Day + 3368 “Twas Pirelli’s Miracle elixir”

Feb 19th, 2020 by

“That’s what did the trick, sir
True, sir, true
Was it quick, sir?
Did it in a tick, sir
Just like an elixir ought to do
How about a bottle, mister?
Only costs a penny, guaranteed”

Greetings 2020, Can I see clearly now? Well, maybe not, but an update is a little overdue.

Karen is well, life moves along on its own pace. This year’s Super Bowl was not watched in the ER as a year ago, nor did we spend Valentine’s day in the ICU watching shock trauma choppers land on the roof next door as in 2010. All in all a wonderful new normal life. Well, those pesky annoyances post transplant as attributed to chronic Graft versus Host Disease (GvHD) do pop up at the most inconvenient times – yesterday, today, and tomorrow. However, as stated, life is good!

Early last year Karen’s blood pressure started acting up, and through a few visits to the Hopkin’s resident clinic, our lab rat, to her great disappointment, was put on a minimal dose of HCT. She can update y’all on the slew of regular and routine appointments.

“I’m dialing up 911
I’m on the brink of trouble again,
If you could change the time, a little,
Then everything would
fine, fine, fine.”

So, post transplant, Karen has been dealing with muscle spasms and cramping. Mostly, it is an inconvenient spasm, such as in the hand which then looks like one of those road signs in the middle of nowhere pointing haphazardly in all direction. Nome: 3211 miles that way, Seattle: 1400 miles 90 degrees out, Tokyo: 4 months 3 days swimming on the opposite, DC: 90 miles sorta south, and Baltimore: well, just straight down. You get the picture. Unlike us males, cramps are also nothing new to women; hence, let me supply an updated definition:

Hmm, 1) Cramps, like muscles knotting and the arms not really working. Yup, you had those too?
2) Cramps and spasms so that you can watch the pretzel reform itself repeatedly while trying to elevate and depress the bed to some position for sleep. Old hat you say, just drive on – well, ok.
3) Spasm shooting up both sides, inability to walk, labored breathing… feeling like being drawn and pulled apart by horses with no one crying mercy to put one out of her misery.

Well, if you had those too, then you bloody well wound up in the ER like Karen despite assurances by her of “I’ll be fine, fine, fine,” and fears that the doctor on duty also moonlights as a barber on Fleet Street. (The escalation of pain meds and muscle relaxants during this buildup was omitted so as not to cloud dramatic effect – or they didn’t do a damn thing.)

Bloodwork, IV, observation…slightly low sodium? Hey, she’s ok again. I mean fucking really?!? Sorry, forgot to bleep that.

“Oh, baby, baby, it’s a wild world
It’s hard to get by just upon a smile
Oh, baby, baby, it’s a wild world
I’ll always remember you like a child, girl”

So, Karen had this idea to try adding Pedialyte to her daily routine. Ok, 9 parts salty tasting crap and 1 part cranberry juice – result palatable? (Yes, it does come in obnoxious flavors for the brave). Wow, significant decrease in all the spasms and cramps. Of course the blood pressure meds and Pedialyte don’t complement each other, and Karen did another couple rounds with the Residents Clinic to get the meds changed.

The part in all of this that really strikes home and is continually the most frustrating is simply the lack of aftercare for post transplant patients. The journey continues, and there is just a lot of hit and miss in post transplant care. After all, the miraculous and statistical five year mark – you are cured; well years ago so… YES! Grateful to be alive, but are there so few that gathering the lessons are not considered valuable? Well, that may that is just the problem – not a horrible markup to be had on measured salt and sugar water. (Not important – but discovery learning: Pedialyte does screw with a low carb diet).

So, looking forward….

Thank you!

First and Foremost to Mary Lou … the gift of life, doesn’t get better then that.

The doctors, nurses, technicians, clerks, general staff, et al that make the medical profession move forward, step by step…and yes, it is Tuesday every day.

The fellow travelers and your families – share the lessons, trials, and tribulations.

Finally to Karen, Mausi the lab rat. 97 – 35 love.

Finally, thank you for enduring the excerpts from the diary of just another mad man.
As normal, for fun ..three sets of song lyrics embedded above.

20:20 …far sooner than the mind attempts to plan a cloudy future, the past will be Picasso clear.

Michael

Day +3287: And all I ever needed was the one…

Nov 30th, 2019 by

“Like freedom fields where wild horses run
When stars collide like you and I
No shadows block the sun
You’re all I’ve ever needed
Babe, you’re the one…”

11/30/2019 I cannot let this rebirthday end without many thanks to my DNA sister, Mary Lou, for whom I’m enormously grateful every day. Without the precious gift of her healthy bone marrow 9 years ago, I would not be alive today. Now and always, she’s literally a part of me.

Much love, Karen

Day +2996: I know all there is to know about waiting…

Feb 12th, 2019 by

“Never mind a quick disintegration
Wind will carry you just like a leaf
Like a guide that’s broken captive from a string
So much to remember when the day ends
So much to forget when you’re afraid
After all the troubles and the breakage
I know all there is to know about waiting
Waiting, waiting, waiting….”

2/12/2019: Last week’s biopsy went smoothly – 5:30am arrival, 7:30am procedure, home by 11am, comfortably medicated and with instructions that included soft diet for two weeks. According to Michael, my surgeon was very happy afterwards. She thought everything looked good although there was a “mysterious blood spot” so she took an extra sample. And then, as usual, we waited…trying to remain optimistic for that difficult space in between biopsy and results.

Happily, we didn’t have to wait too long, just six days. Better still, all results are benign:

INTERPRETATION AND DIAGNOSIS: (lmr) 02/07/2019 @ 07:37 pm
1. RIGHT BASE OF TONGUE (BIOPSY): BENIGN SQUAMOUS MUCOSA WITH NECROTIZING SIALOMETAPLASIA AND FIBROSIS.

Since we had no clue what this meant beyond that all important word BENIGN, some quick research revealed:

Necrotizing sialometaplasia (NS) is a rare benign, ulcerative lesion, usually located towards the back of the hard palate. It is thought to be caused by ischemic necrosis (death of tissue due to lack of blood supply) of minor salivary glands in response to trauma. Often painless, the condition is self-limiting and should heal in 6–10 weeks. It occurs more often in men in the fourth decade of life. Although entirely benign and requiring no treatment, due to its similar appearance to oral cancer, it is sometimes misdiagnosed as malignant. Therefore, it is considered an important condition, despite its rarity.

We had a good laugh as soon as we saw RARE – yep, I’m still the outlier. We strongly suspect a connection with ongoing GvHD.

I close with another tagline, dedicated to Michael who has undoubtedly suffered way more than I have through this recent branch in our continuing journey.

“You’re the meaning in my life
You’re the inspiration
Wanna have you near me
I wanna have you hear me saying
No one needs you more
Than I need you…”

Love to all,
Karen

p.s. Next post will be tag line identification for this and several previous posts. Get your guesses in now.

Day +2988: The odds get even – you name the game…

Feb 4th, 2019 by

“The odds get even – the stakes are the same…
You bet your life…”

3408B96A-A33D-4468-8410-18EC41EB6943
If one were watching the documentary of life, this Episode is narrated by Marlin Perkins:

‘Here we see Jim wrestling with the lion, Maya, so that she could be safely relocated to the game preserve. Ouch! Those claws are sharp! Poor Jim! He quickly pulls one the three syringes of tranquilizer and expertly aims. Jim[Karen] injects the tranquilizer[antibiotic] in the jaws of the wily beast [Persian] Maya. She escapes and bounds across the savanna of the living room and launches behind the recliner! Ouch! Karen? Ouch?’

This existential moment of feline care is rudely interrupted by Fate and another toss of the dice.  Cut to commercial.

‘Budweiser not only makes great beer but also great Superbowl commercials.’

[Commentator] ‘One of those may be correct.’

Change channel – Cool, an episode of ER on at 3:00 PM

Karen and Michael are driving down 95 towards Baltimore.
Karen looks calm enjoying the sunshine – Sunday traffic is very light.
They turn left to park in the garage across the street and head to the 4th floor walkway over Orleans Street.
Karen stops midway and takes a couple of pictures of the hospital and traffic below.
The admissions clerk is friendly and polite, the process goes smoothly. All of the records are there already; within moments, it is on to triage.

‘What brings you in today?’
Karen with a smile: ‘High spiking blood pressure, dizziness.’

[Nurse for BP, Bloodwork, EKG, CT scan….second review with PA, back out front to the general waiting area.]

< Cut to Super Bowl Pre-game show >
< Cut to ER waiting room: daytime drama – the People Watching Show >
< Cut to National Anthem >
< Cut to three hour vital signs check >
< Cut to ER waiting room: nighttime drama – the People Watching Show Season II >
< Cut to Super Bowl halftime show overlaid with People watching Show Reruns and two identical sound tracks with a 2.5 second delay betw..betwee…between them >
< Cut to the starving wife/patient – brought to you by Subway roast beef sandwiches for your emergency needs >
< Cut to Michael wolfing down a pepperoni pizza in the main hospital >

‘Karen give me that remote / call button.’

< Room 29. 9 PM. Gown, socks, heart monitor – check. >
< Room 29. 9:30 PM. Vitals … 192 over 94. >
< Room 29. Buzz nurse. ( Ok audience, you go to the bathroom with a heart monitor! )>
< Room 29. Chair and pillow acquired!>
< Room 29. Episode 2. The exam! >
< Here we see the intense young resident doctor, Nick, asking probing questions about Karen’s medical history, recounting the current episode, and trying to be unobtrusive about checking for signs of stroke.>
< Karen politely counters with a few select questions about BPs, causes, symptoms, blood clots, and other coffee room chatter, and a good time is had by all.>
Nick states the asymptomatic nature of high blood pressure except in extremely rare cases cancer of the adrenal gland that may manifest in a high BP. ‘Highly unlikely.’
< Cut to hysterical laughter from Michael and a short discussion of the curse of Mausi’s (Karen’s) Medical Mathematical Mayhem >
< Nick would like to do work in the international community and has a keen interest in music, and stroke and heart attack are ruled out.>
< Cut to Super Bowl victory celebration >
‘Ok, ready to go back to the bathroom, yup I unplugged the monitor wait I need to take the saline too! ‘
< 00:30 AM BP 146/72 … cool >
< Room 29. Episode 3. The exam! Supervising Doctor (Play episode 1 for details) >
‘Did you get his picture?’
‘Nope, busy playing Legendary’
< Room 29. Episode 4. The underachiever exam >
‘So a critical point for your age is a BP of 150 over 90; however, we would not force a decrease in blood pressure unless there were signs of major organ damage.’
‘I’ll provide you a referral and then we will see if we can get you out of here.’
Karen asks if Michael got her picture.
‘Yes’
< Cut to a very somber Dr. Nick >
Nick asks ‘What did they tell you?’ Karen looks alarmed. ‘What do you mean…’
‘I mean it is all good news’

< Cut to the wild Maya >
Maya is picking at her food, but eating.

Karen is exhausted … the Hopkins protocol for treating patients with neurological symptoms is a nine hour phased approach with EKG/Vitals/Blood collection at the three hour marks.
We are home after an 11 hour dance at the ER.

< Cut …Hey the Twilight Zone is on 6 February >

Here is the preview:

< Rod Serling announces the recap of our last episode of  “You get all of this and new normal, too.”

< Recap of last month’s spine tingling highlights >

< Last Month: John Hopkins Outpatient Center, 6th Floor >
Christine manipulating the scope in Karen’s nose to highlight the area of the small ulcer, explaining to Michael that it is probably caused by her viral URI or reflux and nothing to worry about.
Christine and Karen chat about the ragdolls, and ‘if it still bothers you in a month, come back’

< Last Week: Tuesday, John Hopkins Outpatient Center, 6th Floor>
Young resident inquires ‘is it better’
‘No, but it is different.’
‘So it is worse.’
‘No, just different.’
‘But is it better or worse?’
‘Neither, just different.’
Christine zooms in on the right side near the base of tongue after Karen explained about nerve pain and general soreness originating from that area.
‘Looks a little enlarged’
Speaking matter of factly – ‘doesn’t look like cancer’
< Karen and Christine chat a bit and the path is determined: Schedule an MRI. >
On the way out, ‘For good measure, let’s do a biopsy under sedation…’

< Wednesday, Phototherapy as usual, with intermittent scheduling calls >

< 11 PM Friday, MRI finished, Pre-op done, Time for the Weekend and a little relaxation!>

< This ends this broadcast >

Everything is routine; the worry and fears are quick to jump out ahead of any confirmations. The hard part is not getting a diagnosis…diagnoses come with plans. The waiting and not knowing is the hardest.

In the meantime, day at a time, moment at a time.

Karen and the cat crew are relaxing at home.

Sidenote: Karen and I joke about some of our medical staff being underachievers, meaning they are top performers in their field, and perfection seems to come easily.

~Michael

This ER visit was in sharp contrast to Day +1806 at Upper Chesapeake. Everyone at Johns Hopkins was incredibly kind and sympathetic, professional but friendly, and extremely thorough.

p.s. Maya is very easy to medicate, never fights it and is too old and slow to get away.

“Anarchist reactionary running dog revisionist
Hindu muslim catholic creation / evolutionist
Rational romantic mystic cynical idealist
Minimal expressionist post-modern neo-symbolist
Arm chair rocket scientist graffiti existentialist
Deconstruction primitive performance photo realist
Be-bop or a one drop or a hip hop lite pop metallist
Gold adult contemporary urban country capitalist…”

~Karen

Day +2939: You and me…

Dec 17th, 2018 by

December 17, 2018: Feeling especially happy and grateful today. This is one of my favorite scenes and songs from my favorite movie with three of my favorite actors. It makes me think of two of my favorite people in my real life. Can you identify all of these?