Saturday, June 20, 2015

Life Changes VIII: OK, That Was Uncalled For

And then just like that, I had a week and half ripped out of my life.

On Wednesday, June 10, I began what had become my daily routine normally enough.  I went to the Banner-University of Arizona Radiation Center for my daily dose of radiotherapy, then headed to the Arizona Cancer Center for what was supposed to be the last of my current round of chemo infusions.  On the way to the second stop, a pain flared in my belly.  At first it presented itself as a mild cramp, the kind you might get before needing to go the bathroom.  But a trip to the bathroom did not resolve it.  Within moments, the pain in my abdomen was more than I could bear.  I kissed off the infusion session and announced that I was going back to the Radiology Center to see if I needed a trip to the emergency room.

By the time I arrived, that issue was no longer in question.  The pain had flared to a point where it was the most horrible I’d ever experienced—and I’ve had two rounds of kidney stones, so that is saying something.  I could barely breathe.  My immediate goal was pain control.  It took what seemed like hours to get me into the ER, but really it wasn’t; the team expedited my case.  Finally an IV had been set up and they administered a shot of morphine; it just bounced off.  By now I was hurting so badly that my heart was racing and I was having a hard time keeping my breath.   A follow-up IV shot of Dilaudid did the trick; the pain receded enough for me to have meaningful conversations with the medical team.

But now another problem presented itself.  I began shaking like a like in a leaf in gale.  My blood pressure began to crash.  It was apparent that the Dilaudid was not helping the latter, so the doctors ordered all pain meds cut off.  The agony returned full force and now I had to face it without any pharmaceuticals whatsoever.  “Ten on  a scale of ten” doesn’t begin to describe it.  It felt like something had exploded in my gut.

The medical team suspected acute septicemia, which is a  known complication of the type of cancer treatment I was receiving.  They began administering their protocols for that.  I don’t know what all those protocols are but the team does have a regimented approach and they save a lot more lives, I’m told, through these procedures than they used to before having established them.  One tactic included immediate flushing of the body with strong antibiotics.   At this point I began drifting in and out of consciousness, but every time I woke up I saw that more and more people seemed to be hovering around looking concerned.  I learned later that my blood pressure sank to the low 40s over the low 30s—a state that is not compatible with life.  Sometime during this ordeal doctors found time to install a central line and also an arterial line, which is necessary for administration of the specific type of blood pressure medications needed to pull my butt out of the fire.  Sometime during this period a urinary catheter also went in.  And finally, at long last, the situation stabilized enough to where a doctor authorized the resumption of Dilaudid.  My pain, at last, began to recede and come under permanent control.

Blood cultures confirmed that I had a bacterium growing in my blood stream.  Interestingly, no fever ever presented itself.  But something bad had taken root in my gut and finally had managed to transfer itself to my blood.  The flow of antibiotics increased.  Meanwhile, a CT scan, MRI and ultrasound investigation probed my condition further.  It was learned through this that there were, thank God, no perforations in my gut, which had been a real possibility.  Parenthetically, the MRI was a trip.  The sound effects were something like being held hostage inside a pinball machine, and it went on for what seemed like hours but really was only 45 minutes.

At the low point of all this I was left so weak that I literally could not lift my head.  When they transferred me to the ICU, they had to do a full lift to get me into the bed.  For a short time I couldn’t do so much as turn my head to look at the clock.  During this time the biggest pain I faced from was from the compression of my flesh on the bed, a problem that mounts up when you are  unable to switch positions or rearrange your weight!  The nurses did try to do something about this, adjusting my weight themselves, but I found that unless I was aligned just exactly right then the pain from my belly and the cancer in my side began to reassert themselves.

After two days in ICU I wound up in a room on the oncology ward.  During this time I was not eating and my bowels were mostly not moving.  But my vital signs continued to improve and little by little I did begin to eat again, although not enough to sustain a bird, really.  Day by day the tenderness in my belly receded, and they transitioned me out of pain management by IV to an oral dose of Dilaudid every four hours.  I’m in the process of trying to reduce that further.  The pain from the inflammation is mostly gone now but pain from the cancer itself is still there and has to be contended with.  So far I’m finding a dose to be still necessary if I am to sleep.

Two days ago they set me free and sent me home, still on the catheter, and now facing a program of home infusion for the antibiotics.   My wife and I received courses on how to do that from some very knowledgeable health technicians.  I’ll be honest and say that I’m not sure about this whole home infusion thing.  My wife, whose mechanical inclination rates at or below zero, still has troubles programming the TV set, and now suddenly she’s supposed to be acting as a highly trained medical worker?  This stuff is very complicated and if not done right the consequences could be severe.  But it’s expected in today’s cost-conscious medical environment.  So, four times a day I take 90 minutes and Deborah and I set up and administer the infusion. 

I am finding—just now, by way of experimenting with this blog entry—that my pain is sufficiently controlled and I have enough stamina to be able to sit at the keyboard for at least short stretches of time.  I have not had time, nor the energy, to return the many kind phone messages that have been left for me; this blog entry is my effort to reach out to everyone efficiently.  Trust me when I say that all the feedback has been wonderful and continues to delight me in unexpected ways.  We even had one fan from the radio station drop by early in the ordeal, and that took some doing because Deborah had not publicly revealed my whereabouts because of the isolation protocols I was under.  But I got to wave at her through a window and was very touched.

It doesn’t seem like the timing could have been worse, but actually it could have.  At least I had gotten my last novel, The Dark, out there.  I’ve been so out of it I haven’t actually had a chance to see if anyone has bought a copy although I know some have.  Nor did I get the opportunity to spend more than a day on marketing on it, and looks like my efforts in that arena will be curtailed for a while longer as my energy levels slowly recover.  So the best I can say along those lines is, please check out my page and consider buying a copy.  I think it’s my best yet, and the previous novel got excellent reviews.  If you do buy a copy and do like it, you could do me no greater favor than to go on that Amazon page and post a good review.  That is how struggling authors like myself get known.

What is next for me medically?  To be honest, right now I’m just in daily survival mode, trying to plant one footstep in front of the other and get through each day with body and soul still attached.  It’s been a shock to me to learn how quickly your life can fall into jeopardy, and that Wednesday night in the ER was a very close thing.  My oncologist told me that if I’d decided to go home and try to tough it out rather than to present myself immediately for treatment—well, let's just say that any delay would have been a very bad idea.  Even with seeking immediate treatment they damned near lost me.  But I don’t claim to be any smarter than anyone else; just less tough.  My goal that night was pain management, not survival—that’s how bad the pain was.

When we began the radiation and chemo a month ago, this certainly was not where I’d hoped to find myself at this point down the road.  But the good news is that all  my organs are intact and relatively undamaged.  If I continue to recover, then we’ll be able to assess options.

My spirits remain high.  You can do your part to keep me in good cheer by buying one or more of my books, especially the new one.   Meanwhile, I have many unanswered Facebook messages  and emails to wade through.  Many thanks to those who’ve reached out to me.  Thank you for your patience.  This may take a while.


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