1st hospital stay

Well, my complaints about mild boredom were answered by the universe with an overnight stay for observation at the hospital! Since this is my first time being admitted overnight in my life, I guess it qualifies on the "unchosen adventure" side of things.  As I'd said, I was waiting to see if I was going to need another blood transfusion, and feeling like it was likely. Thursday I swam for about 35 minutes in the morning, but by afternoon I was feeling like I was starting to crash. This could still have been an after-effect of the steroids they give me the day of the chemo (Tues). But Friday and Saturday I was feeling the same light-headedness upon exertion that, after the previous carboplatin/taxol combo treatment, had gradually gotten worse until I needed a wheelchair to get from the car to the chemo infusion room the next week, and received 2 units of blood. 

To give you a sense of the symptoms, this past Saturday I went down to my ceramics studio for the first time in a few weeks, and FINALLY glazed a piece that I made about 6 or 7 years ago -- it's so lovely I've been looking for the right glazing technique for it all this time. As you can see from the picture, the piece has a part that overhangs, and I was squatting down a few times to glaze it from underneath rather than turning it upside-down. By the time I got done, I was exhausted, and disappointed that meant I wasn't going to get to go swimming (I'd hoped for a lake swim that day -- I've been swimming in the pool but when the weather is perfect and I have energy, swimming in the lake, which medical folks assure me is safe enough). 

I didn't sleep very well Saturday night, feeling physically weird and anxious about whether to go in for a transfusion on Sunday. My oncologist and other medical staff had repeatedly told me it was fine to go through ER on the weekend if I felt like I needed a transfusion then. Sunday morning I meditated for a while and used some techniques I've learned from Robert Gass and Judith Ansara Gass to check my intuition or "inner knowing" about whether to seek a transfusion. I kept asking "should I" and “is it in my best interests to” questions, and getting indeterminate answers. Finally I realized it was a choice, not a "should" -- that I could choose whether to go in or not. It felt like a choice between spending a few hours in the ER on Sunday to get the transfusion, and then likely feeling better, vs. feeling increasingly weak for a couple more days and spending longer at the clinic to get the transfusion after chemo on Tuesday. Why wouldn’t I opt for a couple more days feeling better, if I could?

The clearest “answer” I’d gotten from my inner knowing practice was a “yes” to calling the oncologist on call to consult about the decision, and hopefully to get more information about what the procedure would be like if I did it through the ER. The doctor advised me to go in and get a full blood panel done, not just a hemoglobin test, in order to check to make sure there was nothing else going on like an infection that was causing my weakness. She also checked and said there were “only” 24 people in ER at that point, and all of them already in beds, so it wouldn’t be much of a wait if I went in then.

So, Don and I arrived around 10:30 Sunday am at UW ER. After a longer-than expected wait in a nearly-empty waiting room (during which time I found a reclining chair, because sitting up straight made me feel a little light-headed), they took us directly into a room rather than through triage (somehow we’d gotten lost in the system and the triage nurse, not being busy and seeing us waiting, had figured out what was going on). They did an EKG (normal) and drew blood. Somewhere along the way they began telling us that in order to receive a transfusion via ER, I would have to be admitted to the hospital and stay overnight for observation –which we found outrageous and very annoying, given that the oncologists had made it sound like no big deal to do it via ER, and I certainly wouldn’t have “chosen” to go to the ER that morning if I’d thought I’d need to stay overnight just for the transfusion. We figured if they insisted on this, I would just refuse the transfusion and go home – the worst of both worlds, I felt, having to spend half the day in ER and still not feeling better afterwards.

However, my hemoglobin, surprisingly, was not as low as I’d expected – 9.1, not grounds for transfusion in their book. Seeking other explanations, and due to the fact that I confessed to occasional chest pain, they did a second EKG (still normal), a chest x-ray, and tested my troponin levels and found them high, a possible indicator of heart attack! So, they didn’t give me a blood transfusion, and admitted me to the hospital for overnight observation, including a heart telemetry monitor. This was a little scary for a while, until we learned that both anemia and recent blood transfusion can cause troponin levels to be elevated.

(We did talk to one of the supervising nurses about the policy on transfusion via ER; she explained that it wasn’t actually a hard & fast rule, but that it was a policy designed to discourage people from using the ER as the weekend option while the infusion center is closed – which is exactly how my oncologists were treating it!!)

I am writing this from the hospital bed now. I actually slept reasonably well, managing to fall asleep again after multiple interruptions (yay lorazepam). I also find the food here to be quite edible (gluten-free blueberry pancakes for breakfast!). I’ve had phone calls, visitors (more are welcome!) and plenty of entertainment options (explored the TV but gave it up in favor of the iPhone & iPad). My chest x-ray and heart telemetry results were all normal, and the troponin levels aren’t rising and are arguably going down a little (though my guess is they are still within the margin of error of the tests). They also thought I was a bit dehydrated coming in, and have been giving me fluids in hopes that might help. They keep checking whether I still feel light-headed or not. Since even at its worst I didn’t feel the symptoms while lying in bed, I took it upon myself to get up before breakfast and take a walk.

With the nursing assistant’s help I found a lovely outdoor patio area (see picture) and walked around, and actually did a few squats – a normal part of my workout routine. Sure enough, after 8 squats, a short rest, and then another 10, I was feeling light-headed and headachy again. While my hemoglobin is still technically higher than where they recommend transfusion, people apparently have their own set-points, and my hemoglobin was fairly high before chemo. So, after discussing this with the wonderful oncologist (Justine Tang Bruce) and nurse practitioner during rounds (with two students looking on, the two of them simultaneously listened to my chest, each with their own stethoscope! How’s that for teamwork?), I am now about to (finally) get a blood transfusion and (hopefully) be discharged later today!  (Their goal is to discharge me today because if not, it will interfere with me getting chemo tomorrow – apparently our lovely insurance-driven health care system considers it “double-dipping” for someone to be released from the hospital and treated at a clinic on the same day – and they’re not allowed to give me the chemo on an inpatient basis. Sounds kinda screwy to me but I’ll be happy to go home tonight!!)