Posted by: Adrianna | July 31, 2010

In Hospital

I just had a shower, slept a few hours, and am going back for a visit.

So last night around 8pm Elliott vomited a bunch more times (this is with Anzemet on board) and started looking miserable.  I’d decided anyway to take him in today for an ultrasound but after all the vomiting then I was worried that he was getting dehydrated so I decided to take him in tonight.  Also he had been vomiting before, but didn’t seem nauseated all the time but now he looked miserable and exhausted.  For the previous two days I thought this was a poor reaction to vincristine; now when I looked at him I saw the same exact scenario as I did when he was diagnosed.

The difference between a bad rection to chemo and losing remission (after 2 weeks) is enormous in terms of prognosis.  If he has lost remission, how much farther should I go with this?  He is on the best protocol, the one associated with the longest symptom-free survival time.  If this intensive program can’t beat down his disease (advanced beyond the possibility of cure anyway) it’s just a bad sign.  Very bad.

The other related possibility was that his liver was shot.  Elliott has a history of chronic hepatitis and there were already issues of him perhaps not metabolizing his chemo drugs as well.  If his liver was done, we were done with what we could do.

I called a friend to see if she could drive us; after saying hello I froze up.  I couldn’t say anything for more than a minute.  I couldn’t ask her for a ride to take Elliott away to maybe never come back.  His last car ride, was this it? HIs last time in the apartment?  I’d return alone forever? I squeaked out a few words and she said she’d be right over for us.

He got up and was actually very excited to put his leash on.  He stayed “up” through the car ride and the arrival at the hospital.  Bloodwork showed no elevation in liver values (nothing above his normal elevation) and a slightly lower neutrophil count (appropriate for a dog on chemo).  We gave him some IV stomach protectants (Protonix, Pepcid), an anti-emetic (Cerenia) and a general-purpose antibiotic (ampicillin) and put him on fluids. This morning we started a Reglan CRI for nausea and to help move things along in his GI tract.

Friday night, not feeling well.

He slept like a rock most of the night.  (I set up a bunch of comforters on the floor of the cardio room and we stayed there, IV pole and all.) He didn’t want to get up to go to the bathroom but I dragged him out every 4 hours in case he actually did absorb some Cytoxan yesterday before vomiting and to keep him from peeing on himself.  He did pee a little on himself anyway.  Today before I left to come home he looked a lot brighter, though.

There was no internist today so no ultrasound.  I was very, very disappointed since that test holds the major part of the answer to our big questions.  So just supportive care till she comes in tomorrow.  The oncologist–who I’m counting on to look at all the results and tell me if we’re looking at remission/failure or an acute chemo reaction–spoke to the critical care specialist in charge of Elliott’s case.  I was too emotional to speak to her.  She says that vincristine can cause ileus and his symptoms are consistent with both this and a relapse, and we need to see how his ultrasound looks.  Even though his outer lymph nodes are not enlarged like they were at the time of diagnosis, if the lymphoma is pushing back it could first show this in the spleen.

(Ileus in this case is caused by a poisoning of the GI nerves by vincristine; the motion of the GI tract is slowed, nothing moves along and the result is a person/animal who feels miserable and vomits anything placed in the stomach since nothing is moving out.  This side effect resolves usually within 9 days of administration.  We’re on day 9 now, but if Elliott developed the ileus at day 6-7 he could still be feeling bad from it. Also, Elliott’s liver means he metabolizes drugs more slowly so that could also be a factor.)

So we’re back to waiting for the ultrasound.  I am trying very hard not to get my hopes up that he is going to get better and come home.  I can’t walk around thinking this is his last day on earth, though, so I’m trying not to think too much at all.   I plan to just go and  visit him, but it will be hard to leave him there.  It’s funny, all these days I’ve wished I could sleep a whole night and now I have the opportunity to do so but I’d rather sleep a few hours on the floor next to him.  I’ll keep this in mind the next time I get aggravated at having to wake up at the crack of dawn to take him out, if there is a next time.

Thank you to everyone for your good wishes.  I will try to keep you posted.

Advertisements

Responses

  1. Deep sigh. Thanks so much for posting an update. I’ve checked the blog so many times since last night that I’ve lost count.

    I know exactly how you’re feeling; it’s so tangible I can’t shake it. The conflict between hope and the gut-punching reality that the fight might be over, the guilt over being grumpy, the invading thoughts of “lasts” and all else that races through the mind at these times. Those of us who have been there know the road far too well. And I’m sorry you’re going through it…that you have to wait yet another day for answers.

    We’re on this journey with you, albeit from the back seat and via an internet connection. If there’s anything at all that you need, we’re here.

    Sending you and Elliott many, many positive vibes.

  2. thank you for the update. we’ve been very worried about you. hoping this is just a bump in the road and elliott is on the mend. (((JESS)))

  3. Hugs for you and Elliott. Go stay with Ellie ott . Just enjoy your time together. sending love and prayers to you both.We love you both. We are always here if you need us. Love always


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Categories

%d bloggers like this: