Still there

Adrienne is still in the hospital as her pain isn't under control yet. We're trying to get her on oral meds but she still needs the IV dilaudid. Hopefully, we'll see some improvement soon. At least her mouth is better but she has little appetite even though I keep bringing treats in.

In Hospital

Adrienne is in the hospital now. We had her admitted yesterday afternoon after giving her everything we had at home. I was concerned about overmedicating and drug reactions, so after calling the clinic, we agreed to so in. She dropped her class at UNLV, which is no big deal, but it's a prerequisite for most of the classes she planned for the fall. She's been on IV dilaudid every two hours since being admitted and this afternoon we started to get her on oral pain meds. She still isn't pain-free so she'll keep the IV as long as needed. If the pain is from the Neulasta, it should go away on its own in a few days. If not, well, we'll deal with it then. The mouth pain is much better and she even ate some fried chicken for dinner. Except for the pain, she's actually doing okay, no shortness of breath, no weakness, nothing.

Except...I went downstairs to get her some ice cream and came back to find a neutropenic sign on her door. After a bunch of checking, she really isn't that neutropenic but they're being extra careful. They wanted to give her a Neupogen shot, which would likely give her even more bone pain. Huh? I made them call the doc and the shot was cancelled but I expect her ANC will be almost nonexistent tomorrow. We had hoped to get her out of there on oral pain meds but now I don't know. We'll see what tomorrow brings. For now, she's resting fairly comfortably.

Miserable

Adrienne got the vinblastine last Thursday with little fanfare and no nausea. She didn't feel up to going to class that evening, but that's probably because Curt and I talked her out of it. Friday and the weekend were a different story. Between the mouth pain from the vinblastine and the bone pain from the neulasta, Adrienne has been absolutely miserable all weekend. She took as many pain meds as she could but you can only take so much and it wasn't helping. Last night, she finally got the right combo and was able to sleep but woke up early this morning hurting again. Since taking yet more pain meds, she's feeling a bit better now. I have a message in to the nurse to get some Magic Mouthwash, which should help her mouth pain at least. We can't tell if her former pain is gone yet because she's hurting so much all over. Hopefully this won't last much longer as she refuses to go to the ER for IV pain meds.

Vinblastine it is

Adrienne saw the new oncologist at NVCI yesterday to get counts, assess her pain, and determine how to move ahead. Her CBC showed low hemoglobin, which is typical when she has a lot of disease, making her pale and tired. Still, she finished the first summer term and started a new term on Monday. Her lymphocyte count is almost nonexistent so she needs to be extra careful as this makes her susceptible to opportunistic infections. Her CT showed a small problem around the bile duct that connects the liver and gall bladder. The elevated alk phos confirms this so it's something we need to watch. This liver issue surfaces from time to time and typically resolves on it's own so we'll just keep an eye on it.

On to the pain. NVCI has a new pain doctor who spent a lot of time with us yesterday. Both she and the oncologist did thorough pain evaluations and no one can figure out where Adrienne's pain is coming from. There's nothing on the CT that explains it and pressing everywhere doesn't make it worse. We can only assume that it's coming from bone lesions. She's had these before and they can be quite painful. We got several new prescriptions so she can escalate as the pain gets worse, and hopefully, she'll have less breakthrough pain.

The general feeling is that everything showing in Adrienne's lungs is disease so we need to move ahead with treatment. We made the decision to do vinblastine every other week. This is the "V" in ABVD. Adrienne never did ABVD but she's had vinblastine before, though not since 2002. With Hodgkin's, you can often go back to old drugs and we're hoping that's the case now. She starts tomorrow (Thursday) and we're counting on this being relatively easy.