Monday, February 11, 2008

Fish sandwich

Chris and I have a little joke about fast food restaraunts and fish sandwiches. The theory is that there's only one fish sandwich at any given time and should you be so unfortunate as to order one everything stops. There's a mad scramble as workers try to locate the sandwich and have it transported in. So the joke goes: if you want to gum up the works, order a fish sandwich.

Last night, I was the fish sandwich. My temperature spiked to 101.6 so Chris packed a bag and loaded me up in the truck intent upon driving to Houston. He had me take my temperature again just before we left and it had fallen to 99.1. He decided to take me to a local ER instead, just to be on the safe side. It was roughly 10PM and my experience with hospitals is that the later it is, the busier they are. As it turns out, if you're a stem cell transplant patient, you get bumped to the head of the line just behind serious trauma victims. Who knew? The admitting nurse was kind enough to find a private room for us to wait in away from the general population. I had to wait while a private suite was readied for my admission. White glove service and all.

I was interviewed multiple times before the doctor came in and it turns out that he spent his residency at Baylor and Texas medical center, so he was very familiar with MDA. He also specialized in liver transplants so he had a rough grasp of what he was dealing with as far as my treatment was concerned. I got a full workup including blood and strep and flu swabs in addition to being tested for mono. They just wanted to be sure that my PTLD wasn't flaring up. Imagine my horror when I was fitted with an IV line. I had a friend who also underwent transplant who passed away at the same facility last year. She went in with a chronic cough and ended up with pneumonia.

My CBC came back relatively quickly and it showed that my red blood cells were 4.37 and my hemoglobin was 13.8. That's spectacularly normal. My white blood cells were 1.7 and my absolute neutrophil count was 1.0. Boo. Not only was I neutropenic, but my white blood cells were depleted due to my being sick. Even more surprising was my diagnosis. I had tested positive for influenza B. That's what I get for taking a chance and going out without a mask. An oncologist at my local doctor's practice was consulted and the general consensus was that I was safer at home and that they didn't want to take a chance on me catching anything else by admitting me. They sent me home with a prescription for zithromycin and tamiflu. I must have been living under a rock, because I had never heard of tamiflu and was under the impression that I'd just have to ride the flu out. The ER nurse told me that they were seeing a spike in the number of influenza B cases over the last two weeks.

I got out around 2AM and the first 24 hour pharmacy we went to was out of tamiflu. They told us that another pharmacy across town had it in stock, so away we went. The beauty of trying to get a prescription filled in the dead of night is that you don't have to wait long. In less than 5 minutes I had my pills and we headed home. By this time I was desperate for sleep and all I wanted to do was put my pjs on and hibernate for the next 10 years. Unfortunately, I had to take the two new pills and as luck would have it, they have some pretty nasty gastro-intestinal side effects. Within 10 minutes of taking them, I felt nauseated and had stomach cramps. Chris informed me that tamiflu has some other pretty nasty side effects including dementia and decreased judgement. There have been cases of people dying from walking out of windows or into traffic. Super.

So far, I haven't experienced any overwhelming need to run naked into the street or eat cat litter and for that I am grateful. I am still experiencing nausea and stomach cramps. My transplant doctor wants us to continue to monitor my temperature and should it climb above 101.5 again, Chris needs to take me to the ER. We'll probably go to Houston should this happen. My temperature has been hovering between 100 and 101 which irritates me to no end. Needless to say I feel like poo and am really hopeful that the baby stem cells don't suffer from a steep learning curve. On the bright side, my new immune system has taken a break from attacking my skin to deal with the flu virus. I haven't had any new rashes in two days, nor have my hands itched. Sweet relief.

I'm off to take my temperature and then burrow under the covers to do my best impression of a statue.


pj said...

I'm glad you posted--I was worried. Now I'm regretting my decision to go out to a restaurant last night to celebrate my son's birthday. We sat in a corner, and I used half a bottle of Purell, but based on your experience, it was probably a dumb idea. Take care of yourself, please.

Nancy said...

Ann, Ann, Ann... I thought I was being over cautious by staying in (plus, my husband and son are sick, so either I get exposed at home or outside the house). I didn't think I'd have to worry at 21 months post-transplant but I always worry. That's why I've opted to be home-bound. Too many colds... who knew that you'd finally venture out and BAM, you catch it. Not Fair at all! I'm sorry you are sick, but glad you went to the hospital and so happy they treated you so well. I hope you are better soon. And Thank God for Chris... he's so caring and cautious. Take Care. Love, n

Carilou said...

That blows. But it seems like the entire universe is sick today. Just consider it a crash diet. You will be so skinny!