So yesterday morning the blood work came back showing improvement. Karen is no longer in danger of needing blood. In fact, all of the things they were watching in her lab work had shown improvement. She's feeling much better; she even managed to eat three breakfasts. And then a snack after lunch, a gluten free chocolate chip chocolate muffin, which she says was very good.
Her white blood cell count is still really low, but with things on the up swing and nothing much they can do for you when you have gastroenteritis, they agreed to release her. Her output has reduced greatly, but was still a concern. Part of her release includes getting the home hydration we've become comfortable with after chemotherapy. They won't send people home with an IV in their arm, but Karen's PowerPort lets us go home with IV access - they just send us the supplies and we call a home health nurse to de‑access her port when we're done.
Gastroenteritis, aka the stomach flu, can be fatal in people with weak immune systems, but it's actually very easily managed in a hospital. Some people seemed very concerned when finding out Karen was back in the hospital, but there's no better place for her to ride out a stomach bug. She was in very good hands with Mayo and we weren't worried once we'd arrived. We knew it was just a matter of time. Our biggest concerns weren't health related, but things like getting taxes done, and keeping the animals at home safe and fed.
Thursday, April 17, 2014
Wednesday, April 16, 2014
Hospital Again
So this weekend we went down to Tucson to visit family and everything went really well. However come Monday afternoon, Karen was feeling quite nauseous and stoma output was very liquidy and very fast. This is equivalent to diarrhea for people with a stoma. She was losing a lot of fluid, and on top of that, had taken different anti‑nausea medications to try to control the nausea. Usually it only takes one to calm the nausea and you can alternate them, but nothing was working and she ended up vomiting around 2 pm. And despite all the chemotherapy she's been getting, she hasn't actually puked once. We called Mayo and were told to go to ER. They take any kind of illness very serious when you're on chemotherapy.
The first doctor we talked to said it was probably a stomach bug. They continued to give Karen anti‑nausea medications but she just kept vomiting. By the time they had admitted her, she had puked 3 more times. Although technically, she hadn't been admitted, just given a room and put on "watch", which allows them to keep her for 23 hours without admitting her. They said most stomach bugs pass in 12 hours.
After being admitted her vomiting stopped, but she continued to lose fluid quickly. There was some concern this could be food poisoning. "Salsa - it's always the salsa," said one doctor. Over the next 24 hours she lost over 6 liters of fluid. They were waiting for her output to slow down before letting her go, but it never slowed down. Since we get home hydration they entertained the idea of releasing Karen with a home hydration order. They said if she were convincing, they'd let her go, but she said she didn't feel like being convincing, and would wait till everyone was happy to release her. She was officially admitted to the hospital.
By the next day Karen was looking a lot better, the nausea had passed, and all the cultures and tests had come back negative for food poisoning. Seeing as how food poisoning had been ruled out, and any other possible toxins would be flushed out by now, they started her on Imodium to slow down her output. However, her electrolytes have dropped from all the diarrhea and release was now off the table - even though Karen herself was feeling better and now felt good enough to leave. Her blood cell counts have also been falling. They're already low from the chemotherapy, so any drop makes people concerned. If the numbers continue to drop tomorrow, there's a good chance she'll be getting a blood transfusion.
We're still not sure when she'll be able to leave. Some doctors say tomorrow, but the oncology department seems to want her to stay through the weekend. Either way, she missed chemotherapy this week and there will be some additional time off from chemotherapy. Karen was actually quite excited about finishing up her last two sessions of chemo, but now it looks like there will be at least a small delay in that.
The first doctor we talked to said it was probably a stomach bug. They continued to give Karen anti‑nausea medications but she just kept vomiting. By the time they had admitted her, she had puked 3 more times. Although technically, she hadn't been admitted, just given a room and put on "watch", which allows them to keep her for 23 hours without admitting her. They said most stomach bugs pass in 12 hours.
After being admitted her vomiting stopped, but she continued to lose fluid quickly. There was some concern this could be food poisoning. "Salsa - it's always the salsa," said one doctor. Over the next 24 hours she lost over 6 liters of fluid. They were waiting for her output to slow down before letting her go, but it never slowed down. Since we get home hydration they entertained the idea of releasing Karen with a home hydration order. They said if she were convincing, they'd let her go, but she said she didn't feel like being convincing, and would wait till everyone was happy to release her. She was officially admitted to the hospital.
By the next day Karen was looking a lot better, the nausea had passed, and all the cultures and tests had come back negative for food poisoning. Seeing as how food poisoning had been ruled out, and any other possible toxins would be flushed out by now, they started her on Imodium to slow down her output. However, her electrolytes have dropped from all the diarrhea and release was now off the table - even though Karen herself was feeling better and now felt good enough to leave. Her blood cell counts have also been falling. They're already low from the chemotherapy, so any drop makes people concerned. If the numbers continue to drop tomorrow, there's a good chance she'll be getting a blood transfusion.
We're still not sure when she'll be able to leave. Some doctors say tomorrow, but the oncology department seems to want her to stay through the weekend. Either way, she missed chemotherapy this week and there will be some additional time off from chemotherapy. Karen was actually quite excited about finishing up her last two sessions of chemo, but now it looks like there will be at least a small delay in that.
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