Friday 28 June 2013

The $5 quiche





My habit each evening when I got home from the hospital was to have a hot bath. My left arm had to hang out of the tub to keep the PICC line dry but every day I looked forward to the routine. It allowed me to scrub off the smell and feel of the hospital. I filled up the tub, soaked my body, dipped my head under the water and washed my hair and scalp. Recovering from the high dose cyclophosphamide back in May, my head was now lightly covered with tiny strands of hair, like a baby’s scalp, with more hair in some places than others. When it was wet it reminded me of bathing the girls as infants. Their blonde hair would become invisible against their wet heads. The memory made me smile. I felt so relaxed and happy in the hot soapy water, a million miles from IVs and blood tests, that I had an epiphany. I suddenly wanted to volunteer. I saw myself driving old people to doctor’s appointments, volunteering at a hospice, helping the sick wherever and whenever I could. Then a reality check about wanting to do good things, but wanting to make a bit of money came crashing through. I wanted a selfless, satisfying, charitable job that paid.
      Thursday I checked in but didn’t check out of the hospital. I was having diarrhea again and my blood pressure was high at 158 over 102. My creatinine had lowered to 139, but was still more than twice my normal output. My mouth was starting to get inflamed.  A red area around my PICC line had to be watched for infection. My neutrophil count (the white blood cells that defend the body against infection) was almost zero.                On top of this there had been an “outbreak” in the hospital. The nurse wouldn’t tell me what sort of outbreak it was. But we were banned from using the communal kitchen and the cleaning staff would be working overtime to scrub every surface and throw out thousands of dollars’ worth of medical supplies that might be tainted. With no neutrophils, the word “outbreak” had me cowering in my room. I was given a GCSF injection, the same drug Alex had delivered to me to boost my stem cell count, to encourage my neutrophil count up.  It was time for me to stay in the hospital 24/7 hiding from germs.
      The prospect of the next five days with no immunity was pretty scary. Alex got obsessive about using alcohol solution. He used the pump inside my room, in the unit, in the ward, and in the main hospital. Everywhere he saw a bottle he squeezed it on his hands. We were really nervous. I read a story in the New Zealand Herald about listeria at Hawkes Bay hospital. Two immune-compromised older people died after eating tainted salami. They had probably used alcohol wipes and everything. You never knew where the bugs were hiding. But to go through chemotherapy and a stem cell transplant then lose your life over bad salami was pretty cruel. What a way to go.
      Fever set in on Friday. The highest it registered was 38.4 but it kept above 38 for the next few days. By Monday I was still feverish. My white blood count was under .10 (normal was 4.00-11.00). My hemoglobin was 93 (normal was 115-155).  My platelet count was under 10 (normal was 150-400). I had zero neutrophils (normal was 1.9-7.5). I was in bed a lot of the time, and spent my nights in feverish sweats. I hardly ate, slept a lot during the day and felt lousy. My anti-nausea medication and anti-diarrhea medication both did their jobs commendably however and both issues resolved themselves quickly. By the following Thursday my white blood cell count had risen to 1.97 and neutrophils to 1.37. I had bounced back enough that I was released to go home that night.
      The next day, Friday July 27th, after a PICC dressing change and a blood transfusion to combat my low hemoglobin, I was officially discharged at 2.30pm. I had been in the hospital just two weeks. The staff wanted me out of the room because the next patient was waiting for it. I packed up and walked down to the hospital lobby. Alex was in Hamilton. He said he would leave immediately but it was still a two-hour drive to Auckland. I sat on a sofa in front of a TV, with a knitted hat on, hiding my now almost completely bald head, thanks to the high-dose melphalan. My few possessions in plastic bags were next to me. I started dozing off so I went to Muffin Break to get a coffee and decided to get a spinach and feta quiche that caught my eye in the warming cabinet. Halfway through eating it I suddenly remembered what I had read in the low-immunity food guide. I wasn’t supposed to have food from warming cabinets or soft cheeses. In fact the delicious little quiche probably ticked all the boxes for everything I wasn’t supposed to eat. I hadn’t even left the hospital and I had gone wrong already. I thought about the salami ladies and imagined the opening sentences pertaining to my death:
      Ten minutes after being discharged from a $200,000 stem cell transplant, a patient died in the foyer from complications after eating a $5 quiche.

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