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taken 8/4/07

Courtney and her kids

Courtney and her kids
taken 8/4/07

Saturday, January 19, 2008

D + 38 – Home Again

When Tuesday’s clinic visit came, we figured it would be a relatively short visit. That turned into what we thought would be an overnight stay at the hospital so they could run a couple of tests the next day. Then one night turned into two which quickly became three. Finally, after four nights in the hospital, Courtney is back in her own bed.

This was a long week made longer with uncertainty. Each day brought with it more questions that seemed to take forever to get answered. When is the EGD? When do we get results? Can Courtney go home? What’s causing the nausea? Will there be more tests? Can Courtney go home tomorrow? Is that a new medication? What are we waiting for? When can we talk to a doctor? Why are we here?

Eventually most of the questions were answered, and Courtney’s condition slowly improved. Her blood counts took a turn for the better. The pain she had been feeling just below her ribs subsided. And, the nausea, that had been so persistently bothering her for the past week, finally relented today.

Here’s a quick recap of what transpired since Wednesday:

Thursday – Courtney finally underwent the EGD (For those of you wonder how to pronounce “Esophagogastroduodenoscopy”, here’s the pronunciation - ĕ-sof′ă-gō-gas′trō-dū′ō-den-os′kŏ-pē). Other than the fact that Courtney’s resistance to Versed caused her to fight the nurses as they forced the scope down her throat, the procedure went well. The doctor’s report actually includes the statement, “After adequate conscious sedation was achieved, the patient was intubated and the scope advanced under direct visualization to the third part of duodenum.” I’m not sure how they define “adequate.” I suppose they thought Courtney wouldn’t remember it. I think that’s usually the case with the “conscious sedation.” Anyway, they got the information they were looking for, and in the process took some nice pictures of Courtney’s innards. (Not many people can say they’ve seen their duodenum.) The verdict – Courtney has gastric paresis and acute gastritis. Given the recent chemotherapy and all the meds she’s been taken, neither of these was a surprise. In the process, they took a couple of biopsies. These results won’t be back for a few days.

After the procedure, Dr. V. started Courtney on the steroid Prednisone. This is used to counteract the GVHD, if any, and hopefully help her feel much better. Unfortunately, it has the unpleasant side effect of causing restlessness, and Courtney didn’t sleep well Thursday night.

Friday – First official day to be off the Foscarnet. Thank goodness. Hopefully she won’t have to revisit this drug. And hopefully we see her condition steadily improve. Basically Friday was spent weaning Courtney off of the IV meds they had been giving her since Tuesday. By “weaning” I mean switching to an oral form. They want to make sure she keeps them all down before sending her home. Right now, their biggest concern is that she consistently gets her antibiotics and Prograff (anti-GVHD drug). They really don’t want these to come back up or for her not to take them because she feels too nauseous. So, one more night in the hospital. And it was NOT a fun night.

The night was long because she had a bad reaction to another drug. Add Meclizine to the list. Dr. V. decided to try it to help her nausea since the scopalomine patch didn't seem to be helping that much. She took her first dose yesterday afternoon without problems. However, her second dose, given around midnight last night, made her react much the same way compazine did back in October. Skin crawling, muscle twitching, painful, irritating, etc. Unfortunately, the nurse had to page the doctor to get permission to give her benedryl. So, it took a little while to get and took a while longer for it to work. Since that was the only new medication given, and since it's kinda in the same family as compazine, we were fairly confident that meclizine was the culprit. So, we told her nurse to skip the next dose, due at 6:00 AM, until we could discuss it with Dr. V. Well, at 6:00 AM the nurse came in, nudged Courtney awake just enough so she could take it. Courtney, having only been asleep for barely three hours, took it without really knowing what it was. And, sure enough within an hour, was feeling the effects again. Fortunately, Dr. V was at the hospital by then, and Courtney was able to quickly get the benedryl and dilodid via IV. That helped alleviate the side effects much faster than last night. So, no more meclizine.

Dr. V gave Courtney the go ahead to go home if she felt up to it. After sleeping for a few more hours, she was feeling much better and very much wanted to go home and see the kids again. So we packed up and headed home. Now, after a good evening of spending some time with the kids, eating a couple of small meals without getting nauseous, she’s sleeping soundly in her own bed once again. Quite the contrast to last night.

One more thing. Dr. V came in yesterday evening and told us the genetic tests came back. The report states that her cells were >95% donor (Tracy) cells!! >95% is the highest it can be reported. And Dr. V said basically it's 100%. She also said, "No recipient (Courtney) DNA detected." Which means no leukemia, and less likely that it'll reappear!! Very good and happy news. Courtney couldn't wait to call Tracy, but when we did get her on the phone, Court was too emotional to talk.

It's nice having good news once again. These happy milestones help soooo much, especially after a very long and crummy week.


Elena said...

Yay! I'm sorry for such a tough week. I can't even imagine what it was like. But, I'm as excited as can be about the AWESOME news. My prayers are still with you. Best of luck.

Cheryl said...

I am so glad to hear that you are home! Way to go Tracy's cells!! I knew you would kick cancers butt... I hope that you continue to feel better.
We are thinking of you while we are here in Idaho! Always in our thoughts and prayers!!
Love and Miss You,
Cheryl, Cobi,Preston & Adyson

Anonymous said...

Wonderful news about Tracy's cells and so glad that you are home again!

I can't remember if you had any reaction to lorazapam - but that was what I used as a "sleeping pill" to counter act the prednisone. The Drs. usually give it in .5mg dosage but at night I found it usually took 1 mg to counteract the prednisone enough to sleep. Dr.s are usually aware that prednisone leads to lack of sleep but also will not usually give you anything to counteract it unless you ask. A plus side to the prednisone is that it can help increase your appetite!

Still praying.
Lisa Dahlmeier

Rhonda said...

We are very happy that you are home and feeling better
Rhonda, wi

Amy said...

just the news we have been praying for...congrats! Such a great way to end this rough week you have had. I hope it only continues to get better from here!

Kiera Mathis said...

That is great to have some happy and good news. I am glad you are home and able to be with your kids. I hope things continue to get better! We are all still praying for you.

Marla said...

That's great news!! So glad you are home!!

meredith said...

Wonderful news!! I'm so glad you are home!!!

Meredith B. said...

Yay for Tracy's cells, I'm so glad that you got such GREAT news to end your bad week....hope things will be looking up from here!

Anonymous said...

Courtney ~ I was thinking of you today and wondering how you are feeling. We hope that things are looking up for you. It was good to see the girls on Sunday. We are always here if you ever need anything!!!
Love, Emily & family

crys said...

Man, I am feeling crazy right now. For a few minutes I was furious for you and wanted to march to your hospital and yell at them. Dumb nurses are so annoying and versed is no longer an option for Alexa at all because she acts the same way you do on it. I could just picture it and I am really feeling for you. Then I went straight to extreme happiness when I read NO LEUKEMIA. I am so excited for you and I can't imagine how you must feel for your sister. Keep up the good fight and I am glad you are home. Hope to see you soon. Hope your hair grows back quickly too even though I think you are so beautiful regardless but I know what it means to have such an outward reminder of sickness.

Bryner Family said...

Thank heavens for Tracy! Glad you're home now. This week will have to be better, right? :) The Bryners are still praying for you guys!

Crysta said...

So glad to hear the great news! Courtney you are a fighter. Grayce had a good time playing with Emma at Mc D's storytime Monday. She didn't realize that they had gone home and she came to me crying and said, "Oh no mommy, my friend Emma is missing!" It was so cute. Wishing you better days and stronger health.

Emily R said...

yay!! i am so happy for the great news!glad you are home again!

Leisha said...

It was nice to read such good news at the end after reading what an ordeal you've been through this week. I hope being with your children and sleeping in your own bed strenghtens and heals you even more!

Anonymous said...

Courtney, this is great news for you and hooray for Tracy ... she is one tough lady, witnessed by her incredible cells!! What a woman and what a remarkable and brave woman you are, Courtney. You are truly an inspiration to us all. Keep getting better. We all love you.


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