I took the girls to see Kirsten at the hospital tonight. Kirsten had a difficult day, and it showed. It was very nice, though, for the girls to see her and for her to see them. The mood was somber, but with a lot of love (with an almost urgent, purposeful feel, which is weird). This situation has been difficult for us all; the gravity of Kirsten’s declining health was evident in her watery eyes.
Kirsten has not had another hypertensive crisis episode since Wednesday morning, but she is in constant pain and her blood pressure rises to the 150+ mmHg (systolic) range. They are running a twenty-four-hour urine test again, telling her they can only test one thing at a time. The serum in blood test showed negative for pheochromocytoma, but they want to be confident of ruling it out with the urine test.
Dr. Isacke suggested cementing her fractured vertebrae (vertebroplasty) to provide support, as well as manipulative therapy of her spine. Dr. David Keller stopped by today and did the therapy.
Dr. Hedly, head of the resident endocrinology team, as well as Dr. Kulke, Kirsten’s oncologist at Dana-Farber Cancer Institute, thinks the chemotherapy targeted cell lysing is causing hormones (catecholamines) to be released causing high blood pressure spikes. I’m curious how that’s possible, since her tumors are pituitary, which does not secrete catecholamines. I was at work today, and not available to talk to the doctors and ask follow-up questions. I would also like to know why they were hesitant to diagnose anything before completing the myriad tests, but now are quite confident despite not having received the results. Perhaps they just needed time and consulting with each other to narrow down based on what they already know.
While we were hoping Kirsten would come home today, that obviously didn’t happen. She has to be in the hospital to finish the urine collection. After that, they’re going to start her on blood pressure medication, which she will continue at home. They have talked about sending her home with a blood pressure monitoring machine, but that was apparently decided against because heart rate is more easily monitored at home. They will keep her in the hospital until her blood pressure is stabilized. I have no idea how long that might be, obviously.
Because they suspect these current issues are caused by the chemotherapy, they are suggesting a scheduled inpatient stay next month during the course. Also, Dr. Kulke would like to see her in Boston next week, even though our scheduled follow-up isn’t until the end of May. I’m not confident she’ll be strong enough to travel to Boston next week (at least not on the train and subways).
Kirsten is pretty down. Hope and optimism have been mostly replaced with a sober realization of the seriousness of the prognosis and imagining what the future is likely to entail. I hate that someone as sweet and caring and giving and selfless as Kirsten has to suffer as much physically and emotionally as she has. I will never understand what drives people to double-down on god when confronted with these difficult situations. Random is depressing and unfortunate; “Purpose” would be inexcusable and infuriating.
Thank you all, again, for your many kindnesses. We need you now more than ever.