BMT Day +134 Teri baby … watermelon cool … cancer relationships

Teri’s pace of speech is deliberate – she still has trouble finding words – but her voice has progressively strengthened.  She gives thanks and love for family and friends who have come and helped, sneaks her off hand wry sense of humor in, manifests her strong will, breaks out in spontaneous song or sing alongs (musicals), and expresses hope and even dreams for the future. 

This week she will only be in the Day Hospital for three days, a record low.  Yesterday, it was 9 hours for lab draws, doctor visits, and intravenous blood transfusions (2 units), platelet transfusions (2 units), albumin and lasix (diuretic). 

Teri baby

Teri is 99.9% umbilical cord to her (marrow) core.  Everyone tells her she will get better by appropriately taking baby steps.  When I help her dress, she says roll up her pants just like dressing a baby.  “Wahhhhhhh, I’m your baby,’ she says, “I’m starting over!”  As she has now regained enough dexterity to maneuver chopsticks, she says, "I'm now up to age 5."  Teri may be a real babe in the making but for now, with all the compression dressings encasing her legs and tummy, she looks more like a mummy.

Watermelon cool

Teri continues to crave watermelon juice.  We buy whole half or whole watermelons, cut them into small sections, and then blend them instantaneously in a Magic Bullet on the spur of her thirst.  As she drinks it through a straw, her closed eyes reflect ecstasy.  Watermelon we learned from one of the oncology nurses is one taste that post-chemo patients desire.

This past week it has been in the high 70’s.  It’s summer here, finally, but even at 78 degrees inside our condo Teri invariably feels cold.  She dresses in 4-5 layers enveloped by a hooded sweat shirt and full length sweater and topped off by a knitted hat and scarf.  When she reaches the Day Hospital, she adds one or two heated blankets (to 180° F).  This coolness (? hypothalamic thermostatic dysfunction) is we learned yesterday common to SCT patients and lasts six months. 

Cancer relationships

I learned that over this prolonged ordeal Teri has developed uniquely intimate relationships with many of her oncology team, from cleaners to receptionists to aides to physical therapists to social workers to nurses to numerous fellow and attending physicians.  At first, I thought it perhaps was initiated by garnered respect of being a faculty wife as the nurses once referred to her as a ‘celebrity’ patient.  I now know quite otherwise.  As I observed her on rounds, in clinic and in the hallways, I believe it is her innate ebullience and ability to reach out with warmth that has endeared her to them.  As she rolls down the hallway, she says 'great to see you', 'it's a great day', 'have a great day' to her extended cancer family and identifies each and everyone to me that is special to her ... "she took care of me on a day when I had to go urgently and accompanied from the lab to the bathroom ... ever since then she has been there to for me [to draw my blood and comfort me] every time I go to the lab ... one of my angels."
Yesterday in clinic.

Dr. H. “I’m sorry I didn’t receive your text message about worsening kidney bleeding since I was asleep.  Next time, I want you to call me on my cell phone.”

Teri:  “I can’t do that.”

Dr. H.  “Yes you can, you are family!”

Yesterday, Teri’s sleep-over team included a record three including Linda (college classmate from Sacramento), Grace (niece from San Jose) and Mary (a close close friend from Madison who is preparing for her daughter’s wedding next week) seen below.

Several more friends encouraged me about the book.  Hmmm …

BMT Day +132 Wonderfull days …

 3 Wonderfull days in a row!

3 days – no day hospital, lab or infusions – except the twice a day IV meropenum at home

3 days – Teri goes out

3 days – Teri has vim, vigor, sings, rediscovers her joie de vivre

“I had a wonderful day” she says when asked what her main message is tonight.  I’m eating wonderful food made by Grace.  She expresses genuine exuberance at being alive and relatively pain free.  Grace and she are in sync and she knows all of Teri’s routines and foods – congee or won ton soup, fresh watermelon juice, blended protein-fresh fruit shakes (freezes aliquots) – and Grace decides to spend an additional week.  Grace made “dropped” panko chicken last week.  This week she blended “dropped” protein shake, what a sticky mess.  She’s dropping food like flies – mixed up metaphors.   

Edema and ascites persist, renal bleeding continues, intentional tremulousness and bladder spasms tingle but she’s looking beyond…

Teri bought an iPad2 and is enthralled with this little computing device or enlarged iPhone however you look at it.  She attended a session on how to use it at the Apple store and is also helped by niece Grace who also just got one.  She ate out.  Some children and adults stared at her.  She said “I don’t care!”  She went to the mall mostly pushed about in her mobile walker.  She invited company – Grace’s close friends – and actually cooked one dish, sweet and sour ribs.    

She is returning to woman in charge.

B:  “You should wear slippers or sandals to protect your swollen feet.”

T:  “I’m OK in my [hospital] stockings.”

G:  “I agree with uncle B, it would be better to protect your feet.”

T:  “I’ve made up my mind, I’m walking in my stockings!”

T:  “Take these metal clips back to work.  I don’t want them on my bags, they are too hard to open.”

B:  “I’ll put them on my bag of chips.”

T:  “I don’t want them in my drawers!”

It was a gorgeous weekend, sunny and in the upper 70’s, light wind.  I rode 38 miles at an average of 17.86 mph. Exercise is still my only healthful and mindful space besides Tai chi.

BMT Day +125 B’s week … Pain beyond pain … Little wonders …

B’s week on service

Yesterday Sunday marks the end of my week-long duty on the in-patient service and on night call.  I awaken early to administer Teri’s morning IV meropenum infusion, ready her 10 oral medications and heat up her morning food before heading off to in-patient rounds at Children’s Hospital.  These rounds are supposed to be ‘patient-centered’, that is to involve the family in the discussion of the day’s plan.  We invite the parents, vastly outnumbered, to join in our intimidating, technical discussion full of jargon and numbers.  After rounds and completion of the written notes, I perform GI procedures (e.g. endoscopy), teach, and provide curbside consults or opinions to referring physicians.  Because this week is not so busy, I choose to help the medical students spiff up their oral presentations on their patients because of needed improvement.  It was a good weekend as we were able to discharge 7 patients on Saturday and Sunday and perform one urgent procedure.  Removing a swallowed coin (quarter) lodged in a 3 year old girl’s stomach is very satisfying … fast, dramatic, and increases its ‘value’ by an estimated 20,000-fold.  It’s a lot to run a nursing home at home and work at the hospital during the day. 

I exercise at the club before returning home where I begin Teri’s evening IV meropenum infusion and her oral medications.  This weekend, Grace (niece from CA), Phyllis (niece from IA), Judy and daughter Meleah provid the food supplies and support, cook regularly spiced fare for the group and bland unsalted fare for Teri. Grace makes a panko-encrusted baked chicken thighs but accidentally drops them on the floor.  Taking a cue from the famous dish Drunken Chicken, I promptly rename this new dish Dropped Chicken to the guffaws of all.

Teri gives me a tie as a father’s day present.  Rachel and Ben give me a massage.  Yes, perfect, just what I need.  Stop by my father’s apartment to wish him happy father’s day.  Check on his medication.  I help get Teri into bed, administer pain and sleep medication, position her feet above her heart.  She continues to have bladder urgency and I am up until 1:30 am pushing her in the walker to the bathroom.  

Overall, a nice day – Teri had a pretty good day – a nice Father’s Day. 

Pain beyond pain

Teri tolerance to pain may have declined.  For example, she barely flinched during her first nine bone marrow aspirations, but during her 10^th, she screamed at the top of her lungs.  

I’ve thought about this and there may be several concepts that apply.  There may be ‘central sensitization’ where hypervigilance (hypersensitivity) in the brain heightens the perception of pain.  There may be a ‘cumulative’ effect in which the total amount of pain has exceeded a maximum threshold and now all pain becomes unbearable.  It also seems likely that there are the added effects of post-traumatic stress.  It just seems as if her body has undergone too much physical torture and no longer can bear even usual bodily sensations.

I’m hoping these gradually reverse.

Little wonders

On little Jack’s last day here, Rachel demonstrated ‘baby yoga’ seen in the picture.  She warms her hands by rubbing them together and gently placing them on his head and limbs while saying a rhyme.  It is amazing to watch how calm and centered he becomes during this.  What is next?  Infant Montessori (Teri does it) … fetal massage …

Little Meleah enthralled us with her musicality, her powerful full-bodied vibrato notes on her new half-sized cello and her delicate and deft notes on the piano.  She enjoys performing.  What one can see after three years of piano and one year of cello (“always room for cello” Bill Cosby) is her clarity of tone, her expressiveness, and her love of music … and one son of a gun Tiger Mother.  Whoops, I wasn’t supposed to say that.

It is amazing to watch the next, next generation … who will they become?

BMT Day +122 An average day … Rachel, Jack & Great grandpa … Epiphany … Why the blog?

 An average day

Teri spent most of the day at the Day Hospital with sister Terri having blood drawn, being seen in Wound Clinic and having platelets transfused.  Since her last dressing change was so painful, she took Dilaudid (narcotic) and had topical lidocaine applied before the nurse cleaned and dressed the five open blisters like burns and covered them in three additional (pressure) layers.  Her leg swelling has improved and the blistered areas are healing after two days of this!

Terri sister returns to CA tomorrow and has been a great help.  Grace niece came from CA this afternoon, thus preserving the Wisconsin-to-California Teri Midwest-West side village balance. 

Rachel, Jack and Grandpa

                                                                                    

Jack has lit up the house.  He has an knowing smile that says ‘I know what’s up– I’m on the inside’.  He squeals as he watches the boats go past.  He watches you intently.  He laughs and guffaws so easily.  Great granpa Li is completely enthralled with Jack, and said as he watched him tool around in his diapers, ‘Jack and I wear the same underpants!”  Lest you think he has gone daffy, yesterday Great grandpa Li was sent galley proofs of a chapter to be published that he had written on a Yuan dynasty painting.  Can you imagine publishing original material at age 91 … when most of us if alive will be lame brained?

Rachel is a fitness buff, although retired from her Ironwoman events.  How you learn from your kids, she has challenged me athletically.  She has outfitted me in light weight running and biking gear.  She has taught me different weight lifting routines that I use consistently.  She got me to try a spinning class with her and John which helped preserve my summer biking legs over the winter.  She had me run with her yesterday, pushing Jack in his jet streamlined jogger.  I realize I enjoy it when the kids push me along … eventually in my own stroller!

Teri's epiphany

Teri says that she had her third epiphany of this exhausting illness.  She said that last night she was struck by the sudden realization that she will be cancer-free.  That she just has to jump over these many low hurdles.  But it will be.   She believes it.

Why the blog?

Some of you have asked me directly, why did I write this blog?  It is very simple.  When I first learned of Teri’s diagnosis of AML and the dismal long term prognosis, I knew that our time together was likely to be shortened.  My dream that we could age gracefully and enjoy sunsets together was shattered.  I therefore vowed that I would record as best I could our time together in order to preserve Teri indelibly in my words, in my memory...  Thank you for sharing this journal, even as painful a journey as it has been to date. 

Write a book?

In the past two weeks, about seven people have asked me to consider writing a book on “our harrowing journey to the center of her marrow, and back”.  This includes friends, colleagues and Dr. H. our primary oncologist/BMT physician.

I had thought about this fleetingly given the highs, lows, twists and turns of a fight with cancer that has turned our world completely upside down.  The shock and awe diagnosis.  The failed world wide search for a matched donor.  The joy of first remission.  The shock of relapse.  The near death from a superbug infection.  Resuscitation by autologous transplant.  The soul searching.  The insurance abandonment.  The successful transplant but with myriad complications. 

Ben asks the tough question.  What would the main point of the book be?  How would it differ from all the cancer survivor books on the market?

What do you think?  Do you have any suggestions?

BMT Day +120 Blisters … Rachel & Jack visit … Big Ben’s big news

Blustering Blisters

Teri needs two good days in a row! 

After a great day of firsts, she developed abdominal pains that kept her up at night.  Last night while sleeping with her legs wrapped, she popped up four new painful blisters on her left leg from the persisting lymphedema (swelling) in her legs.  So, part of today’s Day Hospital visit was to see a Wound Care nurse who popped them (pain) and encased her whole leg in dressings and pressure stockings.  Also, she had her 6^th (I think) abdominal paracentesis (to withdraw fluid from her abdomen through a large needle) under ultrasound guidance.  They withdrew 3.7L = 8.14 lbs which is like removing the weight equivalent of a large newborn.  Whoa.

Jack and Rachel visit

                                                                                    

I noticed a twinge of pain in my back today and asked myself what I did differently yesterday.  I then realized I had lugged 16 lbs of wriggling Jackmeister outside to spot his first horse. 

Rachel and Jack drove by themselves making only two stops in 8 hours through the bumper cars of Chicago to arrive yesterday. 

Jack remains, as Teri said again tonight, the ‘light of my life’.  I have been totally displaced and replaced.  He wriggles, he scoots, he rolls, he grabs, he tastes, he chews, he squeals, he smiles, he makes brrrrrrrrr sounds on your skin and gives love bites, he pats your back, he gives you a big wet smooshy one (how can I compete with THAT) … he brings delight and light to all of us, especially to grandmother Teresa.  And, we marvel at how good and natural a mother Rachel is.

Big Ben’s big news

Ben calls Teri daily on his way home from work.

“Hi Mom, how are you?  I have some news for you.”

“What is it? “

“You have to guess.”

[I don’t want to jinx anything by mentioning medical school that I’ve been waiting so patiently to hear about, but, oh well … here goes.]

“It’s not medical school is it?”

With a distinct twinkle, “Yes, I was accepted – I just received an e-mail at noon!”

[Sobbing with joy, completely speechless, long .................................. pause]

“Which school?”

“You have to guess.”

“Kansas?”

“No.”

“Cincinnati?”

“No.”

“Which was the other one?”

“Michigan State.”

“Where is that?”

“East Lansing.”

[More sobbing.]

And so there you have it, the end and the beginning of Ben’s story. 

After a degree in sociology at Santa Cruz, a year in China teaching English, two months tossing pizzas, four exhilarating months in Ecuador, one serious life-changing bus accident, travels to the Amazon and Galapagos, one unhappy year in a post-baccalaureate pre-med program and doing research on childhood obesity in Chicago, three intense years completing his other science requirements in San Francisco while working as a clinical research coordinator (Crohn’s disease) and volunteering in the S.F. General Emergency Room, one serious bike accident later, and a final uphill climb over a 40:1 applicant:matriculant peak … finding your mojo, hard work, persistence, maturity and miracles come together.  

This was 2^nd (to witnessing Jack’s birth) on Teri’s bucket list.

Kudos, Ben.

BMT Day +118 Four firsts … GVHD responding … turning it all around

Day of four firsts

Today was a day of firsts, small but significant events that happened for the first time in 5 months. 

Teri wore ear rings.

Teri ate out [but Qdoba did not agree with her tumnmy.]

Teri walked without a walker with assistance.

Teri went shopping for summer pants with her sister Terri.

Teri:  "It was a great day!"

GVHD is responding

The biopsy results came back and confirmed ‘mild’ tissue GVHD.  Three forms of corticosteroids are working to halt the injury and incessant diarrhea including IV methylprednisolone (systemic = total body), oral prednisone (systemic) and oral budesonide (local to the intestinal wall).  Her stools have firmed up in the space of 48 hours.  However, her gastrointestinal tract still seems delicate, sensitive and easily perturbed ala the severe Qdoba belly ache that is keeping her up tonight and not succumbing to a narcotic.

Clinic visit with Dr. H.

Teri was animated, humorous, upbeat, and most of all, thankful, 

“You look much better than four days ago!”

“I have never worked as hard on one patient as I have with Teri.”  B:  “Yeah”

How did Teri turn it around, regain her spark? 

Dr. W. her psychologist came to see her in clinic today with Dr. H.  Teri said she feels much better and had her spark back for the first time.  Teri spoke freely about how her mood and attitude have recently improved since discharge on 5/28.  She described putting her foot down.  First, she negotiated with the doctors (while I was in clinic) to discontinue the nasojejunal tube (feeding proboscis) that had become totally plugged (probably by coagulated protein).  That is, if they couldn’t open it up tube with guide wires or cleansing solutions, they would remove it and she would do her best to eat.  She won that battle.  She refused to undergo a bronchoscopy to sample a new lung lesion just prior to her discharge.  I asked Dr. H. to instead try antibiotic therapy and delay the test to a later date if and when she became sicker.  She won that battle.  She also reiterated that she was not going to return to the hospital as an in-patient.  She is winning that battle – all the doctors now present the alternate ways they can manage her myriad problems in Day Hospital.  Teri won three battles!  Superwoman kicks butt.

What seemed to transform Teri then was regaining her moxie, getting reempowered, recovering her autonomy that had been lost amidst all her hospitalizations and left her with clinically reinforced helplessness and powerlessness.  What she rediscovered was what clinicians call ‘self-efficacy’, perhaps one of the most important and ignored patient resources.  That is developing one’s ability and responsibility to take care for one’s chronically illness evolving from being the victim of the disease and to becoming master of ones self.  As a clinician I also find it to be critical in managing chronically ill adolescents but often don’t know how to help the patient achieve that state of mind.

Jack is coming!

Summer of China (in Milwaukee)

Exhibit:  The Emperor’s Private Paradise:  Treasures from the Forbidden City

On Wednesday, my father and I attended (except for Teri) the pre-celebration of a ground-breaking exhibit of furniture, artwork, calligraphy, screens, paintings and personal effects of Emperor Qian Long (Qing Dynasty 18^th c. 60 year reign and prolific supporter of the arts).  These objects had been recently restored  and are being shown for the first time anywhere.  This exhibit began at the Peabody (Massachusetts), traveled next to the Metropolitan (NYC) museum with its final venue is here at the Milwaukee Art Museum (MAM).  The pieces are dramatically and elegantly displayed and as my father the art historian stated, “They look better than in their native [Forbidden City] environment!”

A note about the MAM.  The Quadracci Pavillion which houses the exhibit was designed by Santiago Calatrava, a Spanish architect, and opened in 2001.  It is a beautiful sleek white marble addition which has moveable wings that when extended resembles a whale’s tail suspended above the surface as it dives into the deep.  It has become the architectural signature of Milwaukee.

There are also four side exhibits including a personal one entitled “Emerald Mountains:  Modern Chinese Ink Paintings from the Chu-tsing Li Collection”.  We are excited that my father’s collection and his discerning eye for contemporary Chinese art are on display here.  In fact, quite a number of the pieces have adorned our walls and it is cool to see them shown formally in museum format.  My father is very pleased with the results.  Ying Wang his former mentee served as guest curator and did a wonderful job of selecting and arranging.  One displayed work done by a Vancouver woman painter Koo Mei was painted especially for Teri.  For those of you visiting between June 11 and September 11, we hope you can view the treasures and ink paintings.  Click on the Milwaukee Art Museum link just to the right of the blog for more details.

BMT Day +115 Diarrhea and cramps (? GVHD) … Messages from Dr. H.

 Diarrhea and cramps … ? GVHD

After we finished the drenching fluid removal last week, Teri began to scrunch over in spasms of abdominal pain around the clock.  Shortly after, her stools turned watery.  She was seen as an out-patient on Tuesday and received extra fluids, albumin and K⁺.  However, the cramps, urgency and diarrhea continued her misery, day and night, and she began to get dehydrated.  I contacted Dr. H. and he arranged for an unplanned visit to the Day Hospital where she received IV fluids, albumin and also methylprednisolone (steroid) for possible graft-vs. host disease (GVHD) and metronidazole for possible Clostridia difficile (difficult) a bacteria that is selectively enhanced after prolonged antibiotic usage.

Today, she seems a bit better and only awakened twice last night to go to the bathroom.  When queried today, she even responded to Dr. H. “I feel better.” To which he responded “That’s the first time I’ve heard that in 2 months!”

Right now, she is undergoing a sigmoidoscopy to obtain biopsies to determine if there is evidence of GVHD now that the C. difficile toxin assay is negative.  She was initially terrified reliving her ordeal in the MICU on a ventilator from complications during her last endoscopy.  Dr. H. and I calmed her by explaining the low risk (she’s heard that before), avoiding the airway and brevity of the procedure.

We had hoped to dodge the GVHD bullet but it appears not to be, knowing Teri’s track record.  GVHD occurs when graft lymphocytes from the donor cord stem cells recognize Teri’s host intestine as foreign because of the imperfect match, and attack it, causing damage, inability to absorb nutrients, and voluminous diarrhea.  However, Dr. H. is anticipating that this will be a milder version of another potentially treacherous mountain climb.  The silver lining is that those same graft-attacking CD4 lymphocytes can also direct their attention against the recalcitrant BK virus that continues to cause kidney and bladder bleeding that has lasted 3 months to the day today.

Messages from Dr. H.

This week we saw Dr. H. three times, once in clinic and twice informally in the Day Hospital.  He gave Teri many messages.

“Teri, look at all positive things that are happening – your marrow is working!   We don’t find any more cancer!”

“There is light at the end of the tunnel.”

“You are so close to recovery.”

“This is just a bump in the road, the big picture looks good.”

“You will see Jack graduate from high school.”

“You’ve got to begin to think about the future.”

 “Teri, why are you so sad?  What can we do to pick up your mood?”  Teri:  “It’s been too long.”

“Teri, you need a dose of [grandson] Jack as soon as possible.”

“In my 15 years as a oncologist/BMT specialist, you have had the most difficult case – the most complicated course!”

“Teri, I never give up when there is a ray of hope.”  Teri:  [tears]

I asked Teri today what she recalls of what heard of last three days conversations.  She said, “Dr. H. is happy [for me].”  She is processing some of the good news despite being mired in an endless quicksand of complications.

As I processed the Dr. H’s comment on Teri’s penultimate clinical course, several thoughts percolated up.  You never ever want to be a subspecialist’s worst case, especially not an oncologist’s.  It is not a distinction to be proud of.  However, that statement validates Teri’s immeasurable pain and suffering, as if it needed such.  On further thought, knowing that Dr. H. has lost numerous patients to AML, that statement also implies that death may have been an easier course than Teri’s.

Family

Anita, Henry and Simon, Teri’s second oldest sister, husband and oldest brother from CA, that is the elders of the Ho family, formed a SWAT team to cook, clean, fix, sharpen, and organize our place.  Given Teri’s ups and downs, they had less time together than planned since she was in the Day Hospital 3 of the 4 days they were here.  They gave massages, but kept forgetting my turn.  They made oh jia, a family favorite made by Teri’s mother, comprised of ground pork stuffed between two thin cross sections of lotus root, then battered, and deep fried.  Yum.

We just got word that Jack will be driving up on Tuesday!   Hey, hey!

BMT Day +110 Awash in fluid … vicissitudes @ home

Awash in fluid

Fluid and weight disbursed:

3.7 L       albumin & lasix diuresis – Tuesday        

3.3 L       abdominal paracentesis – Wednesday

2.4 L       compression ace wraps – Thursday

Total = 8.4 kg weight = 18.5 lbs lighter in 3 days on the same scale!

Problems caused by the edema include the large blisters on Teri’s left foot that formed on Thursday and have made it painful to walk.  Looking at Teri’s taut skin, and worried about additional blisters, I realized we had to do something.  I fashioned mummy wraps with ace bandages in lieu of compression stockings. 

Vicissitudes at home

Teri putters about with a full palette of disability tools – grabbers, extenders and the like.  Dad’s walker serve as both upright support and ad hoc wheel chair.  She is opening mail, talking a bit on the phone, watching movies but not yet reading or doing e-mail.  Her emotions run high (Jack on skype) and low with tears that represent the condensation of the long haul, her disability, and simply not feeling well. 

We have spent 6 of the 8 days of Teri’s release from the hospital at the Day Hospital for 8 or so hours per day.  Part of the long out-patient haul.  Sometimes, we close the place and in fact have had difficulty exiting the key- controlled doors. 

It is definitely busier for me at home trying to meet Teri’s specific dietary needs and taste bud desires, household chores and nursing (IV, drug and dressing change) requirements.  Aina from Columbus came and helped us for 3 days, and Monica and Kevin, Elena at the Day Hospital, and Sharon dropped by.

A book

I read a little after Teri goes to bed.  I just finished “Cutting for Stone” by Abraham Verghese, the third book (My Own Country, My Tennis Partner) by an Indian-Asian internist now at Stanford.  I highly recommend it.  It is the epic saga of the interwoven fates of two Indian-British twins who grow up in war-torn Ethiopia.  The incredible characterizations are interwoven with the intricate medical details.  This really doesn’t do it justice.  

Bumps in the road vs. big picture

Teri hates it when the BMT team or I refer these endless medical challenges she encounters as ‘bumps in the road’ (e.g. blisters) as compared to the ‘big picture’ mountains that have to be climbed and traversed (e.g. engraftment, graft vs. host disease).  However to her, whatever the panoramic perspective of the medical viewpoint, each of the bumps that causes pain and suffering become personal mountains to her. That is just being a bump in the road is no comfort to her.

Finally

Terrible tummy cramps last night kept us both awake trying various medications and measures to no avail.  Although we had a planned Day Hospital visit, we went in early to be evaluated by the covering resident and BMT attending.  The initial abdominal x-ray was OK with some dilated small bowel loops and the CT showed an edematous small bowel loop, excess stool on the right side and other previous findings remaining the same.  The attending as expected suggested that Teri might best readmitted and she reiterated her stance that she was not crossing that river.

Sunday’s medical verdict is:  We can go home, but no free day tomorrow, back at the hospital for re-evaluation.