Catching Up

It's been a while since I wrote anything. As Inigo Montoya might say, "Let me 'splain. No, there is too much. Let me sum up."

I'm pretty well recovered from my first stem cell transplant. My blood cell counts are pretty much normal again, my blood chemistry is pretty much normal again, and I'm largely over the aftereffects of the massive dose of chemotherapy that killed my bone marrow in the first place. So what have I learned? First, I've never experienced any kind of fatigue that comes close to the fatigue you feel when your white blood cell count drops to zero. It's amazing. You can't do anything but sleep, and even sleeping wears you out. Even things as mundane as undressing and taking a shower have to be done in stages. You get undressed. You lie down for a while and rest. You take your shower. You lie down for a while and rest. You get dressed. You lie down and, spent, sleep for two hours.

It didn't help that I picked up an infection of clostridium dificile somewhere along the line, a rather unpleasant intestinal bug that requires special antibiotics to kill. The resulting diarrhea was profuse, and though I managed to drink enough fluid to stay ahead of the fluid loss, I lost so much potassium I verged into the "criticial deficiency" category - I think at its lowest, my potassium was 2.7, which is low enough that the doctors were starting to worry about cardiac problems.

The obvious solution? Hook a bag of potassium up to my central line and replenish, stat. As soon as the potassium started to go in I developed a most spectacular pain in the right side of my chest. It was as bad, and perhaps even worse, than heart attack pain. They thought I was having a heart attack; they wheeled in the portable EKG and ran some strips, and were puzzled when my EKG proved to be normal. But as soon as they stopped the drip, the pain went away. So that night I went home and tried to replace all my lost potassium by choking down potassium tablets the size of modest rodents, and the next day they tried to give me more IV potassium, this time through my old chemo port. Same result - devastating chest pain, and another night spent trying to choke down potassium tablets.

It turns out that both my central line and chemo port had failed - both had developed kinks that rendered them useless and triggered intense pain when the infusion pumps attempted to force potassium solution through them. They gave me potassium the old-fashioned way (that is, highly diluted with saline and mixed with lidocaine and infused through a vein in my arm) and eventually my potassium rose from "critical" to merely "low".

So what's the next step? I went back into the Special Procedures unit and had both of the failed lines removed and a new Hickman line installed in the right side of my chest. That was yesterday, and I still feel like I've been kicked in both sides of my chest by a large man wearing pointy-toed shoes.

But that brings us pretty much up to the present. My white blood cell count collapsed and came back up. My potassium level collapsed and came back up. My clostridium dificile infection came and (mostly) went. My old lines were ripped out and a new one installed. And as I write this, I don't feel too bad. My chest and neck are still extremely sore, and I don't have enough stamina to walk from the hospital entrance to the bone marrow transplant unit (lots of wheelchair rides for me lately). But I don't feel too bad, all things considered.

It certainly could have turned out a lot worse.