Too Much, and Not Enough

Too much pain. Too much nausea. Too much time spent in the clinic trying to pinpoint the problem. Too much gazing up at the ceiling of a hospital room.

Not enough food. Not enough fluids. Not enough relief. Not enough time for a reprieve before the next treatment begins.

Jordan spent the whole of Monday afternoon in the ER checking out chest pain. He spent Tuesday, from about 11 AM to 5 PM, in the clinic, looking for some help with pain management and nausea. Back again on Wednesday, he sought help for both again, with nausea and vomiting at an intolerable intensity. from 10:30 AM to 5 PM, they worked with him, sending him for an abdominal X-ray, administering morphine, enema, kytril and saline solution with potassium. Finally, he rushed home to pick up a few things, then proceeded on for admission to the hospital, where he seems to be improving.

Why all the discomfort of this week? The verdict (although it's felt more like a sentence), is that he was given "too many" Neupogen injections to stimulate white blood cell production, which led to excessive pain. Then, he was given too much morphine to control the pain, which led to a cessation of peristalsis, and/or iileus bowel obstruction; hence the nonstop nausea and emesis (barfing). Just for you, a couple of definitions follow.

Peristalsis: The wavelike movement of intestinal muscles that propels food along the digestive tract.

Ileus: Obstruction of the intestine due to it being paralyzed. The paralysis does not need to be complete to cause ileus, but the intestine must be so inactive that it prohibits the passage of food and leads to blockage of the intestine. Ileus commonly follows some types of surgery. It can result also from certain drugs, injuries, and illnesses. On listening to the abdomen with a stethoscope, no bowel sounds are heard (because the bowel is inactive). Also called paralytic ileus.

For his pain control, it's Fentanyl to the rescue. This is an opioid analgesic with a potency approximately eighty times that of morphine. Fenntanyl transdermal patches work by releasing fentanyl into body fats, which then slowly release the drug into the blood stream over 72 hours. Oh, and fewer Neupogen injections! The doctor said we'll cut back from nine to six next time.

For the ileus bowel obstruction, no more mor"fiend"! A diet limited only to clear fluids seems to be helping. Over the last few hours, he's been able to keep down some 7-Up and ginger ale.

All his counts are on the way down (HGB from 9.0 to 7.2 since yesterday), so he'll have 2 units of packed red blood cells today, and then, if all goes well, he'll be released later this afternoon. With the WBC's dropping from a high of 2.1 yesterday, down to 1.6 this morning, we hesitate to celebrate. After the first treatment back in Jan., the rising WBC had us on cloud nine when it reached 2.2, and the next morning when it dropped to .6, we were in despair, with good reason.. It meant the rhabdo was on the move again, in a big way.

What You Can Do:
Please continue praying for Jordan to be strong and well. And will you send him a birthday greeting? He turns 26 on Sunday, the 16th. Thanks a trillion.