June 1st.

Some great news: Blood tests have shown that there are no myeloma cells present and that Denise's white cell count is normal. She is in good spirits - well, as good as can be expected for someone who has been in hospital for 5 weeks. She did 2 laps of the hallway yesterday and is showering every day now.

Posts about D will be light-on from today and until she is ready to accept visits,  so adopt the approach that no news is good news.

May 28th.

A picture tells the story today:

May 27th.

Good news: Denise was moved back to level 7 last night. She is still in isolation and has a 4 bed room all to herself.

May 26th

All is well. Denise looks better each day. No dialysis and no drugs being administered by IV. She is depressed and claims that I have been to see her only a few times. Last night she nibbled at her dinner  but ate most of a magnum I got from the cafe. Eating is not on her 'things to do' list right now.

Denise got up yesterday and did a lap of the unit with the aid of a walking frame and a nurse. They also went for a stroll outside into the sunshine.The nurses have been wonderful. If anyone ever slags off the RPA staff to me I'll deck em.

At this point she is recovering and things are going as expected. However she is not up to visitors yet and remember, flowers carry fungus and spores, so no flowers please. I will let y'all know when she is ready to receive visitors.

May 23rd

Denise was wide awake when I got to the RPA. She has recovered from the infections but she is desperately depressed. It breaks my heart to see her looking so sad. With time, the depression will go away.

The plan is to move her upstairs to level 7 as soon as a bed becomes available. We talked about visitors and she is adamant that there are to be no visitors except family members. I agree with her. Denise is a very private person and the last thing she needs right now is her friends seeing her in this condition. To paraphrase a great Aussie, "She loves yez all!" - But she doesn't want you around right now. I will let y'all know when D is ready to see you.

May 20-22

Marvin was nowhere in sight. The line into Denise's jugular vein that Marvin was using has been removed and a catheter inserted in D's upper chest so that Mini-Marvin can get vascular access if required.

Denise is a little depressed - who wouldn't be after being bed-bound for 3 weeks? She looks healthier each time I see her. Her temper is not improving. Guess why. She is not eating much at all. Nibbling would be a good definition of her approach to meals. This is not helping her recovery and she knows it but if she doesn't want to eat she doesn't want to eat she told me somewhat forcefully.

On Sunday D was taken off the monitors - cardiac, blood pressure and some other funky thing that I never got around to checking out. Pulse oximetry was left in place. There is nothing unusual about that. The plan at this point is to move her back to level 7 as soon as a bed becomes available.

I didn't get hammered on Friday night - a couple of wines and that was it.

May 19th.

All is well. Denise is very tired and Marvin is still on the job. The SVC  catheter that Marvin uses is going to be replaced on Friday or Monday. This replacement is being done because:

• An SVC can only remain in place for a limited time.
• When Denise is moved back to the apheresis unit (look it up. I can't spoon-feed you all of the time) if required, she will be introduced to a Mini-Marvin who will do the job much quicker than Marvin. The ICU consultant told me that the possibility of long term dialysis being needed is remote. 

I am having an RPA-free Friday night - I'll probably get pissed - and will not see D again until Saturday arvo. Another update will be posted on Saturday or Sunday.

May 18th.

Marvin is awake...

Blood tests run today showed that Denise's kidneys were not handling the load so Marvin was woken up and brought back to help them out. I hate to see the bastard back in business but he is doing good work.

The central line was removed and a PICC line inserted in D's right arm. The ICU consultant checked the x-rays and declared the PICC perfectly placed. Denise's white cell count is normal and has been for a few days now. She is not eating enough so a protein, fat and glucose mix is still being given by IV. Her breathing and BP are good and her cardiac rythm is better than mine. She got up, was able to take a few steps with help from the nurses and sat in a chair for an hour today. I was there when the central line was removed. A doctor walked up and said to her, "You look pretty good.". She gave him her smiling assassin stare and replied, "You should see it from my side.".

May 17th

I'm posting this one from one of the coffee shops in the RPA while Denise is being moved out of isolation to an open area in ICU. She continues to improve. The only IV up, is her feeding line. BP is good and her breathing is easy. She is bored, tired, a little bit aggro and ready to go home. I can't say that I blame her for wanting to leave but she has a few more weeks to go yet. She got up today and sat in a chair for a while. I've been here for a couple of hours watching her spend most of that time sleeping. I don't have an update on Denise's white cell count but if I get it before I leave I will post it later tonight.

May 14-15

The highlights of these 2 days are:

• Denise is no longer receiving Noradrenaline.
• She is getting stroppy and swore blind that I had not been to see her since she was transferred to ICU - so much for going there every day, but if she's stroppy she must be feeling better.
• Mr Dialysis still gathers dust in the corner.
• Temperature is normal.
• Denise, when she eats, keeps it down. 

All is well on the Denise front but I am totally buggered.

May 13th.

There were no real changes on Friday, in spite of it being the 13th. White cells continued to increase and got to 10.1 by noon. While I was there in the evening Denise ate a half sandwich (cheese and tomato), drank a full container of Resource and kept it all down. Mr Dialysis remained alone, aloof and unwanted, and I told him to maintain that position. Noradrenaline was being delivered at 10 ml/hour to regulate Denise's blood pressure which was holding in the low 100s over low 60s. You've always wondered haven't you? So click on this BP numbers for an explanation.

May 12th.

Mr Dialysis has been banished to the corner of the room. Just like Marvin the Paranoid Android he is standing there alone, bored and forlorn, with nothing to do. Denise's kidneys are returning to normal and tomorrow morning they will be checked again. Depending on the outcome of this, Mr Dialysis will either be sent from the room entirely, or used again when required, until the kidneys can do the job alone.

Denise is looking much better. She slept for most of the 4 hours I was there tonight and for most of the hour that Kate spent with her this afternoon. She was lucid, her temperature was normal and her blood pressure was holding. Robyn's stem cells continue to perform magnificently; white cell count at noon was 7.1. The wheezing has stopped and Denise is breathing normally. The oncologist talked to me today and told me that everything is now going as expected.

Providing everything stays on this track, Denise will be taken for a walk around ICU tomorrow and probably have a shower.

May 11th

When I arrived at the RPA after work Denise had not had much sleep and was a little delirious. The most confronting thing was the dialysis machine she was hooked up to. On Tuesday evening when I left, her temperature was high, she was febrile because of the high temperature but not convulsing, and her BP was normal. Mr Dialysis was not at her bedside.

Today, the ICU consultant spoke to me, answered my questions and gave me a summary of what has happened since Tuesday. Here it is:

• The blood cultures have not revealed the infection so a broad-spectrum antibiotic is still being given. More cultures are being done.
• To combat the fever a heavy hitting antibiotic was given to Denise. This antibiotic affects the kidneys because the waste it creates is evacuated through the kidneys. Impaired renal functions are an expected side-effect; hence her new bedside companion. I'm sorry, I cannot remember the name of the drug. However, the good news is that it has done its job and is no longer being administered. The dialysis will continue until Denise's kidney functions return to normal.
• Denise was taken to radiology and had scans performed this morning. Infections were found in her lungs and in her bowel. These are being treated.
• Now for the really good news - yesterday, Denise's white cell count was 1. Today it is 5, so Robyn's stem cells are working their magic.

I'll  post another update tomorrow night.

May 7th

Today, Denise is feeling much better. Her blood pressure is 124/70 and she is not having any breathing problems. I spoke to her. She sounds just like our Denise. On Friday night she sounded like she was preparing to step into the void. I'm using a bit of hyperbole there or, as the the 2nd worst PM we've ever had, one Julia Gillard would say, "I'm using a bit of hyperbowl.".  Who is the worst PM we've ever been burdened with? It has to be that rank narcissist, Kevin Rudd. I digress.

The source of the infection has not been discovered at this point so she is being treated with a broad spectrum antibiotic. A blood culture is being run to nail the type of infection. Once the result of that is known the antibiotic will be changed to match. 

May 6th

Denise's condition has improved throughout the day and everything is heading in the right direction. BP is normal and she has not had any breathlessness. The outlook is good and all going well, the plan is to get her back on Ward 7 sometime this afternoon or tomorrow; probably tomorrow.

May 5th

There was a bit of a setback today. Denise has developed an infection and is being treated with antibiotics. Occult blood was taken and will be tested to make sure that there is no internal bleeding being brought on by the diarrhoea. Her blood pressure started to drop and she became breathless so she was transferred to ICU.

The move was for a couple of reasons:

• The PICC line was removed and a central line inserted just to be sure to be sure that the PICC isn't causing any problems. The central line provides essentially the same sevice as the PICC line.
• Keeping the infection at bay is critical and the nursing staff are better able to monitor Denise's condition in ICU.

I have spoken to the nurse who is caring for Denise and he assures me that she is doing well. I also spoke to Herself and she also assured me that she is OK.

May 3rd

So far so good. Compared to where she was at this stage after her previous transplant, Denise is doing well. That said, the effects of her white cell count continuing to go down are expected to kick in sometime in the next couple of days. What she will go through then is not something I would wish on anyone. An IV fluid drip will be put up tonight and Denise will stay hooked up until this stage ends; probably in 7 days. Taking anything by mouth during this time is almost impossible because it will pass straight through her system. The drip is to counter the inevitable fluid loss that will occur.

Denise's grace under these circumstances is inspirational.