D+19 — No News Is Good News

There is nothing much to report from the last couple of days. Win!

Both mornings have started with an early morning walk, trying to beat the sun. (More on my need to have something approaching a vampire's fear of the sun in a later post.) Then breakfast, some work, a nap either before or after lunch, some more work, another nap, dinner.

Yesterday, I walked by myself. On the path around the pond in Mattis Park, as I was approaching the footbridge, I saw a hawk sitting on the railing. It kept peering down over the railing and then back at me, and it allowed me to get within 10 feet. I rued my failure to bring a camera. It finally lit out for a nearby tree. As I crossed the bridge, two squirrels bolted from under the bridge to a different tree, so I think I spoiled the hawk's breakfast plans. (Sorry, hawk!) (You're welcome, squirrels!)

Today, I walked with Jan. This is a great small pleasure, for both of us, though I do ask her to slow down occasionally. My exact words are, "Slow down, Sparky." This deprives her, she jokes, of the satisfaction of walking faster than a man recovering from treatment for leukemia. Those who know Jan know that she's usually multitasking and doing whatever she's doing at a quick pace — that's how she gets so much done. So it runs against form for her to stroll, even when we are walking somewhere in no particular hurry, and the current situation is not the first time I have tried to rein Sparky in while we're walking or when she drops something in the kitchen.

I have learned that I should take naps before they take me. Late in the afternoon yesterday, I headed upstairs to get something. Going up stairs dispels any illusion I may have that I'm back to normal. I have a muscle memory for how quickly I go upstairs, and I have had to unlearn that. First, I slowed the pace. That was not enough. Now, I climb them using the technique I learned when climbing Mt. Rainier with my dad, just out of high school — when the air gets especially thin, you take a few steps, rest; take a few step, rest.

When I got upstairs and into the bedroom, whatever my mission was got deprioritized so that I could lie down for a brief rest. That was when the nap saw its chance and ambushed me, dragging me off into Sleepytime Woods for an apparently much-needed rest.

Today, enlightened, I took a brief nap after lunch and a longer one before dinner. So take that, naps. You're not the boss of me.

Around midday today, I had a return visit from the home care nurse, to show me how to flush the lines on my Hickman Triple Lumen. She was supposed to do that on Monday, but the supplies had not been delivered. Even if they had been, the lesson would not have been conducted, because the supply order from the hospital had been incomplete. When I was back at the clinic on Monday, the nurse said she would get the full order sent down. Yesterday morning, I received a box of supplies, but they were the original incomplete order. Late in the afternoon, I received a second box of supplies, containing the full order. So I now have everything I need, and twice as much as I need when it comes to heparin and alcohol wipes. Jeff tells me the alcohol wipes are useful for getting a fire started in the woods when it's wet, so that would be useful, except that's not a situation I have found myself in very often. I can't think of any use for extra heparin that wouldn't be criminal.

Anyway, supplies on hand, I had my lesson on line flushing. Wipe the nib vigorously for 30 seconds with the swab (and then don't let it touch anything to I'm done), take the cap off the 10cc saline syringe, push out the air bubble, attach the syringe, release the line clamp, squeeze in the saline, take the cap off the 5cc Heparin syringe, squeeze out the air bubble, detach the saline syringe, attach the heparin, squeeze it in, detach it, close the line clamp. Repeat for the other two lines. To keep track of which I have done, take advantage of the three different line end colors and go in this order: red, white, blue.

At the hospital, they used a different wipe, which one nurse said was better than the alcohol wipes. Every time I straightened up my room during my stay, I had another 3 or 6 or 8 of these stronger wipes lying around, which I stored in a plastic bag, which came home with me. So I have a good supply of them, although they are so good at cleaning that you need to wear gloves, which I don't have yet. Maybe I'll snag some on my next trip up.

As I push the plunger on the syringe, I can't help picturing a junkie, since that's the only image I have of people using a syringe. I have to do this every other day for at least a couple more weeks, so I'm sure I'll come to feel less like a junkie over time.

Fantastic dinner tonight, courtesy of our friend Mary, with a big assist from her dad on the roast beef. I had had the exact same combination once in the hospital: roast beef, mashed potatoes, gravy, broccoli, brownie. It was one of the better meal options there, but tonight's was a completely different experience, and only slightly because I was sitting at my own dining table. Flavorful roast beef, real mashed potatoes, a gravy that you had to mix because it separated, chewy brownies... Mmmmm....

= = =

Update (translation: I forgot something): Tuesday morning, I received a call from my doctor. "I need to talk to you about your Prograf levels." Hmm. Could be minor, such as I need to take a little more or a little less. Or, something else...

I get to see (hear) the medical sleuth at work.

"Are you sure you did not take you Prograf yesterday morning before coming to the clinic?" I am as certain as I can be, although that's only about 90% certain, since my short-term memory isn't great. The doctor says it's chemo brain -- let's go with that.

"Where did you have your blood drawn?" There are two choices on my clinic's floor if you are having blood drawn. I had been directed to the apheresis lab, which I'm guessing is the more sophisticated of the two, and that is where I had gone.

"How did they draw your blood?" From one of my lines.
"For all of the blood?" Yes.

Eureka! (She didn't say that.) Prograf levels cannot be tested in blood drawn through the line — something about Prograf sticking to or being absorbed by the line over time and then being released from the line when you draw blood through it, greatly inflating the result. My doctor is not happy that the lab tech did not draw my blood correctly, but relieved that I'm not in danger. If I truly had the level reported by the test, my doctor tells me, I would be in kidney failure. Since I'm feeling well, and had my Prograf level tested shortly before discharge, she feels comfortable waiting until my Monday appointment.