me new hope for a different future than I was heading towards before this treatment.

Right after he left the IPOP, Kathy (the woman who went through the protocall three years ago) called to check in. Again, she was so inspiring and reassuring. It was so encouraging to hear how much our cases/symptoms were similar before the protocol and how wonderfully she's doing now. Kathy said to check in with her after I get into the recuperating phase at home.