T+21 Monitor and Adjust

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	9.5	13-17	^
Platelets	156	140-375	v
ANC	1210	1800-8300	v

When I first met Jill, she was working as the "Building Technology Coordinator" at an elementary school in Tualatin. She was tasked with doing her best to keep the computers that were used by teachers and children, in classrooms and the computer lab, humming along. I was rather impressed, because I had been playing with computers for about ten years. Something in common!! As it turned out, it wasn't that much in common since my experience was all with Microsoft based machines and hers was all with Apple machines. Nevertheless, as she told me about having to reassemble the MacIntosh 2E computers from spare parts she scavenged from other old machines, I thought this is a smart lady. To this day she denies it was a big deal, but then, it's Jill, you know the cute but humble one. 

Sometimes, when we would talk about her work, she said she owed any success she had with computers to an old "teacher adage," that goes, "Monitor and adjust." Of course, that was a different monitor than the kind that are in computers. This monitor is a verb, meaning "to watch, keep track of, or check usually for a special purpose,"* and over the years with her, I have learned how useful this term "monitor and adjust" truly is. 

Being rather pigheaded, my style was more like, "This situation isn't going the way I expected it to go. I checked and double checked my work and still it comes out wrong. There must be something wrong with this process, device, system (fill in the blank). But gradually I am learning that sometimes you just have to observe what doesn't work (monitor) and and try a different approach (adjust), until you find a practical solution to the problem. I once wrote myself a sticky note and put it on the bathroom mirror, so I would see it frequently. It said, "Listen to Jill." That's very good advice, along with monitor and adjust. 

Today is T+21, twenty one days since my bone marrow transplant (BMT) was completed. It is also seven days since I was discharged from the hospital. Essentially, I am in recovery mode from the BMT procedure. As my body and the transplanted cells from the donor begin learning "peaceful" coexistence, the medical team is monitoring my progress via lab tests and clinical observations. As they watch the lab results, they have been making adjustments to the dosages of the medications that I am taking. Sometimes, changing the dosage of medication "A" that is not giving the desired outcome also means changing dosages of medications "B" and "G" that affect the way medication "A" works. To complicate matters, each medication may have undesireable side effects that must be accounted for. It's quite the orchestration that must be done to keep things in harmony. Lots of monitoring and adjusting. 

So, how am I doing? According to the medical team, I am doing great. Things are progressing as well or better than they had predicted. From my perspective there are a couple of problems to deal with. First, all of these medications and the changes going on inside my body make me very tired. I have never needed so many naps! That brings us to the second problem. I have not found a comfortable way to sleep. When I sleep, I sleep deeply, but I often wake with a headache or neck and shoulder pain or some combination of them. Once I am up and moving, I can get the kinks out and things feel better. Night times the past few days have been a comedy of tossing and turning, trying different pillows and positions, trying to sleep in a chair. I think I ultimately fall asleep when the exhaustion overcomes the discomfort. Maybe some of the naps are the result of inadequate rest at night. I'll try a new strategy tonight, you know, monitor and adjust! 

Rejoice in the Lord always; again I will say, rejoice. ⁵ Let your reasonableness be known to everyone. The Lord is at hand; ⁶ do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. ⁷ And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus. (Philippians 4:4-7)

*https://www.merriam-webster.com/dictionary/monitor