Minor Monday Becomes Major

I didn't think Monday was going to be as important as I have now learned that it is.

I thought it would just be the last day before my stem cell transplant, and the day I got a new line. For several days, my attending physician has talked about how we were just counting down the days to transplant, and the Monday would be a little busy because we would be putting in a temporary line for the transplant. (After two infected central lines, my team has decided to avoid long-term ports for me.)

Over the last few days, the ID folks would occasionally stop by to say everything seemed fine, which also suggested a clear path to Tuesday's transplant.

I had not seen the ENT staff since Wednesday, when some ambiguous imagery on a CT scan encouraged them to take a look with some bedside tools. They could not see as far in as they would have liked, but in the absence of symptoms — pain, vision problems, fever — they also didn't too concerned. Without hearing any more from them, and with my attending's repeated description of minimal action on Monday, I thought I knew what Monday would be like.

Then, for not the first time in this round of treatment, I get a visit from anesthesiology about an upcoming sinus surgery that I am not expecting. This throws me off balance. I feel like the various teams of doctors looking after me aren't communicating with each other, because I feel like I'm getting different messages from different teams. I let various doctors and nurses know how I feel about this.

At one point, I'm wondering whether the sinus surgery can actually prevent the transplant from happening. (It cannot.) The surgery does not sound too bad — mostly a looking around — but I still dread it, for multiple reasons.

If I'm lucky, they clean out some crud left over from earlier visits, they don't find anything new and alarming, and they pack my nose full of crap for another week and a half. Transplant on Tuesday.

If I'm less lucky, everything is the same as above, except that they find more active fungal infection hiding underneath the crud, which they (again) do their best to remove. Then there's a complicated couple of weeks as the fungus tries to exploit the missing immune system, the doctors battle the fungus with medications, and the new immune system boots up after the transplant.

So, I'm not happy about my upcoming surgery. I'm not happy that it was a surprise, I'm not happy that I'm going to get my nose packed again. I'm especially not happy that my illusion that I was past worrying about the fungal infection has been broken.

But, on the other hand, it needs to happen, so I'm glad it's happening. We need to know what we're dealing with.