Halloween Update, Vampire Edition

Posted by Becky
Leif's got another dose of Rituxan today. He had some shortness of breath right off the bat, so they dialed the rate back slower. They give him a ton of Benadryl beforehand (standard procedure) so he gets very sleepy, and although he hasn't had a severe reaction lately, it still makes him feel rotten. He got some Reiki during the dose from one of the hospital bodywork volunteers. which he enjoys, and which always relaxes him.

The big worry today is that the blood leak hasn't stopped yet. The doctors said during morning rounds that a radiation oncologist and an intervention radiologist would come by to see him today, in case they need quick options tomorrow if the current treatments (platelets and aminocaproic acid, which encourages clotting) don't control the bleeding. The believe it is a venous leak from his spleen, since the blood loss is relatively slow. The radition people didn't turn up today, so maybe tomorrow. It is possible to radiate the spleen, or go through an artery in his leg and stick a "clot" into his spleen. Scary. Of course they don't want to do anything surgical with his platelets so low.


The sore on his butt is a bit less painful today; still looks red and angry, but no fever. It was draining but now seems to have stopped. They feel they have him on the right antibiotics, and no surgical intervention is necessary, or at any rate would be a bad idea at the moment. His neutrophils are still zero. He just got a unit of platelets and is about to get one of blood; he also got a unit of each this morning before the Rituxan dose (which, since it runs so slowly, takes about 6 hours to go in). They are continuing to check his blood levels every six hours, which will help them tell whether the internal bleeding has clotted, as well as whether he needs additional blood or platelets.

The swelling in his legs and feet has gone down a lot. The Sequential Compression Device (which I described yesterday) and compression stockings seem to be helping that, but it's also going down in his knees and upper legs, which are not being squeezed. No fever today.

He has continued to take walks at least twice a day; one long walk (15-20 minutes) around the hospital building for a change of scene, and at least one short one around the "pod" where his room is. Unfortunately, he can't go outside with his neutrophils so low, which as you can imagine, is stressful for Leif since he loves to be outdoors. No exercise bike today since he was feeling so wiped out from the Benedryl and Rituxan.  We have bread, jam, peanut butter, yogurt etc. for snacks, so he tries to get out to the pod kitchen to prepare his own snack at least once a day. He's careful to wear a mask anytime he leaves his room. They also had a bowl of Halloween candy at a nursing station, so he was able to get some mini candy bars.

Our new contact information

Posted by Becky
Here are the ways to reach us now:

Leif: 603-650-2106. The best time to call him is in the afternoon. Bedtime can be as early as 8pm. If he's sleepy or fatigued, he won't answer, so don't worry about disturbing him as long as you keep calls relatively short. Now that we're so far away from friends and family, phone calls have become really important to keeping Leif's spirits up.

Mailing address: PO Box 939, Lebanon, NH 03766

My physical address (for FedEx etc; there is no mailbox at this address):
Barron Hill Alpacas
3223 County Rd.
Windsor, VT 05089

Our mail will get forwarded from the Brooks address to the PO box; my last couple weeks' worth of mail should be arriving here relatively soon.

Survived a mild fever, leaking blood. Otherwise doing well.

These last few days, other than some back pain, have been relatively good. I have been exhausted, but I had also forgotten that during this period, they usually send me home and I do nearly nothing other than crash on the futon for most of the day. Here, because the routine is the same, I did not get the psychological break that comes from going home. On the other hand, they caught my fever immediately, switched up my anti-biotics, and got it under control in under 12 hrs. Our previous schedule would have been me denying that I "really" had a fever, and 99 degrees was just an outlier, and we could go to the hospital tomorrow if it had gotten any worse during the night. (For unknown reasons, fevers seem to hit in the wee hours of the morning).

Inevitably, I would be sick, and Becky would drag my sorry carcass into Waldo General where they would stand around and look serious for 8 hours before sending me on an ambulance to Midcoast Maine, down in Brunswick. And then I would be stuck there for a week while they treat my now serious fever, and the high pain that comes with it. (although the pain would never seem to be connected directly to the fever  - like now, my pain is in my pulled back. Go figure).

I got 4 units of blood today, as well as getting a unit of platelets. Thank all of you that donate blood and blood products. You, and people like you are literally keeping me alive. The gods only know what I can possibly be doing with needing 4 units of blood though? Where does it go? The human body only has about 10 units of blood total. Clearly there is some sort of leak. I try not to think about it too much.

I have my 2nd round of Rituxan tomorrow morning, but I am not too worried about it. It seems as though they have the routine down. Slow and steady has been the key. I will be fatigued again after the procedure  and spend the next couple days mostly sleeping, but that is my primary job, and like almost every job, it sucks more than it is rewarding. And like a normal job, I have about 8 bosses (here they are called "the Team", which are my doctors.) They typically agree about 4/5th of the time, and so my treatment goes forward, but I never know what is coming up next. We have daily meetings in the morning, and I hear about what the plan is going to be, but typically the plan has changed by noon. Partly because of new blood work, but partly because there are so many people involved and it takes a little while for all the information and ramifications to come through - messages from the pharmacy and nurses for example. 

Watching carefully & waiting

Posted by Becky
Leif's neutrophil (white blood cells, i.e. his immune system) count is still zero, so they're watching carefully for signs of infection. No fever yet, though.

His hemoglobin count dropped quite a bit between yesterday and today, so today after he got a unit of blood and one of platelets, he got a CT scan. They wanted to check his butt, and also see if he had any internal bleeding. They did find some extra fluid in his abdomen that is likely to be blood plus other fluid. There is no way to tell where it might be coming from. The amount that's currently there is not a dangerous amount, but they don't want there to be any more. So, they're discontinuing his Neupogen shots for the moment. That is the shot that stimulates his bone marrow to produce neutrophils, but it can also lead to a ruptured spleen - which of course would be very bad. So no Neupogen for now. They are also going to put him on some aminocaproic acid (Amicar). That's a drug that will encourage clotting.

Aminocaproic acid can also increase the risk of deep vein thrombosis. That's the problem that people can get on flights to New Zealand if they don't stand up and move around often enough; basically a blood clot. So Leif will need to stay active while he's on this drug. They're also going to give him compression socks and a Sequential Compression Device for his legs. An SED inflates and deflates and sort of massages his legs. The doctor says that people say it feels good.

He doesn't have any symptoms of abdominal bleeding, like abdominal pain or dizziness. We will be watching for anything like that.

Despite all this and a lot of drowsiness due to the painkillers Leif is on for his back pain, he feels as good as he's felt in a while. His appetite is returning after a number of days of not feeling hungry. They are going to check his blood levels every 6 hours to watch for signs of more blood loss, and they also check his temperature frequently since he is at such high risk of infection/fever.

Although the CT scan was supposed to check his butt, the radiologist didn't say anything about it. It is hurting a bit more, though and is swelling up a bit. For a while you couldn't really tell where the incision was, but now it's visible again. They're treating it by starting him on Zosym, an additional antibiotic. If he gets a fever, they will add yet another antibiotic.

I got through my Rituxan yesterday, as Becky said. I am unhooked from all the pumps and fluids, which is so nice. I went for a couple of walks today to celebrate. The walks are tiring, but the exercise is good, and I need to get out of this little room once in a while. I think that space travelers are going to have much more difficult psychological problems than most people think. I know that nuclear subs stay down for months at a time, but frankly, they are huge compared to anything I can imagine putting up in a space capsule.

I have been in the hospital for 3 weeks on Sunday, and I am looking at least another 3 weeks, and possibly many, many more. I have to wait for my neutrophils come back up to a reasonable level, because infection is the most dangerous part of the treatment. I have another Rituxan session coming up, but I have not looked to see when, exactly it will be. Sometimes it is better to just go along day by day. After all, it is not like a Rituxan day is something to look forward to.

This last chemo treatment has done good things though, my spleen is the smallest it has been since I went in to the hospital back in May. The doctors are hoping that with another series of this treatment, I might go into remission and be able to harvest my stem cells for use. This would be great. Donor stem cells are pretty dangerous (because the donated white blood cells are in a foreign environment and can perceive everything as a possible source of infection). My own stem cells would produce white blood cells that recognize my antibodies and proteins.

So, there is a lot to stay upbeat for, even though each treatment is psychologically harder. No one likes to be poisoned, and I am currently on something like 37 different medicines, many of which come at different times, so I have been woken constantly during the night every 2 to 4 hours for the past 2 weeks or so. It is tiring in a way that is hard to describe. Some of the medicines, too, have emotional effects, and I have been a little weepy for no good reasons. Sure the chemo is hard, and the room is tiny, but other people get through this fine, and I am stubborn as hell, so I can't see that I am going to be taken down by some single-celled organism. Life is still amazing.

I have been thinking about my friends, and while I wish that I could see them, there are a few things to consider. One is that it is a long haul from Belfast to Dartmouth, and that I do not have the energy for more than a couple hours of visits. Another part of that is that because I am tired so much, I can not hang out with too many people at a time. Two people or so is pretty much all that I can handle, before I get overwhelmed. The third part is that I am neutropenic, and have to be careful of infection. Becky and I were thinking that if people wanted to road-trip out to see me at some point, the thing to do would be to see me for a while, and then hang out with Becky at her rental, and then perhaps see me again in the morning before you leave.

I do enjoy phone calls, and my number here is (603) 650-2106. If I am asleep, or wiped out, I simply don't answer the phone, but I am usually up to a conversation in the late afternoon.

Chemo cycle done

Posted by Becky
This chemo cycle is now done. The Rituxan went okay; they took it very slowly and Leif didn't have any reaction, except a bit of shortness of breath. When he got that, they slowed the dose down for a while, it cleared up, and then they raised the dose a bit again. He also got two units of blood and one of platelets yesterday.

This chemo regimen will drop Leif's already-low blood counts, and keep them down for about three weeks. Patients therefore generally get infections on this regimen. Since Leif has been prone to infections in the past, they're going to keep him in the hospital the entire time his blood counts are low, so they can monitor him closely and treat fevers, etc. immediately.

Rituxan today

Posted by Becky
Today will be day 5 of Leif's new chemo regimen. So far he's had few side effects from the chemo. Today he's going to get Rituxan, which he's reacted to in the past, so we have our fingers crossed. His blood counts have started going down already - he got a blood transfusion yesterday - and are expected to stay down for about 3 weeks, which is longer than any previous regimen. He will be at very high risk for infection over that period of time, so they're going to keep him in the hospital until his blood counts come back up. He can still have visitors, unless you have anything like a cough or cold, since he's susceptible to everything.

I have rented a furnished apartment in Windsor, VT - actually, a guest house on a small alpaca farm. It's quite lovely. We're looking for a secondhand futon so I can put up people who want to come visit Leif. The drawback is that it's about 25 minutes from DHMC, but the bonus is that it's near my aunt's apartment in Hartland. 

If anyone is coming to visit this weekend from the Belfast area, please get in touch with me. I'd love for someone to bring the stuff I packed (like warm clothing) for this trip when I was expecting to be back in Brooks before heading out this way. And now I have a place to put it!

Lead-lined room.

One of the crazy things about this particular room in Dartmouth, is that it used to be used for radiation therapy, and all the walls have 3/8" of lead under the sheetrock. This is true of the doors as well, you can see the thick lead panels in the middle of the doors. Not surprisingly the doors weigh a ton. Ok, not literally a ton, but the lead in the 4 foot door weighs 532 lbs, and in the 3 foot door it is 399 lbs. The doors have these massive hinges and are nicely balanced, but there is definitely some time that goes by between when you start pushing on the door and it begins to move. The addition of having access to pumped air and oxygen, a private bathroom, and a first rate, research hospital, with its own generators and water supply makes this an unusually good room to be in if there is suddenly a zombie apocalypse. I just need a $2 wedge to jamb the door with, and I will have plenty of time to work out the details of the next steps. If you are reading this in Waldo county, and you think that the Waldo County General Hospital would work, let me just say, that I have evaluated those rooms and they will not hold up, for a number of reasons. Your best bet is to get to one of the remaining box cars with your emergency overnight bag (make sure to grab your winter weather kit), food, chains, padlocks and lock yourself in. That gives you 1/4" of steel for the zombies to get through and should give you enough time to come up with more detailed plans.

My feeling is that if the zombies shrug and go grab welding equipment then clearly they have not lost very much of their ability to think or fine motor skills. Which seem to be the downsides of being a zombie. The upside, of course is the whole (apparent) immortality thing that they seem to have going on for them. If they were really dead, they would rot and stink and fall apart in a couple days. They also apparently don't need to eat, although they enjoy feasting on brains. Just about any zombie movie that I can think of, the zombies have been around, or last for months or years. Oh, and in you zombie survival kit put in a bunch of decent hospital-style masks and anti-bacterial soap. it may just be an infectious disease. On the same note, don't kill the suckers in a way that sprays their potentially infected blood all over the place. That just seems like asking for trouble.

Got my hard chemo started today, which is good since we need to smack down these infected white blood cells before they get even more uppity. I am on etoposide and cytarabine as my chemo drugs.

Cytarabine

Etoposide

Etoposide works by causing errors in DNA synthesis and promotes apoptosis in fast growing cells, especially including agressive cancer cells. Cytarabine is an antimetabolic agent which inhibits one of te phases of DNA replication. These hit all my cells, but the faster dividing the cell, the harder it hits it. My normal cells basically lose the ones that were going through division right then, but the bulk of them are unaffected.

Leif

A busy day.

Busy day at Dartmouth-Hichcock this morning. I got up early, and since i had no leads connected to me, I thought it would be a good time to take a short shower. That was a nice way to start the day. Then by breakfast came and was pretty good, althouh i could not remember what it was that i had ordered. ... French toast and a side of cut pears. Not too bad, although the surpy was corn and the toast was a little dry. I was not too surprised, but you would think that NH would be a net exporter of maple syrup, and that they would not be interested in the fake stuff. Or even that the producers could give it to hospitals to defray some of their costs.

Anyway, after I was done eating, this guy Ken came in and wanted to know if I wanted a "pick" line. Having gotten a little cagy after spending 6 months in the hospital, I asked, 1) what was it, and 2) who thought it was a good idea for me to have. Apparently it is an IV which is surgically implanted in your arm for a while (like the rest of your illness, and that literally 5 out of 6 doctor's agree that I ought to have one put it. The 6th doctor was on the phone and offered no opinion. I had a couple concerns with it. First of all, I wanted to make sure that they could harvest my stems cells from it so that they would not have to stick my arm. They convinced me that wether or not I can use it for the stem cell draw, -It will be so my chemo does not require multiple sticks in my arm.

So I had that surgery. They do it just with local anesthetic, and do not knock you out. I would like to say that I handled it like a man, but I have have had a horrible phobia of needles my whole life. When someone is coming at me with a long needle, and I can not reasonably us my fight/flight response, I am overwhelmed by images of needles puncturing the eye and sucking out vitreous humors, or needles slid past the eye to do lobotomies, or heavy needles carving into the bone of my arm, or popping out the little bones in my wrists or my ears. Or the sorts of horrible things that were done to living animals in the 1600s in the name of anatomy. The surgery ended up going fine, and I managed not to flinch too much. The surgery itself did not hurt that badly, it is just the overly of images, visual, verbal and tactile, that do me in. Sweat like a pig.

Other than that fine experience, I got to have another bone marrow biopsy. You would think that this would effect me more, but in fact, i find it somewhat easier to take. The doctor is going straight in, and not trying to follow my veins around with an xray as the thread a long needle trough the vein. With a bone marrow biopsy, a needle takes a plug of a hole, the whole thing is saturated with some sort of anestesia and then they drill out the piece that they need. It feels a lot like being kicked in the hip by a horse, or at least a goat that meant business. I can handle that kind of pain better than the psychological nightmare of a slowly inserted needle.

I also had a CT scan and a PET scan to round out the day. The PET scan is my favorite, and tends to put be right to sleep. I don't know why I find in so relaxing - not very many other people do. I will take it where I can get it. I am going to sleep now.

Leif

Checked in at DHMC

Posted by Becky

Leif's checked in at DHMC after an uneventful drive this morning. His phone number here is 603-650-2106. My cell phone service here seems to be okay, Leif's less so. Tonight he's getting a CAT scan, and a bone marrow biopsy tomorrow. They expect to have plan/protocol in place to start treatment on Saturday.

I will be having supper with my aunt Prue tonight and staying with some friends of hers, and my sister Stephanie will be arriving tomorrow evening to help make my housing arrangements.

Thanks to everyone for the well-wishing and material support over the last week! It feels good to be here, getting Leif back into treatment. We've met with a number of doctors today. I'm getting the sense that DHMC being a teaching hospital, we'll be answering a lot of the same questions over & over.

I managed to escape from Midcoast Hospital today. I am waiting for a room at Dartmouth, and as soon as one is available, I need to be over there ASAP to be admitted. The downside is that I do not have enough time to get back to Brooks/Belfast and see my friends before I am in for the second phase of my treatment, which will be quite a haul. On the plus side, I was able to convince my doctor that I could wait around just as well at my parents house in Cundy's Harbor as I could in the hospital. It is really nice to be out, even though it will only be for about a day.

We are likely to be able to take a somewhat leisurely drive to Dartmouth - go the scenic way, enjoy the foliage, stop for lunch, that sort of thing, unless they have a bed available first thing in the morning when we call to check on the status of a room. 

Sleepy. I keep drowsing off as I write this post. If there are some non sequiturs in here (or more than usual for that matter, that is my current issue.

Once I get to Dartmouth, I will not be starting my treatment immediately. The lead doctor there, Dr. Meehan, would like to run some tests and I need to have my port removed do to a small infection, and it will be replaced with one that can take more IV lines. This is actually good because it means that they won't have to stick me in the arm for an IV every time that they need a second line (which is usually). My veins are nicely visible, and everyone thinks that it will be easy to get a second IV started, but in actuality, my veins are full of valves, and they roll. What this boils down to is that it usually take between 3 to 4 attempts to get an IV started. And I hate needles. I have had a phobia of them ever since I can remember. 

That is it for now. I will write more in New Hampshire.

Leif

Transferring to DHMC as soon as there is a bed open

Posted by Becky
They have decided to transfer Leif to directly to DHMC, although not by ambulance. We are now waiting for a bed to open up, and once it does, I'll be driving him out there.

The current plan is to do some tests before anything else, including a bone marrow biopsy.

Hurrying up and waiting

Posted by Becky

With a ton of help from our amazing friends (thank you, thank you!), we're packed and basically ready to leave for Hanover and the Dartmouth-Hitchcock Medical Center (DHMC). Leif has been at Midcoast until his blood counts come back up, he's off the IV antibiotic, and his pain can be controlled with pills instead of an IV. It looks like he might be discharged tomorrow. No word yet on when he will be admitted to DHMC.

Our plans from here on out are something like that puzzle where you have to cross a river with a goose, a fox, and some grain, in a boat that will only hold you plus two other items. So we're trying to stay loose and do what makes sense. I'll post more as we know more!

Strepmo

So the bacteria that put me in the hospital last Sunday has been identified, and in the words of my doctor, it is a fragile organism with a cute name - Strepmo. It is one of the common mouth bacteria that live casually in the mouth, and got into my blood stream. Granted the name sounds like it should be a muppet. The good news about it being fragile means that we can use a lower dose and less harsh antibiotic. The antibiotics have kept my red blood cells, neutrophils, and platelets from rebounding.

I am still in pain from the muscle spasm that I had on Sunday. It looks like that spasm put a rib out of place, so I am not sure what is next on that. Some sort of physical therapy and massage combo I guess. The level of pain that I am still in from that (although managed in the hospital with drugs) needs to be brought down so that it can be managed out of the hospital with oral pain killers. This is the second thing that is keeping me in. Dr. Connelly says that whenever I am released, I will have at least two days free before I have to show up at Dartmouth.

On another plus side, Dr. Connelly assuaged my fears about the blood draw for the stem cells. I was told at Dartmouth that I would have to have two large stainless steel needles inserted into my arms to draw the blood and put it back in. I have a terrible phobia of needles and have been having nightmares about that whole procedure. She assured me that there is another method that does not use huge needles and makes use of my port instead, and that she would make sure that it would be all ok.

Other than that, I am on quite a bit of pain meds as well as muscle relaxants, including Valium, so I have had quite a bit of fog of the brain. I will think about doing something (like getting this blog updated) and the next thing I know, I will wake up from a 2 hour nap. If they did not write which day it was on the white board, I would have no idea.

My family has been by quite a few times to visit me, and it has been great to hang out with them. My brother was able to come up by himself today and just hang out for several hours. It has been a while since we have done that since he has kids (who are great, but hanging out with kids around is not the same as hanging out, just the two of us). It was really nice just to chill with him. I am lucky to have such a great family.

I have not received many phone calls in the last 2 days or so, and just learned today that it is because the ringer broke. So to those of you who called and thought that I blew you off, it was not on purpose. The hospital put in a new phone and Craig and I checked to make sure the ringer works, so give me a call. It has the same number: (207) 406-7242. I am a little foggy often, so expect the first 10 minutes of the call to be quite a bit of me saying, "could you repeat that first part again". Nothing is wrong with your phone or the technical reception - it is all at my end. :)

Anyway, I am feeling quite a bit better, so I should have daily updates till I get out of here.

Leif

4th Ambulance trip.

I have been moved down to Midcoast Hospital in Brunswick. It was so nice to be able to see so many of my friends today and yesterday before I got transfered. I was in Waldo County Hospital until I used up all the platelets in the area. It sounds like I am kidding, but no, that is the real reason for my transfer. I think that it will actually work out better down here though, as I have direct contact with Dr. Connelly, and know all the nurses. The nurses at Waldo were fine, but the were really paranoid about me being a fall risk and limited how much I could move about. The nurses down here are worried that IF I fall, I could injure my spleen, so they want some one nearby if the worst happens. Much more reasonable. It allows me to get up and stretch, to use the bathroom easier, and generally move around a little more.

I went into the hospital because of a fever that has turned out to be an infection. But also, I went in because I pulled my back rolling over in bed and was in incredible pain. That pain seems to be mostly under control, as I am not getting the spasms anymore, but the whole of my back is a sore mess. So tight. The infection, which is the non-painful but dangerous part is responding well to the antibiotics, and I have not had a fever for the last two days. 

Dr. Connelly does not expect me to be in here for very long, so I might be out sometime Saturday, and can catch a ride up to Brooks with my folks. Becky and I are headed out to Dartmouth almost immediately, instead of in 4 weeks, so it is pretty hectic right now. Becky is amazing, and I am sure that she will take care of all the details, but I am sorry that I can not help out.

New plan

Posted by Becky

This morning, Dr. Connelly told Leif that she and Dr. Meehan have determined that he did not respond to the RICE protocol. Therefore, he is going to go straight to the "hard" chemotherapy that precedes stem cell transplant, next week. We have decided the best place for him to be for that is Dartmouth, so we're headed over there almost immediately, as soon as they let him out of the hospital from this current infection - which will not be today.

The idea is that he will get the hard chemo, then go home for a few days until he gets a fever, which they expect to happen pretty quickly. Then he will check into Dartmouth again and be there until his blood counts come up and they can do the stem cell collection.

We will be calling on our local friends for practical help over the next 5-6 days, as we figure out what we need.

In Waldo County Hospital

Posted by Becky
On Sunday, Leif started running a fever. Our friends Mike and Carol were visiting, so Mike took Leif in to the Waldo County ER Sunday evening, and they admitted him with a temperature of 103. It stayed up there until early Monday morning, when it started coming down, and is now back to normal. His pulse was high and his blood pressure low, and those are doing better now as well, although not quite normal.

There is some reason to believe he has a blood infection; at any rate, he's been getting lots of antibiotics and fluids, and he is feeling better. They're keeping him in the ICU at Waldo because he's neutropenic (low white blood cells), and at Waldo, neutropenic patients stay in the ICU. It's nice and quiet here, too.

On Sunday and Monday, Leif got CT scans to check for brain trouble (since his platelet count is low), lung trouble, and trouble with his abscess site, and that all came back OK. His abscess incsision continues to heal well. They could have coordinated better and taken one CT scan to check for all of that at once, but they didn't. One of his blood cultures is growing gram-positive bacteria, which would indicate a blood infection, but it was just one culture, so it could be due to contamination. They are going to do some more cultures today, and try to isolate whether the infection is in his port, whether he really has one at all, etc.

Yesterday his blood counts looked bad, and he got 4 units of blood and 2 of platelets. There are a number of reasons they were so low; it could be due to his disease, spleen, sepsis, or bone marrow suppression. He's got lots of petechiae (the little blood spots caused by leaking capillaries).

He has some large nodes in his abdomen; Dr. Connelly doesn't recall whether that was the case before.

When he came in, he was somewhat dehydrated, so he's been getting a lot of fluids. They will continue those for at least one more day.

He also was having back muscle spasms since Sunday. Those could have been triggered because he slept on a different bed at the camp; usually he sleeps on a futon, and the softer bed might have caused a problem. At any rate, they were bad enough that they kept him from being able to draw breath; fortunately, Mike, who has been staying at the hospital with Leif, was able to release them when they happened. They've been happening less as the days have worn on. The doctors say they might be able to treat them with muscle relaxants. He can't get any NSAIDs (like Flexeril) at the moment, because he's been dehydrated and they don't want to stress his kidneys.

He'll be here at Waldo County Hospital for at least another 24 hours, then they'll reevaluate how he's doing, and he might be able to go home with oral antibiotics.

I apologize for not getting this posted earlier; Leif changed his blog password, and while he gave me the new password, he has idiosyncratic spelling habits and I didn't copy it down correctly. Mike and Carol left for home this morning; it was so great to have them here. I'll be hanging out with Leif during the day today. He says he's feeling pretty vague and plans to rest today, so the best way to contact us is probably by email.