Her home hospice care is getting set up today. She will be going home at 3:00 this afternoon. Lucy is tolerating her oral medications well. She slept about six hours last night. Her hospice nurse will meet us at home at 3:30.
Thank you for your caring during this difficult time.
Lucy went to Fairview Southdale by ambulance at 3:30 pm CDT. She is suffering from septic shock and the prognosis is not good. The next 24 hours will be touch and go.
Please keep her in your prayers. Her battle may be ending.
That’s a great question to ask someone doing the limbo dance, but not for Lucy’s hemoglobin level. She had a port draw today and came in at 5.3. We knew she was getting low because her low energy level and pale color. That necessitated an immediate transfusion at Fairview Southdale. We arrived at 6:00 pm. It sounds like she will receive two units, and if all goes well, she’ll go home around 1:00 am. Her first unit started at 9:00 pm and each unit takes between 1½ – 2 hours.
Her stomach and intestinal problems greatly improved after the Augmentin completed. Her oncologist suggested she eat yogurt twice a day to help with the noise and slight queasiness. Antibiotics knock the helpful bacteria in the gut for an unfortunate loop. It will take a couple of days for her system to re-balance itself.
Lucy’s leg is almost normal sized again. We will have to lotion her leg a couple of times per day to help soften the skin. That will help with the tightness she feels. Both ankles are much less swollen and loosening up. Her walking speed is increasing though she still needs the walker.
At this point, she has not started her Hexalen yet (the oral chemotherapy). I think she wants to start it tomorrow depending on how her digestive issues are doing.
The extremely warm weather we are experiencing has been very beneficial to Lucy’s gardens. The east side gardens have irises, tulips and daffodils about 3″ tall. Her blue flax is back and some of it is 6″ tall already! No signs of the sqills, snowdrops, or crocuses yet, but they are buried under several inches of leaves. The lilacs and maple trees have leaf buds on them. She also has sedum popping up. A few of the forecasts are hinting at 80°F a couple times in the five-day forecast. That will drive the frost completely out of the soil.
We hope you are enjoying decent weather where you are. Thank you for making the time to support Lucy!
We were concerned Lucy would have to be held another day. She had a fever spike last night of 101.4°F, which took about an hour to break even with Tylenol. That was the last spike. This morning she took her antibiotic (Augmentin) and her Pradaxa on an empty stomach. After some mild nausea and a shot of Zofran she was fine.
Dr. Dittes came by to tell Lucy that he was confident her symptoms were clot related and not infection related. He wants her on Augmentin for 10 days and saw no reason for her to spend more time in the hospital.
Dr. Weinshel was rounding for Dr. Thurmes and he was delayed. Lucy’s hemoglobin was at 8.6, her pain was manageable, and she had no fever spikes today. He saw no reason to keep her in the hospital any longer.
The only snag came when Fairview’s pharmacy thought they would be filling the Pradaxa prescription even though it was called into our local Walgreens. That took a while to straighten out. Fairview’s pharmacy is out of network so there is a higher co-pay.
Lucy will get a couple of days of downtime. Her next oncologist appointment and Alimta treatment is Thursday. I believe she will also be due for a vitamin B12 injection.
We’re both hoping for a quiet boring week for Lucy. She will need a couple of days to decompress. For the first time in nine nights, she gets to sleep in her own bed. She won’t be awakened every two hours and won’t listen to medical equipment.
Thank you for your love, thoughts, and prayers! It helps get us through the rough spots. There may not be another post until Thursday.
Pradaxa (the pills)!
Dr. Thurmes told us that Lucy is going on Pradaxa twice per day for her clotting problems. He wanted something with a shorter half-life in case she starts getting the serious nosebleeds again. Pradaxa has approval for DVT therapy in cancer patients in Europe. FDA approval is pending, but Pradaxa can be legally prescribed for Lucy’s situation.
Lucy’s hemoglobin was at 7.2 and she received a one unit transfusion. Her IVs are disconnected. She had two long walks today while still tethered to the IV tree. Her longest walk came after untethering.
As of now, the only thing that would keep her in the hospital is a fever spike higher than 101.5°F tonight. Her pain management is fine. She started her oral antibiotic. That will be twice per day for a week starting tomorrow. The pills are very large uncoated capsules, so we will split them so she has an easier time swallowing them.
Lucy heard from Steve, Julie, and Suzy today so she told them about her imminent release. The nice thing is the pace here has slowed down.
She still hasn’t had the giant leap towards going home. Dr. Rousey (hematologist) stopped by this morning. He and Dr. Thurmes are still digging though research studies to see if Pradaxa will be the drug of choice, with Arixtra as the runner-up. Pradaxa apparently has a shorter half-life, which is helpful in case of a complication. Lucy likes the fact that it is oral and not an injection (OK, so do I!). Neither drug will need as frequent blood testing as Coumadin requires. I think it is because both drugs manage specific coagulation factors while Coumadin takes more of a “scorched earth” approach.
The IV antibiotics are still going. Right now, she gets Vancocin (vancomycin) and ampicillin, and both are available orally. While the hematologists are researching Pradaxa, Lucy is still on IV heparin. She has not needed a blood test because she hit the therapeutic range.
Julie stopped by this afternoon and really made Lucy’s day! It was nice having nearly no interruptions while Julie was here.
Lucy took two walks today. The first was about 50 feet. Her second was close to 150 feet. She would go farther when they finally disconnect the damned IVs. Her left ankle is loosening up a little. On her second walk, she was able to get her heel on the floor while walking, at least for a few steps. There was still discomfort walking, but she was not wiped out afterwards. Like last time, her pain started decreasing when she sat down.
Dr. Thurmes will be on rounds tomorrow and said he will stop by. He’s been so good to Lucy through this ordeal. He might have the home care anticoagulant and antibiotic choices tomorrow. If so, she could be released tomorrow.
Diane visited Lucy this morning. She always manages to cheer Lucy up and today was no different.
Lucy received some good news today. The Infectious Disease group is very comfortable that the fever spikes and redness in her leg are both clot related. She is still on antibiotics. Her Heparin Factor X is at 0.29. Therapeutic range starts at 0.30.
Dr. Thurmes came by and gave her some better news. She will be going on either Arixtra (injection) or Pradaxa (oral), so her heparin level can be close to therapeutic range. Her IV heparin will be stopping soon, and she will switch to oral antibiotics. He mentioned Sunday as a possible release date. Lucy must be off the IVs before going home.
Lucy’s left ankle is still extremely stiff. She has not tried walking with her walker yet. Maneuvering is interesting enough without having to coordinate with someone pushing the IV stand. If she gets rid of her IVs tomorrow, she will start walking around and get used to being on her feet again.