Day 10 at UofC

Rough, rough, ROUGH night last night.

Yesterday during the day, I called Mark from my office just to check up on him. When I left the hospital early yesterday morning (Jan. 13), he was in good spirits, bright eyed, getting ready to order himself some breakfast from the hospital cafeteria...things were great.

Usually all day long Mark and I text each other with updates, encouraging words, and silly things to make one another laugh. I hadn't gotten one from him all morning or early afternoon, so I sent him one. Then another, and another, and another without an answer. So (of course) I begin to panic. I called his cell, no answer, called his room, no answer. Around 430 or so I texted his friend (& coworker) Lori to see if she'd heard from him at all, she hadn't but was already on her way to the hospital. Once she got there, and didn't find him in his room, she discovered that they had brought Mark down to Pulmonary to do a Bronchoscopy which he still was not back from.

Finally they bring him back (about six hours after the procedure, which they knocked him out for). We didn't realize he was even getting that done, so this is why I was confused and unsure of where he'd disappeared to. He got back into the room and was understandably starving, so he ordered himself some food. Vanda arrived shortly after Lori, then I got there and Brian and Laura showed up to visit as well; and shortly thereafter Ryan came by with some PSP games for Mark. (thanks everybody BTW).

I arrived around 7pm, and between about 7 and 8pm (after he'd eaten a small amount), the anesthesia from his procedure was starting to wear off a little and he was starting to really feel some pain in his lungs. Each 5 minute span that passed, we all noticed that his breathing got worse and worse. The nurse came in and switched his cannula oxygen (that means the little oxygen things that go right into your nose) to a full face mask, (that's the one that looks scarier on patients but is a LOT easier for them to breathe and it doesn't irritate the nasal passage). But we notice that he's really sucking in the oxygen and is not feeling like he's getting enough, ("Oxygen Hungry" is the term that we learned from our awesome friend (and kick ass nurse herself) the lovely Vanda, (fyi: we're very lucky to have her on our side, as she explains EVERYTHING that's happening and has just been a huge saving grace!!!! LOVE you V!!).

His oxygen got turned up and it only made it better for him for a matter of minutes. He was actually getting worn out from trying to breathe. After everyone left for the night was right when things started to get a little nuts.

Starting around 930pm, it was just way too difficult for him to breathe, something was up. So I went and grabbed the nurse, who in turn paged the resident on duty, who in turn paged the thoracic surgeons on duty. They ordered another chest xray at around 1030pm and discovered that even more fluid had built up again on the back of the left lung, and that there was "partial air escape" from the procedure they did on his right lung. I went to speak with the Thoracic team to ask why they even did a bronchoscopy anyway, and they told me the reason was so that they could take a biopsy of the inside of Mark's lung to see if any of the Leukemia cells had infiltrated inside the lung and was actually the reason that we can't seem to get his lungs healed. Had no idea they even suspected that and that was the first I'd heard that. Mark too.

The Thoracic team was now contemplating inserting a chest tube into Mark to help him with his breathing; but because this is a pretty intense decision, they wanted to see how he'd respond first to a few breathing treatments before they went ahead and did that. Breathing Treatment: (that's where they put like a saline mist through the oxygen mask with a bit of a medication that helps to open up the lungs). After the first breathing treatment, he was a little bit better and around midnight, was when one of the residents came in to discuss more about the chest tube. I said "don't they do chest tubes for people with collapsed lungs?" He said "His right lung is partially collapsed, that's what the wheezing sound is when he breathes out". (To be honest that sorta pissed me off cuz um...why not tell me that to begin with??).

"How did his lung collapse?"

"Sometimes that happens with the type of procedure he had today?"

"And the chest tube will totally fix that?"

"Yes."

"Will it screw him up more if he gets a chest tube?"

"It shouldn't, but we're thinking of sending him to ICU so he has more 1 on 1 supervision."

"ICU??"

"Yes, we'll let you know."

"When?"

"I don't know."

Now it's about 2am; and Mark has finally relaxed a little because I asked that the doctors give him like an hour to calm down, (his heart rate was intensely high and as he told the team of surgeons when they asked him how he was feeling and why he was sweating so badly, "I'm freaking out, that's why I'm sweating my ass off!")

After of about an hour of a steady pulse ox (a reading to tell how much oxygen is in his blood, you want it to be in the mid 90s and up), and his heart rate was under 110 and he was actually finally sleeping a little; I talked to the Thoracic surgeons again and asked if the chest tube was definitely happening. They told me that they wanted to try to see if he could make it through the night without one first as Mark wanted his actual oncology team to be there when and if the chest tube happened, and not the midnight team that didn't really know his case as well as his regular team did. I asked "Is that safe when a patient has a partially collapsed lung?" They said it was if he was supervised closely, which...he definitely was.

The nurse came in and gave him another breathing treatment, and some more Dilaudid and then a drug called Lasix which helps excessive fluid accumulation and swelling in the body. The docs told me that the bronchoscopy definitely irritates the lungs when performed and that this is where most of his discomfort was coming from.

He was snoring now, and breathing steadily, and the wheezing had almost stopped. He was comfortable. I layed my head down on the edge of his bed and slept for a moment, then I felt his hand touch the back of my head and wake me up. He was totally awake, staring right at me, smiling. Not only that, but...well...(and in the name of keeping this blog clean as I know that my mother and entire extended family is reading this), I'll say this: he grabbed me in a silly way that only a boyfriend should grab a girlfriend. Get me? Pretty much indicating "sweetie, I'm totally fine, stop freaking out." So, I did.

I went out of the room and told the docs that he was comfortable now and that as long as they thought he was safe to sleep, that he should be allowed to get some rest and asked if they would stop waking him up every ten minutes. They said it was safe as long as he kept his pulse ox/finger sensor on. I stayed awake watching the machine for a while to make sure it was steady; planning on running out of the room to get the nurse had it gone crazy again. It was fine. He was sleeping. I calmed down too.

I had a long conversation with one of the Thoracic surgeons about what was up with him. Here's the deal:

Now the docs aren't totally sure that the "infection" he has in his lungs is a separate infection, aside from his Leukemia. They now suspect that his infection could be PART of his Leukemia; which is why they did a biopsy last night. The fluid he'd had drained from behind his left lung earlier in the week is back again, and they are also testing that to see if it's part of the cancer or it's own infection. They are leaning toward it being part of the Leukemia as most of the infectious tests they've done to figure out what type of pneumonia (or whatever) infection it is, have all come back negative. IF the infection is in fact deemed to be part of the Leukemia, they actually plan on beginning the Campath asap; which will then hopefully begin to help heal him and get him on this road to actively getting better.

The reason they are moving so incredibly slow, (because that's exactly what I asked them, "why are you guys taking forever to do everything?"), again has to do with the fact that Mark's type of Leukemia is so rare, that they HAVE HAVE HAVE to test absolutely every single angle to make sure they are not missing a thing. They are being careful, so we (I) just have to remain patient and steadfast and trust that this team of experts are taking every precaution that they can to get Mark healthy.

So you guys, yeah. It was a rocky night. But I did go into work this morning after waking up to find that his breathing was a LOOOOT better; and the docs are planning on removing the fluid from his lungs again. I spoke to his oncology team before I left, (who have been nothing short of wonderful and patient with my impatience and bitchiness), and they promised me that Campath would be starting soon (not today though), and that I can page them whenever I want to see what's up (especially if I can't find him like before). Right now they're just trying to make him as comfortable as possible before the Campath begins; which (again) they assured me, was starting as soon as possible, (if not this week, then early next week for sure).

I do trust them. I do think they're doing a good job. I just hate being totally out of control of helping him and solving the problem.

Thank you again for all of your wonderful words of support and your visits and texts and emails and cards and gifts and just all around kindness. Everyone has just been so incredible. Both Mark and I are totally drawing on that positivity every day...and it really does matter...so thank you.

Love to all of you.

-Leslie