The Bottom of the List

Posted on July 19, 2022 by Margaret

We promised to let you know if something happened with Nelson’s health, and sadly, it has.

On Sunday evening, Ann Sophie noticed he wasn’t himself. He’d been sleeping most of the day, with an increase in coughing. His oxygen was at 76, dangerously low, and even with a 4-liter oxygen assist, it wouldn’t register above 91. His fever was 100.8, pulse 120, blood pressure 93/68.

Nelson, Ann Sophie, Will, and her mother Astrid are still technically in a covid quarantine period, but the oncologist said Nelson should go to the ER anyway. This is always last choice on Nelson’s list, and being admitted to the hospital is even below that. But he went, and it wasn’t long before they had admitted him, this time to the Methodist Hospital of the Mayo Clinic.

He received antibodies, but the doctor found that because of his depleted immune system, he had contracted another infection, possibly bacterial pneumonia. They began IV antibiotics and gave no promise about going home any time soon—exactly what Nelson had hoped wouldn’t happen.

His breathing, always troublesome, called for a draining of the left lung. They collected over 1000 milliliters, which helped him breathe better but was more than had been collected in quite some time. Even after this improvement, though, his oxygen would go down immediately if he removed the nasal cannula.

Amidst all of this bad news, there was one positive development. His platelets had gone from a dangerously low count of 27 to 325. This means the bone marrow has probably recovered from the last blast of chemo three weeks ago and is now doing its job with the platelets. We rejoice over this victory.

But Ann Sophie’s assessment last night when she left the hospital was that his swelling had increased throughout his body. This is fluid that’s being produced by the cancer itself. There was concern over the extreme swelling in his left arm as a result of the extensive clot beneath his collar bone that extends into three veins. Last we knew, they were talking about another ultrasound to look closely at it.

This report probably includes more medical detail than you might have needed, but many are asking. Thank you for your continued prayers for Nelson and his family as this disease yanks them in and out of crisis after crisis. May God bring peace, progress, and even some fresh joy to them in the midst of all this misery.

“He who watches over you will not slumber. The Lord will watch over your life. The Lord will watch over your coming and going, both now and forevermore.” (Psalm 121, parts)

A Pause

Posted on July 15, 2022 by Margaret

When I was growing up, Coca Cola had a long-running ad campaign that pictured happy people enjoying Cokes under a banner that said, “The pause that refreshes.”

We’ve come to be refreshed by a whole new kind of pause—a pause in cancer crises. For example, right now Nelson is in a measure of calm, and it’s a welcome rest from sudden bad news or blood numbers that cause unexpected strategy changes.

When Nelson and I agreed today that nothing noteworthy had happened in regard to his cancer, we decided it might be a good time for a refreshing pause. Thus our communication through the blog might take a few days off.

Before we go, though, we’ll bring you up-to-date. Nelson is still technically quarantining with his family (Covid), so doctors and others are trying to meet with him virtually—all except the daily blood draws. They lift the quarantine for him to appear in the lab each morning for a poke.

His next face-to-face is scheduled for July 20, an informal decision-making meeting. Nelson’s immune system is compromised, which is why he’s not to go shopping, to meet with other people, or even to end up in the hospital. He’s been advised against any family get-togethers except with those three in his same “pool.” That includes Ann Sophie, Will, and Astrid.

So like we said, there’s not much to tell. “Ahhh. Refreshing.”

If something unanticipated should happen, we’ll get a blog out to you asap. But please don’t think that an absence of posts for several days means calamity has come. It will mean the opposite, that all is well.

Meanwhile, we appreciate your willingness to pray:

…that Nelson will stay out of the hospital.
…that swelling throughout his body will decrease.
…that doctors will know the wisest way to go.
…that we’ll all learn what God is trying to teach us.

“In quietness and in trust shall be your strength.” (Isaiah 30:15)

Grueling Turns to Grand

Posted on July 8, 2022 by Margaret

Although Nelson came home from the hospital yesterday, by 6:45 AM today we were leaving home to go back to “Pill Hill,” which is what the locals call the massive Mayo Clinic campus.

First-up for Nelson was a blood draw— only two tries today, which is the limit for each tech. After that, they have to call someone else to try.

The blood draw was to help doctors closely monitor Nelson‘s clot, along with his levels of blood thinner. And these must be balanced with his fluctuating platelet count.

At our second appointment, this one with an oncologist, we learned that if the platelets in his blood continue to drop, the blood thinner must be decreased. Today that happened, since his new count, which had been 55 yesterday, was down to 42. This was disappointing, since dissolving the clot will now take longer.

The doctor lowered Nelson‘s blood thinner from 10 mg twice daily to 2.5 twice, quite a drop, thanks to chemotherapy doing it’s dirty work.

She spent a while examining Nelson and listening to his comments about how he was feeling. The mouth soreness, which has twisted Nelson‘s sense of taste, has become a film, a coating that makes food taste like sawdust (Nelson’s words). She said this will lessen with time, and we hope that’s true.

She told us to wrap Nelson‘s legs more firmly, noting the swelling of his limbs, which is worse than ever. Blood flowing into his arm and hand , she said, can’t freely return past the clot, causing swelling. The legs, she thinks, are a different problem. Veins are leaking fluid that’s been separated from blood flow (thanks to the cancer), which accumulates at the lowest point.

Nelson‘s third appointment was with pulmonology. His doctor and his assistant drained the left lung through its new catheter, 550 milliliters since yesterday. “You’ll have to drain it daily like the other side,” he said.

The right lung had virtually no fluid in it, which is why Ann Sophie couldn’t get it to drain last night. Doing that lung now will be just on alternate days.

As the doctor did an ultrasound, he showed us small pockets or fissures filled with fluid that only a special drug could “get.” But since that process involves being off blood thinners for 48 hours, he felt it was too risky to use it right now.

Our next stop was in the cardiology department where Nelson had another echocardiogram, an imaging test that sees how the heart chambers and valves are working. When the tech suddenly left the room telling Nelson she needed a signature to continue, he pictured himself leaving the exam room on a stretcher and heading back to the hospital.

He said he prayed harder than he ever had that God wouldn’t let that happen —and God didn’t. It turned out the tech had seen some unusual things on her screen, but when she looked at the rest of Nelson‘s record, she understood. Abnormalities are his norm.

From there it was off to one of the Clinic pharmacies to pick up seven prescriptions. Everything was ready.

Halfway through our busy day, Nelson and I shared a brief
lunch in the hospital cafeteria. He was plagued by nausea throughout the meal, scanning the area for an appropriate place to run, if needed. Eventually it passed.

As we headed home at last, chemo’s misery came with us. Soon after we got there, he was vomiting. When it was over, his oxygen helped, and he quickly settled into his lazy boy and fell into a deep sleep.

It had been quite a day, made worse by chemo dogging our steps. But at 7 PM, something grand happened. Ann Sophie‘s mom arrived to our apartment, all the way from Germany! It was love at first sight for Oma and little Will— something chemo could not snatch from us.