5/10/11 New CVC line and counts

Good Evening!

Today was a busy day for Joe where a new CVC dual lumen line was put into his left arm. The CVC had two people come to Joe's room early today to put it in. Joe says that it does not hurt when it is inserted. They put a tube into a vein in his arm and it does up to his shoulder, along the shoulder blade then down to above the heart. It is an amazing thing that they are able to do such a thing. After putting the new one in, Joe has to be taken down to XRay on the 2nd floor to get a picture of it to assure that it is placed correctly without any kinks or wrapping. Once they are assured that it is okay then the old one can be removed.

We found out there was an issue with the placement when the RN came into Joe's room with an armful of heparin syringes which she told us that is was for a Power Flush but she did not tell us why. The CVC team came back in and they told us the CVC line about the heart was twisted and they are hoping that the Power Flush would untwist it. Each time they entered the flush, Joe had to lean over and take a deep breath. Next Joe would have to get another XRay on the 2nd floor to see if the Power Flush worked and untwisted the lines. Joe said the X-Ray was finished at 6:10 PM and he had to wait for hospital transportation to take him back to the room. They should let me take him and bring him back since it would be way more efficient. Waiting for transportation for another tests takes way longer than the tests themselves.

Joe's RN Melissa told us that the procedure worked and that a CVC team member would be up to take out the old line. She set up all the new IV's to the new line. Joe complained of a headache the last two days and they give him a half of a little pill that stops the headache in minutes. In the meantime I decided to order some Tex Mex dinner from Pappasitos that was only 2 miles away from the hospital. While I was gone to pick the food order up, the CVC team rook out Joe's old line which did not heart at all. They told Joe that he could order a pain pill since his left arm may be sore from the new entry point of the line.

Dr. Romaguera made his rounds about 1PM today. He was pleased to see that Joe's Absolute Neutrophil count went from zero yesterday to 110 today. It needs to be at 500 before Joe can be released. Joe thanked him for calling in the Infectious Disease expert and that we were both impressed with how the doctors work together flawlessly at MDACC. Dr R stated that Joe's last scheduled chemotherapy for 5/19 will be postponed. He could not tell us for how long. He says we need to take each day as it comes. It is important that the infection be gone 100%. Joe will be ordered home care for antibiotic IV's that I would administer after he gets release. MDA, the Case Manager and Applied Health Care would work all of that out for us as they did previously when Joe need home IVs of ERAXIS which was for the believed fungal infection. I told Dr R to make sure Joe fully understands why there would be a postponement since he gets depressed when that happens. Joe understood and was fine with it.

Joe decided to take them up on the pain pill. He was floating away to the twilight zone as the late news came on so I came back "home". It is hot and muggy in Houston where the city has not had rain for 57 days. There is an "exceptional" drought happening in Texas which is causing massive wildfires that are excelled by the strong winds.

Some of Joe's other counts are as follows:
White Blood Cell Count .7 (low)
Red Blood Cell Count 4.85 (normal)
Hemogloblin 13.8 (slightly low)
Hematocrit 43 (normal)
Platelets 63 (low)

With chemo the WBC and Platelets are expected to drop. The good news is that the platelets did not stop to an extreme low level as they have done in the past. The Red Blood, Hemogloblin, Hematocrit are excellent. Joe has not needed any transfusions of Red Blood Cells or Platelets with this round of chemo as he has had on each of the others in the past. We do have some positive things happening in spite of the serious infections.

Joe is getting the full alphabet of antibiotics of which nearly all of them I never heard of before. I can not even pronounce their names correctly. What a blessing that there are so many antibiotics available.

Good Night!