A Room With a View
“All people have been doing since the dawn of time is trying to figure out how to live this life and be happy”
-Will Arnett
That was the celebrity cipher that I decoded from the Lancaster Newspaper as I sat in my hospital bed last Saturday morning. Despite all of the evidence that I had read to the contrary in my internet cancer research, I never really expected to end up in the hospital during my treatment - especially not this late in the game.
Just over a week ago, I was preparing for my penultimate chemotherapy. I woke up last Thursday morning feeling tired, but I have come to expect tiredness, so I didn’t think much of it. I was expecting to feel relatively well on the day before my infusion and I had plans to be productive or at least to use my bimonthly burst of energy to aimlessly roam the aisles of TJ Maxx smelling candles through a cloth mask and impulse buying things I don’t need. I dropped into the office, briefly chatted with my coworkers and headed over to the lab to get my pre-chemotherapy blood work.
After my routine blood tests, I was feeling even more tired, very dehydrated and generally bad. I started to drive home after deciding that the TJ Maxx candles would have to wait and stopped at the Turkey Hill by my apartment for provisions. I bought a large bottle of water and two bologna and cheese Lunchables. By this time, it was approaching 1 pm and I decided that I had no business being awake anymore. So, I ate my Lunchables, drank some water and took a nap. I woke up several hours later to find that I was feeling somewhat better, except for some unfortunate gastrointestinal issues. I will spare you the euphemisms and leave the details to your imagination.
To continue our story, a rudimentary understanding of some medical concepts is helpful. While I am not a medical professional myself, I have learned a lot about medicine during my cancer treatment and I feel qualified to give a basic education for the purposes of this blog post. By far, my least-favorite new vocabulary word has been: Neutropenic. I’ll take a brief interlude from my narrative to inflict this definition on you, but if you don’t care about science and you find your eyes glazing over feel free to skim to the next paragraph.
In short, chemo can really screw up your immune system, and my particular chemotherapy loves to murder a certain type of white blood cell called the neutrophil, which helps your body to fight bacteria. (Still with me?) For the last six months, I have been battling with my body to keep my “absolute neutrophils” at a reasonable level for a disease fighting human- with mixed results. To be more quantitative, (Ah! No, not math and science, make it stop!) I have been trying to keep the “absolute neutrophil” value on my pre-chemo blood work above 1.0. For reference, the standard range for this value is between 2.2 and 8.0. (I’m almost done, I promise.) When I was hospitalized this number was 0.39. (A new record low for me!) Just to recap, 2.2 is the low end of normal, 1.0 is the bare minimum, and anything below 1.0 is straight up garbage, also known as Neutropenic!
TLDR: Neutropenic = Straight up garbage
As I started feeling worse again, I did what people do in times like these and I called my mother, who of course came to the rescue. She arrived with a bag of medicine, a digital thermometer and most importantly, the wisdom to suggest that I call the cancer center. At this point, I was basically in denial about how sick I really was and was only calling the cancer center to confirm our hot chemo date that was scheduled for Friday afternoon.
It was 4:30 pm and I had to call twice to get a real person. When I finally reached the nurse, she listened to my symptoms and told me to take my temperature, which clocked in at 100.8 degrees Fahrenheit. Most people would consider this a pretty mild fever, but for a person who is neutropenic this is bad news bears, because like I said, I have almost no ability to fight infections and a fever is your body’s way of burning off - you guessed it- an infection. Much to my chagrin, the nurse told me to go to the ER - in Lancaster of all places. So, my plans for a quiet evening at home, Facetiming my brother and cooking a Blue Apron meal, quickly evolved into a full on medical production.
Just over an hour later, we arrived at the Lancaster ER which was an absolute shit show. I checked in and tried to exile myself to the most remote corner of the waiting room to avoid contracting any additional infections that might topple my already precarious immune system. The ER took an eternity, as ER’s are known to do, and when I was finally roomed, I was in pretty bad shape.
My heart was racing, my blood pressure was dropping and my temperature, which had regulated when my vitals were first checked at the ER, was now spiking again. Dazed and disoriented, I laid in the cold and hectic emergency room for hours, waiting for answers.
Finally, the ER doctor ordered a CT Scan of my abdomen to make sure that I didn’t have appendicitis. I had a headache and sensitivity to light, so, when I was wheeled down the hallway in my hospital bed for the CT Scan, the nurse who was transporting me covered my face with a towel. I kept thinking that I must look like a corpse, laying on a gurney like that with my head under the blanket.
When I arrived in the scan room, the nurses helped me on to the table and walked me through the scan process. I was instructed to breathe in deeply and hold my breath for 10 seconds while the CT machine took images of my abdomen. After practicing this a couple times and taking some baseline pictures, the nurses injected me with an IV contrast serum to make the CT images more pronounced. This contrast makes your body hot and tingly all over and tricks your brain into thinking you may have peed yourself. Unfortunately, the contrast also made me desperately and immediately nauseous, just before I was instructed to hold my breath for 10 seconds.
What followed was an extreme test of mental and physical fortitude as I endured the longest 10 seconds in recent memory. I was very proud of my restraint, but like those ten seconds, all things must come to an end and as soon as they did, I promptly began to vomit violently into a sterile blue bag.
If you’ve never been admitted to the hospital you should count yourself lucky. But if you have, you know that it is not a pleasant experience. When all was said and done in the ER, I finally arrived to the 8th floor Oncology ward of the Lancaster hospital, which felt like heaven compared to the emergency room. It was already 2 am and my night was just beginning.
The next step was the COVID-19 test, which is not much fun either. I fought back tears for 30 seconds as the testing swab tickled the frontal lobe of my brain. Thankfully, I managed this considerably better than my last COVID test, which provoked an uncontrollable sneezing fit on the poor nurses of the drive-in testing center back in May. (Sidenote: I do NOT recommend sneezing when you have a 4-inch nasal swab shoved up your nose.)
The IV antibiotics and fluids kept me attached to a pole by the crook of my left elbow, which I was now forbidden to bend under penalty of incessant beeping. Throughout the night, the nurses woke me up to check my vitals, change my IV antibiotics, respond to accidental elbow bends, and drain vials of blood from my right arm for additional tests. My unfortunate gastrointestinal euphemisms had also gotten worse throughout the night and were helping to keep me awake while the nurses were busy. I didn’t get more than an hour of uninterrupted sleep the whole night.
I know this all sounds miserable, but that’s just because being in the hospital is naturally awful. It’s no reflection on the facility or the staff, it’s just the truth. In fact, the nurses were the highlight of my stay – they laughed with me, brought heating packs for my stomach, and collected stool samples with a grace and dignity that can only be described as saintly.
Over the course of the next few days doctors also filtered in and out of my room, mostly to explain to me that my chemotherapy was being postponed and that they still hadn’t found what was wrong with me. Apparently, mysterious infections sometimes happen when you are neutropenic and no amount of 5 am blood samples can determine their cause.
Luckily, the antibiotics and bed rest were doing their job and I was starting to feel better by Saturday. With the only notable side effect being an allergic reaction that only made the toes and side of my feet itchy. (???) I was also very thankful to be allowed two visitors, which is quite the luxury during pandemic times. My mom and my sister both came to keep me company and help me with the newspaper word games.
I was finally discharged from the hospital on Sunday, and my chemotherapy was rescheduled for the next day, which didn’t allow for much down time. On the bright side, it did allow me to keep my appointment for my final chemotherapy, which is scheduled for this Friday, barring any more hospital visits.
I was really hoping for an easy ending to my cancer treatment, but, if 2020 has taught me anything, it is to expect drama. Frankly, I should have known better. I think that all my pain and suffering over the last several weeks will only make the finish line that much better. There is also a full moon on Saturday and the waxing gibbous in the sky is just an added reminder of how close I am to being finished. (And yes, I’m keeping track of my chemotherapy schedule with the moon – doesn’t everybody?) After all, it is spooky szn, and I’m trying to keep things witchy. Happy Halloween y’all and fuck cancer.
