When you are neutropenic (low or no immunity) the medical team want to keep a close eye on you. This is for two reasons. Firstly they need to ensure you are not mixing with lots of other people (being confined to a hospital room with HEPA filtered air is one way of achieving this) and secondly if you do get an infection they are able to administer anti-biotics immediately.
So when I was re-admitted to hospital on Monday afternoon my neutrophil level (which is a primary indicator of immunity) was well down – around 0.1. The aim after Chemotheraphy is to get this count down to 0.0 and then wait for your neutrophils to recover.
I kept on asking my medical team how long I would be required to sit in my hospital room, all the time feeling quite OK, waiting for this to happen.
Jess and Suzie were not keen to be drawn on this one, but thought at least 5 days, maybe 7. Ashish the senior consultant was a little more conservative saying maybe 10.
So upon waking on Thursday morning you can imagine how surprised I was when my Nurse, Fiona, wrote up the new blood counts from the midnight collection, showing the neutrophils had started to climb again and were at 0.3. She cautioned me not to get too excited as in her experience this count could bounce up and down a bit each day. I was thinking just a few more days in hospital to get beyond the 0.5 mark when the Heam Team would be happy for me to go home.
My doctors, Jess and Suzie made an early visit with some great news, they felt that as my neutrophils were rising again and i was generally in good health perhaps I could go home earlier than expected but they would have to check with their senior consultant.
They reappeared soon after with the good news that I could be released (discharged I think is the correct term) today subject to Hospital in the Home (HITH) being able to take me on. In the meantime they were happy for day release, wanting me back in the afternoon for another round of Platelets and Ambisome. I was thrilled with this early release after just 3 days and wondered why. In Jess’s words “you are an over-achiever” which bought a smile to my face!
This worked in very well as it was Lachy’s birthday and Jan had planned a small family celebration at lunchtime. We enjoyed a lovely chicken salad lunch with a special Mango cheesecake for Lachy! Happy Birthday Lachy!!
After a nice nap we headed back to Hospital for the top up on platelets and the IV Ambisome. Luckily HITH had found space for me in their program and fitted me up with the portable pump for the Ambisome. I have to carry this 24/7 as it cannot be disconnected – primarily due to the risk of infection. Each time the IV drip is connected to my Hickman lumen the nurse cleans the connection point (tap) for 15secs with an alcohol wipe. Prior to that they ‘flush’ the lumen line with a saline solution – something that I could not do at home by myself.
So the upside is I can now enjoy being home (perhaps for 2 weeks or more) but will have to carry around my ‘bum bag’ 24/7.
What a difference a few days makes.
Goodbye to Jess and Suzie who are now moving to another posting in the Victorian Hospital system – you have been wonderful doctors and I will miss you both!
PS. The new beanie is coming along well. More details on the auction later.