Nasy nadir

2/22/10  Monday

I took Rachel and John to the airport at 5:45 am.  Both of us have appreciated the seamless way in which they have lifted Teri’s spirit and organized the logistics of food, cleaning, getting Dad to the hospital.  She has said more than once that she has really appreciated getting to know John in a unique, intensive, way albeit under duress. 

We were forewarned about the nadir by our nurses and oncologists.  But you still don’t know how it will rear its noggin.  Today was a prime example.  Teri had two days of 9-10/10 rated abdominal pain.  The antispasmodic I suggested took it down to 5/10 but last night she spike a fever, got cultured (two blood, one urine), started on two antibiotics and made NPO (nothing per os).  As I came in, she was being sent for an abdominal CT after drinking oral contrast.  Teri tells me that there was swelling in the small bowel-colon junction and I suspect it is typhilitis … a known serious complication of neutropenia with inflammation in the cecum (colon area around the appendix).  Later in the afternoon when the oncology team makes rounds, they confirm it is.  Teri is upset about being NPO and asking for food.  But she makes a few jokes with the nurses and is beginning to feel better, pain 3/10.  I think the pain results from cramping but the sloughing of the GI lining and typhilitis related to the chemo is driving the cramping.  The antispasmodics helped her symptoms but not the root cause.  By the afternoon – now 12 hours of antibiotics and NP0 – I think she is responding! 

She received a third transfusion of 2 units of packed red cells and first-time platelets.

I am more a half-empty (probably from my mother) mindset kind of individual.  Coupled with an analytical and physician (worst case) bent, I’m realizing I’m not a very good cheerleader, one that Teri says she needs.  As I update our closest friends on the latest GI complication, I realize I’m painting a dark picture while she is actually beginning to show improvement.  Like the zen story of the monk who carries the pretty woman across the swollen stream.  His young acolyte later says that Zen monks are not supposed to have contact with women. The monk replies ‘I left her there at the stream, are you still carrying her?”  To use a more American analogy, why am I stuck in reverse?