T+18 Choices

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	8.8	13-17	v
Platelets	198	140-375	^
ANC	1900	1800-8300	v

Sometimes in life you have to make a choice. Take last evening for example. I was faced with the difficult choice between spending Saturday night at home in Marquam Manor with my lovely bride or going to the Emergency Department. Can you see my dilemma? In the end, of course, I opted for the ED. 

It seems that around mid-day I was not feeling 100%, so I took my temperature and found it to be 99 degrees. Ever the optimist, I opted to believe it was because I had just taken a nap under my heavy Afghan, made by said lovely bride. We went out to Terwilliger Blvd. (I dare you to have a couple of Tequila shooters and then say that ten times) for an afternoon stroll. Once we were back in the manor and had time enough to reasonably assume that my core temperature had not been raised by our exercise, I took my temperature again. This time it was 100.5 degrees. 

Now there is an old established rule among us AML  patients that says, "If your temperature is 100.4 degrees after hours, go to the ED." I asked Jill later why we were at the ED, since my temperature was not 100.4. I distinctly remember, it was 100.5. I'll tell you a little secret. I was joking. But the real secret is that if you want to go to the ED on Saturday night on a holiday weekend, just tell them you had a Bone Marrow Transplant 17 days ago. They usher you right in to a treatment room, within a couple of minutes. Granted it may be the smallest room in the unit, but it will be quick. 

This room reminded me of the stateroom that the Marx Brothers occupied in the movie "A Night at the Opera." If you have never seen the movie, that scene in itself is worth your time to do so. Every time a nurse or doctor came in the room. Jill had to get up and move her chair. Then the medicos would squeeze into the room with whatever piece of equipment they needed, sometimes having to make several trial runs, turning things this way and that before they succeeded. But succeed they did, every time. These are true professionals. 

Once we were settled, they drew blood; they ordered a urine sample (fortunately they let me take care of that one alone); they sent me out for  chest xray; they did a nasal swab for flu, covid and RSV. When the lab results were ready, the doctor came in and explained that everything was looking pretty good. By that time my temperature was back to normal, but he was a little concerned about the urine sample and thought I might have a UTI. He ordered a blood culture, which involves drawing more blood through my PICC line and an equal quantity via venipunture...you know, the icky kind, with a needle and everything.  

Ultimately, he ordered an IV push of antibiotics and sent us home with a presumptive diagnosis of UTI, pending results of the blood culture, and a prescription for antibiotic tablets. Now it is interesting that, because I was referred to OHSU for BMT at Kaiser's expense, all of that treatment is covered by my Kaiser insurance, but if I go to the ED at OHSU and need a prescription for something not directly related, that is not covered by Kaiser. So, this morning we had to find a Kaiser pharmacy that is open on Sunday on a holiday weekend. Fortunately, the East Interstate Kaiser pharmacy fits the bill. I wouldn't have wanted to miss out on the opportunity to round my current inventory of daily pills up from 23 to 25!

Today, I have not had a fever at all. I woke up with some back and neck pain, for which a dose of OTC Tylenol seems to have done the trick. I confess I have been pretty tired today. I took a long nap this afternoon, and when I awoke, my temperature was still normal. So, things are looking up. Since Marquam Manor is about five blocks from the ED, a trip there is not a long one or difficult, but you know, in the future I plan to opt for Saturday night with my lovely bride, and hang the ED. 

The Lord sustains them on their sickbed and restores them from their bed of illness. (Psalm 41:3)