Kirsten Update – April 27, 2013

10:44

Dr. Devon Evans came in while we were talking to Dr. Ross Isacke. They’re still running the 24-hour urine test, which we hope will provide some answers. Dr. Evans doesn’t think it’s a chemo-related problem (tumor lysis syndrome), because we would likely have seen it several-fold more severe during the higher dose in the first round.

Every doctor seems to have a different hypothesis, which I actually find somewhat encouraging, as it reduces groupthink and keeps the discussions open. Dr. Evans (Kirsten’s oncologist before we started seeing Dr. Kulke in Boston) seems to have good reasons for disagreeing with what I’ve been told by other doctors the past couple days. If her tumors are pituitary, I don’t see how they could now be pumping out catecholamines, unless they were releasing things that would then trigger a pheochromocytoma to start pumping them out. That seems a bit too complex, but Kirsten is, if anything, complex. He thinks this might be something completely new, unrelated to the complications of last summer (she no longer has adrenal glands) or chemotherapy.

Kirsten enjoyed her breakfast this morning of French toast and bananas
Kirsten enjoyed her breakfast this morning of French toast and bananas

They are going to monitor Kirsten today for more hypertensive episodes, and give her oral medications if she has one. If she does, and they do, and it’s successful, they feel it would be safe to discharge her from the hospital. Otherwise, going home is just too risky.

She ate a delicious-looking breakfast and is now sleeping. Pain is a blissful “2”.

My old buddy from this summer, endocrinologist Dr. Emily Demetriou, stopped by. She said Kirsten was put on Phenoxybenzamine last night, and that it seems to be working (Kirsten is sleeping, has low pain, and normal blood pressure). It was great to see her. I’m glad people from this summer, who are familiar with Kirsten (and me and my constant probing, challenging, postulating, and second-guessing) and her medical history, are joining the team. We talked a little bit about alpha- and beta-blockers, which I need to read more about.

When the nursing student, Jennifer, was about to wake Kirsten for her medications, I did a quick review and noticed she was giving a double dose of Phenoxybenzamine, which is wrong. Eff. Good thing I checked. #FAIL

That's a lot of freakin' coffee and donuts!
That’s a lot of freakin’ coffee and donuts!
Train crosses Congress Street in Portland.
Train crosses Congress Street in Portland.
FedEx 2491, Boeing 757-200, departs KPWM for Burlington (KBVT).
FedEx 2491, Boeing 757-200, departs KPWM for Burlington (KBVT).
Good thing I checked! Kirsten was about to be given a double-dose of her new medication, Phenoxybenzamine. Oops.
Good thing I checked! Kirsten was about to be given a double-dose of her new medication, Phenoxybenzamine. Oops.

20:53

After my previous update, things were pretty slow. It’s the weekend, so most doctors are off and the hospital is pretty dead (Oh, bad choice of words. My bad.).

Kirsten bought me lunch. Actually, she wasn’t very hungry so she ordered herself soup and ordered the rest based on what she thought I’d like. She is taking care of me, even as she’s in the hospital. That’s so like her.

We went on a walk around the Gibson Pavilion (Maine Medical Center Cancer Center). It was nice. Kirsten is very frail and slow, but it was great to hold her while we walked.

Then we laid in Kirsten’s hospital bed and watched murder investigation shows on tv (the non-fiction variety). It was nice to just hold hands and cuddle a bit.

When a helicopter finally landed on the pad, the sun was creating these awful reflections on the window, ruining view, so Kirsten assisted me by holding up her black sweatshirt in front of the window so I could get my shots. She’s a great helper, and a real trooper.

Pain has been pretty okay today, and well managed. No hypertension problems. Basically, pretty good. We’ve enjoyed our day together.

Kirsten and I laid next to each other on her hospital bed, ane watched murder investigation shows on tv.
Kirsten and I laid next to each other on her hospital bed, ane watched murder investigation shows on tv.
Kirsten and I went on a walk around the Gibson Pavilion today.
Kirsten and I went on a walk around the Gibson Pavilion today.
Kirsten knew she wouldn't eat her entire hospital meal, so she ordered it with the intention of giving it to me.
Kirsten knew she wouldn’t eat her entire hospital meal, so she ordered it with the intention of giving it to me.
The Downeaster passes through Portland on its way to Brunswick
The Downeaster passes through Portland on its way to Brunswick
I didn't get the flight and type of this bird and her contrails. Rats.
I didn’t get the flight and type of this bird and her contrails. Rats.
I have never flown in a helicopter.
I have never flown in a helicopter.
After dropping the patient in the ED, N135DH departs the MMC helipad.
After dropping the patient in the ED, N135DH departs the MMC helipad.
DHART's Eurocopter departs the MMC helipad.
DHART’s Eurocopter departs the MMC helipad.
New Hampshire's White Mountains at sunset from Maine Medical Center in Portland, Maine.
New Hampshire’s White Mountains at sunset from Maine Medical Center in Portland, Maine.
The sunset from Maine Medical Center, Portland, Maine
The sunset from Maine Medical Center, Portland, Maine
I love how the setting sun, in the right conditions, colors the bottoms of clouds.
I love how the setting sun, in the right conditions, colors the bottoms of clouds.

6 Comment

  1. Keryn Gottshalk says: Reply

    I’m so sorry that you guys are going through this, Brent, but man, Kirsten is so fortunate to have you in her corner. Sending your family my best wishes for a love-filled weekend!

    1. Thank you. I’m fortunate to have her, too. We make a great team. :)

      1. Keryn Gottshalk says: Reply

        Yes!

  2. 1. Good that you were able to have a bit of “nice” time together
    2. So great that you’re such a competent “amateur doctor”!
    3. http://www.lenskirt.com/
    4. Flying in a helicopter is quite… different! I hope you do get the chance. I have only done it a couple of times – I enjoyed it but also found it slightly disconcerting because (a) you know, “50,000 parts flying in close formation” and all that, and (2) the manoeuvres seem kinda “unnatural” if you’re accustomed to fixed wing!

    1. “Or throwing a road flare into the room.”

      So cool! Thanks for the tips.

  3. That picture of the two of you on the hospital bed might be one of the sweetest, loving photos I’ve ever seen. You two are an inspiration.

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