Friday, January 18, 2008

January 18, 2008 Late Evening

I am writing this tonight from the U.W. Hospital. It has been another long day. We all expected yesterday that Sabine would come home (after all, we go the house all set up in time!) but other things were in store for us today.

There appeared to be a conflict between the kidney doctors and the cancer/blood doctors. Yesterday the renal team wanted Sabine to be taken to dialysis but the oncology team wanted to wait (I think they were worrying about infection as Sabine had already received her chemotherapy. I had to try and get the conflict resolved between the two teams. Late this morning the kidney docs said that if Sabine did not get dialysis right away she would be getting VERY sick (creatinine levels went to 7 and the BUN to 70!).

But we did not want to start dialysis until we had a sign off from the cancer team. We finally got the two lead doctors together (who hadn't met before!) and agreed that we had to do the dialysis.

Sabine then had surgery in her room to put a "pic" line into her jugular vein in order to receive the dialysis. At 6:30 p.m. she head down to the dialysis unit for 2+ hours of dialysis and 2 pints of blood. She will get dialysis again tomorrow afternoon and then again on Monday. They start slow with dialysis in order for the body to get accustomed to this intervention.

I just got her up to her room and it appears that so far she is tolerating both the dialysis and transfusion. As her blood count plummets in the next few days we have to watch out for infection. We hope we can get her out of the hospital early this coming week.

Over 30 days in the managed health care system is a frightening experience -- so far we have experience what appears to be a lack of system coordination and our HMO fighting over where the labs are to be drawn. Because our HMO wants us to use their lab, we frequently find ourselves meeting with the specialists at UW Hospital without the lab data in their possession. We get blood pressure medication that is known to compromise folks with acute renal failure because it drives Potassium levels (Atacand). We repeatedly have to ask, "Now who's in charge here?" Who takes the lead when different disciplines conflict?

God help us.

Sabine greeted me this morning (after warning me by phone) that she had had her head shaved in anticipation of losing her hair. So this morning I had a chance to meet either Sigorney Weaver or G.I. Jane -- take your pick.

Yes, our life is changing and it is a scary time for both of us. But we are convinced that it can be just as good a life as we have always lived -- dialysis? We can do it!

Sabine and I have always been a team that has been able to handle whatever is in front of us. This is no exception.

Thanks again for your love and support.

p.s. If someone now and then could help my son, Josh, out with some painting inside the cottage in nearby Mazomanie, it would be of help to us. Just give me a call on my cell (608) 444-7207.

Now for a good night's sleep in B6/624 with my beloved! What could be better than to be with her?

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