Thursday,
March 20th
With the outside chance of going home I was anxious to see the blood results today. My WBC was over 6.0, platelets were good, Hemoglobin was a little low, and they ordered a pint of blood for the morning. The only issue was that the absolute neutrophil count was not on the report. For some reason it was not ordered which was strange since it has been on the report every other day.
Throughout the day each doctor seemed satisfied with my condition and was ok with my release. I started asking the nurse what was standing in the way of me going home that evening. She said that she'd have to check with my primary doctor; who had already told me he was ok with my condition. By this point, NCAA games had started so I began watching, but was constantly wondering what was going on. Next the nurse told me that my primary doc wanted to hear from the Infectious Disease doctor who also had already been in to see me and said he was ok, assuming my ANC was above 1.0. My last test showed 0.97 and I knew that a new blood draw would show a number higher than 1.0. But now it was late in the day and I was unable to get anyone to authorize another blood draw and CBC test. I was starting to feel like the system was conspiring against me to keep me another night.
In the evening, another doppler was ordered on my arms to look at the PICC line and any potential clots. The clot in my right arm was still there, what was unknown is if it was smaller or larger than the first scan. I'd have to wait until a radiologist reviewed the scans. They also found a second clot in my left shoulder. Obviously my body doesn't like the PICC line in my veins, but the doctors agreed to leave it in rather than remove it and have to reinsert it on my next visit. I have to assume that they're not that concerned with it, but I do think about it every night when I go to bed.
As the day wore on, I resigned myself to staying the night. I had basketball games on and was unhooked from all medications, so it was really just sleeping through the night. I'd be headed home in the morning.
Friday, March 21st
I learned the first time through that discharging from the hospital is a slow-moving process, so I was balancing constant pressure on the staff with the patience to wait until the steps took place. The new nurse came on at 7:00 and knew the plan to get me out. The blood test from overnight had all levels where they should be for discharge. Now the challenge was to get final sign off from each doctor. I tried to push the nurse to get the sign offs, but she was having a busy morning with her other rooms, so I didn't see her for the second time until after 9:00. Now she began chasing doctors for discharge orders. The problem is she chased one at a time rather than all at once. It took until 11:00 to get the ok from Oncology. Next was Infectious Disease, who said ok. Then primary care, he said ok and signed orders for meds. Now it was after 1:00 pm. The last thing I needed was supplies and instruction from the nurse to flush the PICC line during the break. Again, her busy schedule kept her until around 2:00pm.
She demonstrated the process (which I've watched 100s of times by now), but during the demonstration she found that one of the two lines was blocked. She'd have to call the IV team to come and unclog it. I knew that meant at least an hour before they showed up, the day was slipping away and my anger level was on the rise, so I settled in to watch some basketball games. The IV guy showed up and went to work. He found the line blocked as well, which meant they needed to inject some cathflow to dissolve blockage. This needs to sit for two hours! UUUUGGGGHHHH!!!!
Despite my best efforts, it took until after 5:00pm before I was walking out the door. Now I got to sit in 5:00 Friday afternoon traffic through Orlando on my way home. After 30 minutes I was on the turnpike and on cruise control headed for Vero. By 7:30 I was home for dinner and the start of a two week break before round three. I think it was a longer trip from my room to my truck than all the way home, but I made it at last.
With the outside chance of going home I was anxious to see the blood results today. My WBC was over 6.0, platelets were good, Hemoglobin was a little low, and they ordered a pint of blood for the morning. The only issue was that the absolute neutrophil count was not on the report. For some reason it was not ordered which was strange since it has been on the report every other day.
Throughout the day each doctor seemed satisfied with my condition and was ok with my release. I started asking the nurse what was standing in the way of me going home that evening. She said that she'd have to check with my primary doctor; who had already told me he was ok with my condition. By this point, NCAA games had started so I began watching, but was constantly wondering what was going on. Next the nurse told me that my primary doc wanted to hear from the Infectious Disease doctor who also had already been in to see me and said he was ok, assuming my ANC was above 1.0. My last test showed 0.97 and I knew that a new blood draw would show a number higher than 1.0. But now it was late in the day and I was unable to get anyone to authorize another blood draw and CBC test. I was starting to feel like the system was conspiring against me to keep me another night.
In the evening, another doppler was ordered on my arms to look at the PICC line and any potential clots. The clot in my right arm was still there, what was unknown is if it was smaller or larger than the first scan. I'd have to wait until a radiologist reviewed the scans. They also found a second clot in my left shoulder. Obviously my body doesn't like the PICC line in my veins, but the doctors agreed to leave it in rather than remove it and have to reinsert it on my next visit. I have to assume that they're not that concerned with it, but I do think about it every night when I go to bed.
As the day wore on, I resigned myself to staying the night. I had basketball games on and was unhooked from all medications, so it was really just sleeping through the night. I'd be headed home in the morning.
Friday, March 21st
I learned the first time through that discharging from the hospital is a slow-moving process, so I was balancing constant pressure on the staff with the patience to wait until the steps took place. The new nurse came on at 7:00 and knew the plan to get me out. The blood test from overnight had all levels where they should be for discharge. Now the challenge was to get final sign off from each doctor. I tried to push the nurse to get the sign offs, but she was having a busy morning with her other rooms, so I didn't see her for the second time until after 9:00. Now she began chasing doctors for discharge orders. The problem is she chased one at a time rather than all at once. It took until 11:00 to get the ok from Oncology. Next was Infectious Disease, who said ok. Then primary care, he said ok and signed orders for meds. Now it was after 1:00 pm. The last thing I needed was supplies and instruction from the nurse to flush the PICC line during the break. Again, her busy schedule kept her until around 2:00pm.
She demonstrated the process (which I've watched 100s of times by now), but during the demonstration she found that one of the two lines was blocked. She'd have to call the IV team to come and unclog it. I knew that meant at least an hour before they showed up, the day was slipping away and my anger level was on the rise, so I settled in to watch some basketball games. The IV guy showed up and went to work. He found the line blocked as well, which meant they needed to inject some cathflow to dissolve blockage. This needs to sit for two hours! UUUUGGGGHHHH!!!!
Despite my best efforts, it took until after 5:00pm before I was walking out the door. Now I got to sit in 5:00 Friday afternoon traffic through Orlando on my way home. After 30 minutes I was on the turnpike and on cruise control headed for Vero. By 7:30 I was home for dinner and the start of a two week break before round three. I think it was a longer trip from my room to my truck than all the way home, but I made it at last.
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