MCL - Sent to the ER

MCL - Sent to the ER
Cally Berry Dog showing concern. Either that or she wants treats.

(Originally published March 11, 2022)

There are certain advantages to being a morning insomniac - such as being alert and awake when the oncologist calls you at 5:30am on a Tuesday morning telling you to go to the ER because your pre-treatment blood labs tell him that things are going sideways.

Wake up the partner, go back to the Inova Alexandria Acupuncture Spa and Wellness Center (eg - the local hospital), get to know the current ER nurses, install IV ports in each elbow, be wheeled around to various scanners, and, after all that, get admitted, again.

So many blood tests.  At one point, the nurses brought out the mini-bar blood bottles.  Overall, I probably gave a pint of my own blood for testing.  In exchange, over the course of the day and well into the evening, I received 3 bags of blood in an attempt to get my hemoglobin levels high enough for me to get another bone marrow biopsy.

The next morning, they wheeled me back down to Interventional Radiology.  The nurse looked at me, looked at the chart, looked at me again, and raised her eyebrow - "Weren't you just here?  Didn't we do this before?"  Yes and yes.  I like them so much that I decided to come back and visit. The Inova Alexandria Interventional Radiology crew make scary and uncomfortable procedures (like a bone marrow biopsy) painless and a lot less traumatic.

I asked why my experience with bone marrow biopsies was so drama-free compared to other stories. The anesthesiologist suggested that getting a procedure like a bone marrow biopsy in a hospital where they can administer the best drugs (fentanyl FTW) is the way to go.  Apparently, most people get bone marrow biopsies in outpatient clinics with only local anesthetic. During a bone marrow biopsy, the surgeon drills a small hole in the back of your hip to get to the bone marrow.  A procedure where they are drilling holes in your bones using only local anesthetic sounds pretty miserable.

The party drugs they give you in the hospital makes that procedure a visit to lala land. The other advantage to hospital-based procedures is that the anesthesiologist can help me with pain control for that day. After each visit to interventional radiology, I am pain-free for a good 8 - 10 hours.  As long as I don't sign legal contracts or spend a ton of time online shopping, I'm OK.

It turns out that I am no longer generating my own blood. This indicates one of 3 things: that I'm reacting poorly to all of the stuff that has been happening recently that has pumped anesthesia and other things into my body (such as the PET scan and the Medi-port install, which I will talk about later); I'm reacting poorly to our current treatment plan; OR that my cancer has become hyper-aggressive and we have a big problem. We'll know more as the analysis comes in.

During my stay, I received multiple bags of IV anti-biotics to help address some issues with my spleen. Apparently, the stress of the cancer, the gross enlargement, and all of the extra goodies being pumped into my body is causing further damage.  After significant discussion with the surgeons, the hospitalist, and the oncologist - they feel the anti-biotics will help at least slow down if not reverse the damage. Second option will be blood thinners. Everyone, including the surgeon, is looking at spleen removal as an absolute last resort.  As the surgeon joked, "I love to do surgery, but this is one that I don't think will help.  We all want you to keep your spleen. You need it."

They released me from the hospital Thursday morning.  The hemoglobin numbers stabilized and started to grow back on their own accord after the 3rd bag of blood.  My hemoglobin and red blood cell counts are still really low.  This next week is likely going to require multiple visits to LabCorp. The oncologist, my partner, and my family will be having numerous discussions over the next few weeks to determine what happens next.