Thursday Doctor Visit

Posted by Becky
I was able to talk with Leif's doctor a bit about how he looked on Monday. The enlarged spleen is a concern, but not necessarily evidence of active disease and doesn't change his treatment plan. The doctors can't tell anything from its appearance while he's getting chemo, especially since he's been getting platelets, because it soaks up cells like crazy.

If the lymphoma breaks through, they will not want to do a stem cell transplant while it's active. So, they will do another PET scan prior to proceeding with the transplant.

They are going to keep Leif in the hospital tonight and check his platelets again tomorrow since they've been going so low. He's been having quite a bit of nasuea, so his appetite's been poor. He just had a tomato sandwich and some black bean soup, which is his first meal since lunch yesterday. The low platelets gave him a nosebleed, and I'm sure you can imagine how nauseating it is when that runs into your stomach.

The doctor thinks his unusual (compared to previous chemo sessions) level of fatigue and "fogginess" is due to the ifosfamide, one of his new chemo drugs. That can have temporary neurological effects, including sedation. They don't worry about it unless the patient goes into a mild coma, and Leif's not that sleepy. 

Today's other drama is that Leif fell in the bathroom. The doctor and nurses think it was probably because his blood pressure's been low, and standing up made it drop lower. So much for his being able to tell when he's lightheaded enough to need an escort. Leif reports that he felt basically fine, then blacked out and discovered himself on the floor. He came to in a good fall position - yay martial arts - butt on floor, head in air. He scraped his back and conked his head on a plastic trash can. I was in his room reading, and the first I knew about it was hearing his IV pole clank and an angry yell. I pulled the remote control out of the wall, which we were told was a quick way to make people come running (it works), and found him in the bathroom on his knees, looking surprised. They did a CT scan on his head (standard procedure for people who hit their heads if they have low platelets) and he doesn't have any bleeding; also, no bruising on his head. Being bald makes that easy to verify. So, no big harm done. Leif now has a red "fall risk" blanket on his footboard. Oh, the ignominy. His nurse mercfully turned off his bed alarm, though, as long as he's good and doesn't try to walk anywhere without company until further notice. It would be extremely dangerous if he fell and really nailed his head on something, with his platelet levels so low.

A question many people have is, if Leif's spleen is acting so crazy and gruesome, why not take it out? Lots of people live fine without a spleen. The answer is that doing so would not affect the course of the disease, and naturally that kind of surgery is very risky for someone in his condition. So, although it soaks up all his platelets, it gets to stay.