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.
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
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.