Dispatches from TransplantLand: Day +10 (There Are No Weekends in TransplantLand)

Today is Saturday, but the routine is the same as it has been every day since day +2. Last Monday was a national holiday, Labor Day, but even that day we had to go to the clinic for daily blood tests. Every morning we get up, have breakfast, and drive the twelve or so minutes to the Adult Bone Marrow Transplant Clinic. A nurse takes down Beth's weight, records her vital signs, and takes vials of blood from the catheter implanted in her chest. Then begins the wait for the lab results to come back. It's usually between an hour and an hour and a half.

Sometimes I wait at the clinic; more often I use the time to run errands and/or swim laps at the apartment complex pool. The pool is fairly short, so I have to do a lot more back-and-forth than at the pool near my home. Rather than try to figure out some sort of conversion factor, I just set my water-resistant watch timer for thirty minutes and keep going until it beeps. Turns out the distance is somewhere in the vicinity of 48 lengths, although it varies from day to day, depending on how tired I am. I started my lap-swimming on day 0 and have put in my thirty minutes every single day since then. Well, except I haven't swum today yet--I was too tired this morning--but I will do it before the day is over. I'm nowhere near as diligent about daily exercise when I'm at home, but I'm determined to keep it up here. I need the exercise for my physical health, but it's also a sort of meditation for me. It enables me to think without interruption for thirty minutes. If I think of something that needs to be taken care of, it just has to wait. I'm thankful that my cell phone is not waterproof.

When Beth's lab results are back, the Nurse Practitioner or Physician Assistant will go over the numbers with her, or both of us if I'm back from my swim. Medications might be adjusted, or there might be an immediate need to order IV fluids or, like today, potassium, if those numbers aren't satisfactory. She's only had to have fluids once and potassium twice so far. Yesterday she needed an infusion of platelets. So far no whole blood or anything else. On those days when she needs an IV, we have to stay in the clinic for an extra 1-2 hours. Otherwise, we're free to go. When we go in to the clinic at 8:30 or 9:00, we might be finished around 11:00 or we may not leave until almost 2:00, like yesterday. It's completely unpredictable.

Today the labs were somewhat mixed. The white blood cell count continued up, but at a slower rate. It went from .2 to .3, instead of doubling as we had hoped. Hemoglobin was down a little, which I think is making her more tired. Platelets dropped a little, but still stayed above the level where another infusion would be needed.

I think these results were a little disappointing to Beth. She came back to the apartment and didn't eat much lunch, then went to bed. I think I'm going to have to wake her up and get her to eat and drink something soon. This is the part of being a caregiver that sucks. I hate having to force her to take care of herself. I don't mind if she wants to nap for a while and escape from the situation. I feel the same way when I'm sick. The problem is that if she doesn't eat and drink, her fluids will be low again and her electrolytes will be off and they'll have to intervene in the clinic with chemicals. She canceled her Reiki appointment, too (more about this later). Last time she wanted to cancel it I didn't let her, but today I just didn't want to push her more. We already had a discussion about some of the foods she wanted to eat this morning and it just didn't feel right to keep pushing.

Our other sister is on her way for a visit and should be arriving soon. Somebody is supposed to stay with Beth 24/7, so when she gets here I'll go take my swim then and probably go to the grocery store. I hope we can get Beth back on track a little bit. I'm not that good at being a cheerleader, but my other sister was one in high school, so maybe she'll know what to do ;-)

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