Surprise Weekend Getaway

Dear Lovely People,

I appreciate your gracious patience. In the past five days I've been in the process of transitioning back to work, and semester grades were due last night, and 4 of my 5 classes are AP seniors, so, well -- do I really need to say anything more? If I do, you're one of those people under the illusion that all teachers are done at 3:30 and have summers off.

Wait. I'm still laughing. Hold on.  

Arhghh. Okay. Done.

Woops. Nope ------

Okay. 

You probably heard about the excitement: Cam and I left dialysis early Saturday evening for a spontaneous retreat to the UCLA Medical Center. Though it wasn't a scheduled trip, we've found the concierges at each hub of this destination to be pleasant. The excellent tour guides are warm and truly, carefully thoughtful in planning our itinerary each day. It's clear that they are considering Cam's best interests and --

Ah, man! This, this  . . . thing . . . my arm, pokey . . . look down . . . It's. A. Knob. A knob, I tell you! You know, like the kind that makes a reclining chair RECLINE! A knob of such kind as I was looking for at 3am after I'd finished every tot and tittle of grades so that first-semester, "I have to get into a good college!" dear-hearted high school seniors wouldn't panic by any stone unturned. A knob that I searched high and low for in the dark. Bleary eyed. Cross-eyed. Knob, you vile, hiding knob. The cricks in my neck and back and calves curse you for being on the inside instead of the outside of the recliner where the lever for the foot-elevation is. That settles it. I'm giving myself a present. I'm going back to the gift shop here at the resort and buying that geniusly titled book, You'd Better Not Die or I'll Kill You: A Caregiver's Survival Guide to Keeping You in Good Health and Good Spirits by Jane Heller. For sure Ms. Heller could have told me to plant in my sleepy subconscious the need to feel around the outside AND THE INSIDE of reclining chairs for accessing their reclining function at resorts like this. Wah, wah, wah. Somebody call the wahmbulance.

And if you can spot the teeny, tiny homage to Shakespeare's A Midsummer Night's Dream in that rant, do message me. It would be delightful to hear that someone found it.

So, being walk-ins without an appointment, we had to settle for accommodations in the Suite Emergencia of the resort, which is apparently much less desirable than the rest -- we don't actually know because we haven't yet caught a glimpse of the general resort rooms -- but we were fortunate that a quick get-to-know-you of charming Cam at check-in was all it took to be given a room almost immediately, despite the fact that the resort, including the Suite Emergencia, was over-booked. Cam is so grateful to all those who provide service -- always -- that he kept remarking over and over again how grateful he was to have a room with a door while so many other travelers were waiting hours and whole days and nights in the extraordinarily bright, noisy, frequently chaotic hallways just outside our room.

Intent on finding him better accommodations, last night the staff moved Cam to Gonda a la Observation Suite next door to the ER suite. Still not part of the main resort, and with a glass door that doesn't fully close, it's none the less positively tranquil here. Not a single traveler in the hall complaining. We're quite content. In fact, unlike our accommodations at the resort in Winston-Salem recently, there aren't even tour guides marching up and down halls. Just quiet concierges at a large island of desks outside our room, and the occasional visit from one of Cam's trip planners.

Interruption. "Code Gray, Code Gray. Ronald Regan UCLA Medical Center, 7 East."
Pardon me, I just had to include that because a calm, 20-something male voice has been cooing it over the resort loud speaker every thirty seconds for the past five minutes and it was appearing in front of my eyes anyway. It must mean that a very important party is going to happen soon and all the resort staff have to prepare. 

Our trip planners have all agreed that it's best that our visit ends this afternoon. Don't be sad for us; though they're so, so lovely here, we're actually quite ready to go home and are looking forward to it immensely.

Cam continues to be the ideal travel companion. Every destination is a pleasure that he receives gratefully, and I am learning from him all about how to be a thoughtful, informed traveler myself. Even when he's weary from traveling or he has a touch of this or that traveler's sickness, he still finds something cheerful about each unfavorable circumstance, or he'll remark how so many travelers have much less joyful journeys and that he is so, so fortunate during his trip. 

Your friend,

Krish

At the ER

The doctor has sent us to UCLA's ER. He wants Cam admitted to the hospital.

Cam spiked a fever (102.7), followed by insane chills, after what may or may not have been an allergic reaction to the dialysis filter this afternoon.

There was also lots of vomiting and a near faint during the 90 minutes of what was supposed to be a 3-and-a-half-hour dialysis session today. He's never vomited during dialysis before.

Dr. Copen, our nephrologist (kidney doctor) was making rounds at dialysis today -- thank goodness, since that only happens once a week. He thinks the fever suggests it's an infection. He says that the dialysis ports that go in the chest, like Cam's, can cause infection. (The other kind of port is in the arm, are permanent and for people whll be on dialysis permanently.)

Dr. Copen says they may end up removing the port in his chest at the hospital. And if they determine he has an infection, he'll of course need antibiotics.

The nurse checking him in here at the ER suggested it could be the flu. Cam said he'd wondered the same thing.

The other news Dr. Copen had for us is the result of lab tests for the fluid that was taken off Cam's lung last week: "atypical messothelial cells."  That's how Cam's original appendectomy pathology report was termed . . . the one that was eventually diagnosed as Mesothelioma after the pathologies were sent to expert labs. I asked Dr. Copen, don't we just need to send these "atypical mesothelial cells" to an expert lab -- like the Cedars lab did after the appendectomy -- to confirm if it's Mesothelioma? Dr. Copen says that the problem is that when they first found Cam's cancer, they had tissue (pathology); now they just have fluid cells. I guess it makes it harder and they would need to take tissue at some point, "perhaps."

Dr. Copen had Cam get another chest x-ray earlier this week, and it shows the lung has fluid on it again. Not as much fluid as last time before they drained it, but I saw the x-rays, and it looks like almost as much. Dr. Copen says they'll likely need to drain it.

We got settled into a room here at UCLA's ER pretty quickly. They've begun poking and prodding and taking x-rays, but not much else yet.
I suspect it will take all night to get him admitted to the hospital . . . and I have no idea how long the hospital stay will be. Your guess is as good as mine.

Thanks for prayers and positive thoughts.  Knowing that we have all you behind us makes ALL the difference.

Rare Afflictions

Until yesterday, I hadn't been able to focus on a screen for more than about five minutes. It took me hours to pick out an email or two around Christmas, and I've sent maybe a couple dozen messages since then. And as much as I've missed keeping up with you beautiful people, scrolling through Facebook made me a little queasy (the motion, not the content). Thank heavens for Krisha, who read me posts and jokes and comments every day for six weeks.

Today, however, I need to add to the narrative that Krisha has posted. She has discussed in part many unusual circumstances and complications that we've experienced over the last few months. But she hasn't written about the rare afflictions that consume my thoughts and weigh on my soul.

(This will be a quick single pass, because I'm only seven lines in and already my tummy wants ginger ale and my eyes are a bit swimmy, even with new reading glasses, so forgive the typos and melodrama and roughness that should probably get edited.)

I’ve been afflicted since my diagnosis in June with an ineffable calm and confidence that everything will be fine. I didn't ask for this feeling, and I've wondered many days why it was thrust on me, whether it was real, and when it would pass. Other people with cancer and serious illness don't get this—why should I? For six months, it never let up, growing finally into a distinct and profound sense of peace that undergoing this treatment was the right thing to do.

Krisha didn't have it until that day shortly before we left for North Carolina when we decided to spend some time meditating in our church's temple. Since the surgery I've had many days when the feeling abated and, normal at last, I wondered whether I'd ever feel well. But there was Krisha, now afflicted, reinfecting me every minute of every day and reminding me that all was indeed well.

Before the appendectomy that launched this circus, I was afflicted for many years more than most people with health and safety. No scooter accidents, no falls while rappelling, no chronic or devastating illness, no burdens of pregnancy, no major surgeries, no combat, hunger, poverty or serious threats to my physical well-being. For years, I've been deprived even of the exultant relief that follows a good vomit or the sense of invincibility brought on by the passing of a nasty cold or the pride inspired by the return of regular poops and pees after a period of interruption. And now, despite a couple rough months and some still-to-be-answered questions, I have a pretty good prognosis for many more years of solid health. What do I do with all that?

Every day for weeks now I’ve been plagued by kindness and generosity and miraculous interventions of strangers and kin who have made things easy, comfortable, bearable in tough moments, hopeful on dark days.

How many of you have ever been serenaded—just for you—with Christmas carols by dozens of young children and gotten a hundred hugs to send you on your way? How many of you have ever papered a wall with hand-drawn cards from those children and read their love and wishes dozens of times a day? (And enjoyed some crazy hallucinations when those drawings mixed with your pain meds?) Rare indeed.

How many of you in Los Angeles have had people offer—OFFER, with a smile!—to take you to LAX at 5:00 a.m. and pick you up at rush hour? Rarer still.

And then to be greeted by old friends and new strangers in an unfamiliar town, who joined with family to smother me daily with attention and care.

A mother who threatens the nurses that she'll go all Shirley-MacLaine-in-Terms-of-Endearment on them if they don't fix stuff—and gets a laugh and the attention needed. And a mother-in-law backing up the mother! Fearsome rare.

A brother who spent the best week of the holiday season fussing over my needs in the hospital and making my move to a recovery house possible, and even enjoyable.

Another brother and niece and nephew who drove five hours each way during those festive days to crowd my hospital room for forty-eight hours with cheer and drawings and hugs.

Siblings on both sides of the family who, it seems, have had nothing better to do than overwhelm me by calling, mailing cards and presents, writing messages, making arrangements, sending money, handling needs, spreading cheer and making mix CDs that I'm now addicted to. Too much to bear.

Friends who drive hours out their way to look in on my bloated, cranky, nauseated carcass, even for a few minutes, leaving me with an undeserved sense of love and connection to a big world of concern.

A relative stranger who shares my disease and my cure and offers her food, car, daily attention to my and my wife's every need, and constant assurance that, yes, I will one day feel better again.

On top of all that, I’ve been unable to avoid the constant barrage of meals, messages, calls, visits, gifts, encouragement, treats and the best mojo the universe can offer—prayers, meditations, fasting and who knows what other incantations and oblations from Mormons, Catholics, Baptists, Jews, Presbyterians, Episcopalians, New Agers, agnostics, atheists and various other persuasions on every continent.

And then last night I lost precious sleep, just couldn't get to bed, because I got sucked into hundreds of messages sent to me over the last weeks. I'm sure Krisha read them to me at some point, but, honestly, the two weeks after the surgery are pretty blurry. So I'm reading them all now, unable to stop and go to bed—and I’m still far from 100%, dammit—so the plague grows.

Finally, the intense affliction I haven't been able to shake for even a second, day or night, for all these months: my wife. I can't even sneak out for a 4 a.m. pee without hearing "What can I do for you?" whispered from under the cocoon of blankets on the other side of the bed. At my side in the hospital, at every appointment and treatment, chewing out surgeons and nurses, feeding, cleaning, wheelchairing, note-taking, massaging, driving, worrying, investigating, encouraging, blessing, kidnapping me and making me walk on the beach, letting me be a big baby for two months, removing any reason to my whines, her loving eyes and lips smiling the whole time, just to rub it in good. Why do I deserve all that?

I'm at a complete loss for how to escape these afflictions that have both saved my life and burdened me with an eternal, unpayable debt of gratitude and responsibility. I’ll stack up my plagues against anyone else’s, and it will be obvious that I am the one who has been most rarely afflicted.

To all of you who have afflicted me, just remember that what goes around comes around. God bless you all.

Daily Visits to Cedars Sinai Hospital

MONDAY night: home. Heaven on earth.

TUESDAY, Jan 15

• Our nephrologist calls early to summons Cam to his office . . . his downtown office. A visit there is akin to a French play of the slamming-in-and-out-of-doors genre.
• Leaving downtown doctor's office, we look like the clowns in a farce with their big leg-kick-circles to show how fast we'll go to get to the dialysis center before it closes (closes?! the dialysis center at the hospital never "closed"!)
• Our L.A. dialysis center has Cam's filter (ie, "kidney") ready on the machine . . . to torture. It was the kind of filter we learned the hard way that he's allergic to. I bark at people and sift through Cam's records until I find the information someone missed (I'll forgive, but let this be a lesson to you, readers -- check everything at every visit to be sure you're getting the care you're supposed to get).
• Cam's blood pumps very slowllllyy f o r one h o u r u n t i l the f i l t e r cl clo c l o g s. No more dialysis today.
• The doctor orders a medicine to be put in Cam's catheter tubes to dissolve any dried blood overnight. Perhaps the catheters clogged because his last dialysis was a long time ago: last Friday. Whatever the reason, the blood was pumping so slowly out of his chest catheter during dialysis, the slow-moving blood eventually created a huge clot in his filter (aka "kidney").

WEDNESDAY, Jan 16

• Chest x-ray.
• Dialysis; 3 hours, full run. Relatively uneventful, except for his insanely itchy legs (phosphorous that doesn't get filtered out can cause itchiness, but it's peculiar that his legs itch more during dialysis), and of course he has his usual raging headache in the last half of treatment that takes 4-6 hours following dialysis to quell.

THURSDAY, Jan 17

• Doctor calls to say there is "significant pleural effusion." Half of one lung is "obliterated" on the x-ray. Normal-person speak: one lung has lots of fluid surrounding and compressing it.
• Back to the hospital for the fluid to be aspirated (drained) via a long needle through Cam's back. In all, a liter of fluid is removed. Cam enjoys very much the improved breathing after the procedure.
• The day begins and ends with more dry heaves. The mystery is back, since we'd had a dry-heave reprieve for three days. I call our surgeon's on-call doctor at Wake-Forest. Still haven't gotten to the bottom of all the dry heaves . . . we're diligent about not letting his stomach get empty, and C-diff shouldn't be the reason. Hmmm . . . 

FRIDAY, Jan 18

• Meet with nephrologist, not down-town, but at Cedars Sinai Hospital. The visit is still somewhat like a French slamming-doors farce. But he's remarkably smart. We'll take it.
• Cam gets blood drawn for lab tests. The doctor will dialyze today or not based on Cam's lab results.
• We eat lunch outside at a sidewalk cafe and wait for the doctor's call. We praise L.A. for her beautiful blue sky.
• Doctor calls to say no dialysis today. Cam is to report for labs to be drawn again tomorrow morning before dialyzing.

EVERY DAY, Infinity

• Krisha is grateful.

Half way

We made it to Dallas/Fort Worth, where we were transported via beeping cart through a walkway that  spanned over multiple freeway ramps to arrive at a shopping mall circled with airplane gates.

I’ve concluded that, given the number of people who fly out of necessity, airlines could decrease world crankiness if first class seating and services were standard for all. First world countries could increase productivity and squelch more world ills if every person who started a day of work flying stepped away not leg-cramped, adequately fed sans harried pre-boarding purchase-scrambling, and contented by hot wet rags and a warm chocolate chip cookie.

Cam’s quiet. He was able to have some “weird” plane sleep on the first flight, but is being a patient traveler and overall champ.

Realizing we will return to some semblance of “normalcy” in a few hours brings a quick  wave of surrealness. 

The last time we were away from LA for five or more weeks, I got a study trip to Italy out of it.

I liked Italy better. The protein icecream the hospital started us on is pretty good, but nothing trumps nightly gelato.

Cam just read my first-class paragraph – good progress to focus on a screen that long without dizziness – and posed, “so now you have to explore how to live first class in a non-first class world.” A-ha. There’s a glimpse of the mind I fell in love with. Another inch towards recovery.

I’ll take it. But the philosophizing he suggested is going to have to wait.

LA, the Deavers are coming back to love you even better than before!

Two Words: HOME TONIGHT!

It's all come together quickly . . . Cam has a dialysis appointment for tomorrow in LA.

He’s still feeling rotten from the C.diff and head/chest cold, but he’s been talking about home for a week.

Angels have come together to make it happen. The dialysis technicalities holding things up on the Los Angeles end gave way to an angel doctor in LA, who has been our primary care physician since Cam’s diagnosis, and who we just learned last week happens to be a nephrologist (kidney doctor). 

Gotta love those coincidences, right? Not. That’s our Heavenly Father, that's your prayers and positive thoughts, that’s good karma, that’s a universe conspiring for our good . . . that’s whatever else you want to call it, but it’s not a coincidence.

We owe our flights, transportation and last night's hotel to generous angels we adore: Brad, Dan, Elissa, Kendal, Haewon, Garnet, and Clarence. Oh, wait. Clarence wasn’t in on this one. It all smacks of his kind of work, though. Our friends are clearly in cahoots with his celestial antics.

Cam will hopefully be comfortable in the first-class upgrade, and we will change planes in Dallas/Fortworth, where we hope he can rest in the upgrade lounge between flights. I’ll give you an update then. Our flight out of Charlotte -- where we stayed the night -- is this morning at 11:40. At 5pm PST, I hope Los Angeles will be able to throw her arms around a man none worse for the travel. 

Cam needs your prayers and positive thoughts. It seems like as soon as we booked the tickets Saturday night, Sunday and Monday decided to come in with a vengeance to test him. He’s as bad as I’ve ever seen him since he got out of the hospital. 

But he wants home.

We can do this. You’ve helped us – are helping us. We feel it.

There Are We Happy

I know you need an update.

And I know I could just list some things, instead of making you wade through all this muck below.

But the muck below is turning out to be my medicine for awhile. We really, really miss our family and friends, so we must get our mental medicine where we can.

Which reminds me, Cam mentioned that if I sent out another request for cheer, that he'd like to hear happy things happening in your lives or kindnesses people have done for you. I guess the joke requests were my idea. He does love and appreciate all the jokes, but all the same, wants to change it up.

So, some of you have indicated concern about last Saturday's post (the most recent post till now).  

I'm happy to report that there have not been any more problems with Cam's dialysis filter since they changed the filter brand immediately after his allergic reaction a week ago.

Sorry you didn't get that news sooner, but it would seem that we're perpetually onto the next challenge, and I may not always get back around to telling you things are okay with other here or there items of the past.

Dialysis is going more smoothly in general, with the exception of the really, really wicked headaches Cam always gets during the last hour and a half (as an expert at wicked headaches, I can confirm he's got all the signs of true wicked beating his head up). 

According to those who know, extreme headaches are a really, really rare reaction to dialysis. 

Oh, Cam. It does seem that everything that is meant to make you better surprises those who know by producing in you rarely-encountered side effects and complications.

But, for this week's challenges . . .

I'll be fair, reader, and tell you up front . . . my chest is pretty heavy today.

I was just at the hospital outpatient pharmacy to refill a prescription again, and since they didn't have Tylenol Cold and Flu, I headed to the Walgreen's right by the hospital.

Sometimes I forget that the life Cam and I are currently living is not normal. I mean, of course I know it's not, but the reality is that you just have to deal with things, right? You can't spend time lamenting this or that, you have to keep moving and just figure out what's next, you know?

Well, I requested a consult with the Walgreen's pharmacist. It was interesting to watch his face trying not to react to what I told him. 

It reminded me that all this is not normal.

And it reminded me of Back to School night in September: in walks Dr. Charles, the primary care physician we'd had and loved for 10 years -- until our insurance changed in 2011 and we couldn't see her anymore. It was so out of context to see her in my classroom and not an exam room, and without her white doctor's coat, that it took me a minute to register who this beautiful woman was who was smiling and shaking my hand, and who I knew I knew. You'd think that I would have realized prior to that moment that her child was in my class, since they share the same last name, but -- I hadn't.

After my surprise to see her was cleared up, I barely gave her a moment to shake my hand and ask me "how are you?" before I leaned in and said quietly, "Cam has Peritoneal Mesothelioma."

I suppose I shocked her by putting her out of context now. Surely not what she expected from her child's AP English teacher during a feel-good, welcome to the school year, here are the expectations night. Surely not the first words out of the teacher's mouth at that.

I'll never forget the silence and the startled look on her face -- although like the Walgreen's pharmacist, I could tell Dr. Charles was struggling to process what I was saying and manage her facial reactions. After a quiet moment that felt a lot longer to me, she said -- again, only letting a tinge of incredulity through -- 

"But it's so rare!"

"I know."

So. Today's Walgreen's pharmacist interaction went like this:

"Hi. My husband had cyto-reductive surgery and Heated Intra-Peritoneal Chemotherapy on December 10th. He has renal failure because of the heated chemotherapy."

I paused to take a breath and noticed the minuscule movements in his eyes.

"And he's on the antibiotic Flagyl because we just learned a couple days ago that he has C.Diff."

The pharmacist blinks rapidly a few more times. Minute (mine-ute, not min-et) eye brow flinch.

"He takes Tylenol for the pain from the surgery, and Zofran for the constant nausea since the surgery."

Breathe. Oh, no. Water in the eyes -- my eyes. I've been fighting it for over 24 hours. Oh, wait, I broke down sobbing when Sam, the sweet old hospital valet yesterday said that with what I had "going on," (insert sass), I didn't need make-up. Yup, I just totally lost it in front of a stranger because of a compliment. So he asked if his church could pray for me and Cam, I said absolutely, kept crying, and he just took my hands and started praying right there in the valet office, oblivious to his two co-workers. You can say all you want about the South, but until you've walked this road, you can't know how amazing it is to repeatedly have complete strangers offer to pray for you or remind you that God will help you. Never had anyone anywhere stopped in the middle of day to day life to pray with me like Sam did.

So man, I thought I got out all those nasty tears yesterday with sweet old Sam the valet. 

"Sorry," I told today's pharmacist. "I'm a little emotional today. We really want to get home to Los Angeles, and I'm just a little stressed trying to get ready for the trip."

The pharmacist gave a slight and sympathetic nod.

I blinked back the tears and leveled my voice to continue.

"So now my husband has a terrible head and chest cold, and I've consulted a nephrologist about what he can take that's safe for his kidneys, and the nephrologist said I should double check with you that this Tylenol Cold and Flu and Mucinex won't have any drug interactions with what he's already taking."

I'd only been speaking to him for 20 seconds, but my head felt dizzy with everything that I just  rattled off.

He assured me my purchase would be fine, quietly wished me and my husband the best, and I walked to the front cashier in a daze. Once out the door and in our borrowed van, I lost it. Again. But really this time. All the way back to the Family House.

But while driving back to my Cam, whom I could do so little to help, I thought of Natalie again. 

Natalie, whom I started to write about here in this blog three days ago. Natalie who is a wife who keeps a blog. Natalie who recorded the good and the bad about her husband's HIPEC for a different, but also rare, abdominal cancer. 

I thought of her, and reminded myself that I knew. 

I knew from the time I read her blog beginning to end in one sitting back in August that this was going to be a long trip -- a long trip away from home to get treatment, a long stay once here, and a long journey to recovery. And the long recovery was likely to be riddled with unforeseeable, unique complications. 

I knew, I kept reminding myself as I drove by the now familiar Southern homes and red-brick churches with white steeples. I sobbed, I bawled freely in the car, no one to hear me or hopefully see me. I felt so helpless to help this poor, sweet man lying in a bed, waiting for me to bring him yet another new medicine. 

Nate had one thing after another after his HIPEC in July. He just had surgery again three days ago to remove scar tissue. He's still dealing with the complications and effects of the HIPEC. 

I knew it would be long and complicated.

I suppose I should break here because you're getting impatient with my indulgent writing. What is C.Diff? some readers are still wondering, many paragraphs later.

Well, based on what those who know tell me, it's the intestinal bug that you don't want to pick up in the hospital. Not that you want any . . . but, you get the idea.

Funny. Sounds like what those who know told us about Cam's kind of cancer. I still don't know what to compare Peritoneal Mesothelioma to that's common enough for people to understand . . . but I suppose pancreatic cancer. You just don't, don't want it.

So, C.Diff. It's short for Clostridium Difficile. And although I make students use something other than Wikipedia, I'm going to use it. Again.

"Clostridium Difficile is a species of Gram-positive bacteria of the genus Clostridium that causes severe diarrhea and other intestinal disease when competing bacteria in the gut flora have been wiped out by antibiotics.

. . . C. difficile is the most serious cause of antibiotic-associated diarrhea (AAD) and can lead to pseudomembranous colitis, a severe inflammation of the colon, often resulting from eradication of the normal gut flora by antibiotics."

Then it goes on to say what other things it can lead to that are serious, and we just don't want to go there.

So the antibiotic Cam had in the hospital when Dr. Levine was concerned about infection, that antibiotic wiped out bad AND good bacteria in his gut and left him vulnerable to this thing that people are most likely to contract in the hospital or a nursing home.

And it's made him really, really, really sick. A week of vomiting tons of bile but rarely food; diarrhea that progressed to resembling chopped grass and smelling abnormally horrific, even for diarrhea, etc.

TMI, Krisha. (Readers over a certain age, that means too much information. It's text-speak, like LOL). 

TMI. I didn't need to know that.

Who says? Who says one of my readers might not be grateful one day, thinking, "Hey. Maybe this vomiting and diarrhea after the xyz procedure my family member/friend had in the hospital isn't normal. Perhaps we should ask the doctor to take a stool sample."

You never know. Life is unpredictable, and chances are, you will also want to become sharp about what to watch for. I certainly am grateful for the most minute (again, as in mine-ute) details that Natalie put in her blog about Nate. It all, in some way, prepared me to be a care-giver.

But because I can't bear the thought of making you sad on a Saturday or thinking that our lot is hard -- because honestly, Cam and I are daily humbled by all the things those around us are enduring here and throughout the world -- I have to leave you with some thoughts that have rattled around in my brain a lot.

First, my depressed and also prone to over-thinking friend, Hamlet. He welcomed his childhood friends to his castle, where only he knew that his father's ghost had recently appeared to him and told him that Hamlet's uncle had killed him in order to have the throne and his queen. And he told Hamlet that Hamlet had to make it right by avenging his murder. Oh -- and Hamlet's girlfriend had dumped him to spy on Hamlet for her dad, who was helping Hamlet's murderous uncle and also convincing Hamlet's murderous uncle that Hamlet had lost his mind.

"Welcome to prison," Hamlet said to his old friends in this particular scene.

"Prison, my lord?" one friend asked.

"Denmark's a prison. . . . there is nothing either good or bad, but thinking makes it so. To me, Denmark is a prison."

So there you go, all this is only bad if I decide it is. If Cam decides it is.

And for another character who has outrageous circumstances: Romeo, though I can't call him a buddy. And I can't call his play a love-story, and neither should you. Two teenagers caught up in twitterpation (note: readers under a certain age, consult an adult about twitterpation because it has nothing to do with Twitter) who secretly marry less than 24 hours after setting eyes on each other does not have much to do with love. Anyone who has lived beyond teenagerhood can tell you that.

But to my point: there's a part in Romeo and Juliet where things look pretty bleak for Romeo.

Indeed, after just bawling his eyes out the evening before to the friar (think priest) that the girl he was crazy about had taken a vow of celibacy, he now is bawling his eyes out because after drying his tears with the friar the night before, he reluctantly crashed a party with his friends, fell in love again, married the new love secretly because their families were arch-enemies, resisted engaging in a fight with his now-wife's cousin who was incensed that Romeo dared show up at their party the previous night, saw his friend defend his honor and be slaughtered by his less-than-3-hour's wife's cousin, exploded in rage at the sight of his loyal and dead friend,  slaughtered his less-than-3-hour's wife's cousin for slaughtering his friend, ran away to the friar's place before the prince could show up to exact judgment, and has now just learned from the friar that he is banished. 

You know, before I even tell you the good part, I have to tell you . . . I don't think I've ever understood that moment like I do now. Usually I look at it and think it's over the top. That Shakespeare. Really? All that in 24 hours? To one person? Really?

Perhaps it was Shakespeare's way of saying sometimes life can really pile it on hard, and it just keeps coming.

Indeed.

So, the good part. When Romeo is curled up in the fetal position, crying his eyes out, and then gets the news about being banished, he sobs all over again: there's no life outside the only city he's ever known (and to be fair, waaay harder to relocate in Italian cities with walls in the 1600's), and there is no life anywhere without his beautiful new wife. A punishment of death would be more merciful.

And that's when the friar rocks it. He totally lights into Romeo. I thought about this scene over two months ago, in LA, on a walk one night with Cam. I reminded Cam of the context I just gave you for the scene, and I refreshed his memory on the friar's lecture that I'm about to tell you:

The friar points out all the good.

Your love, Juliet, is alive, whom you nearly died for. "There art thou happy."

Her cousin came to kill you, but you killed him instead. "There art thou happy."

The law that threatened death becomes your friend and turns your punishment to exile. "There art thou happy."

"A pack of blessings light upon thy back; 

Happiness courts thee in her best array; 

But, like a misbhav'd and sullen wench, 

Thou pout'st upon thy fortune and thy love.

Take heed, take heed, for such die miserable."

What I told Cam on that walk that night not all that long ago in LA: I don't want to be like Romeo. I want to be like the friar in this scene, where he sees all the mercy and blessings.

So I guess I'll end this post by saying I am grateful. For learning what has made him so sick this past week and getting medicine for it. For miracles I haven't shared with you yet that brought us here. For miracles that prepared us in odd ways for this.

For the miracle that my love is alive.

A pack of blessings are on our backs. Happiness courts us in her best array.

Oh. And Cam just noisily finished yet another box of Kleenex by simply remarking, "Well I guess it really had been awhile since my last cold."

Nothing is either good or bad, but thinking makes it so. Don't I have a great example from my husband?

Kidney Punch

"I'm going to put your oxygen in," Renee calmed in a not-too-syrupy, but just-syrupy-enough, heads-up voice while she directed the clear tubes to Cam's nostrils. 

He was moaning continuously and trying but not trying to arch his back.

His oxygen absorption rate had dropped to 79 when Nurse Brandy called for reinforcement from the dialysis Charge Nurse Renee.  Now absorption was flickering in the low 80's. Below 90 causes a nurse to stand at attention. Ideal absorption rate is 100%.

Who knows what other numbers where on the heart monitor? Not me. I couldn't take my eyes off him now. 

What should I do? Just keep rubbing his legs?

I'd never seen him in pain like this before.

The nurses worked. Quickly and calmly. They weren't shooing me away, so I tentatively massaged his legs and murmured reassuring words. 

I'm so glad we're still here.  Here, as in Wake Forest, where we're familiar with procedures and the dialysis staff is familiar with Cam. That thought of gratitude actually played through my mind as a complete sentence -- in the hospital even. And the other: I've never seen him like this before.

What I was seeing that I had never seen before was the distinct pain and discomfort of an allergic reaction to dialysis.

I know. Who knew?

I'll try to simplify what I understand of what transpired by using this diagram from Wikipedia, since I can't find the pictures I’ve taken of our machines:

But first, the machine is not larger than a person, as the diagram here might have you think.  The ones we're used to stand a bit less than 5 feet. And the diagram’s parts are hugely disproportionate -- we’ll presume that the artist is providing detail shots -- plus, the big screen at the top has been left off. But, honestly, the only numbers on the screen that I understand anyway are the ones on the count-down timer.

Okay. So an allergic reaction happens because of the dialyzer, which looks like a small vacuum filter. Brandy approved of that observation, by the way. Except that the filter tube is filled with fibers that are way more sophisticated than the fibers in my vacuum's filter.

The filter does the work of -- you guessed it -- filtering the blood for impurities, accomplishing a lot of the work of a kidney. Toxins and urea get filtered away from the patient, while the important blood cells go back to the patient's body.

A patient can have an allergy to the type of fibers used in the filter, or the way that the fibers are sterilized.

According to Brandy, an allergic reaction can happen on the first session or the tenth -- but it usually happens at the beginning of the session. This was Cam’s 15^th session in three weeks, but it did happen in the first twenty minutes.

Allergic signs Cam had:

•  A sudden HOT “mask” across his eyes that grew into a hot flush through his face and then the body. Cam asked for blankets to be removed and that I fan him.
• Extreme pain in the lower back, which he likened to someone hitting him with a baseball bat.
• Temperature jump – in his case, to 100.7
• As mentioned above, oxygen absorption drop.
• I’m pretty sure blood pressure dropped, but also mentioned above was the fact that I wasn’t reading monitor numbers – my job was to love and comfort.
• The flush through the body gives way to chills. Cam was shaking uncontrollably and eagerly received additional layers of heated blankets.

The nurses removed him from the dialysis machine and waited for his symptoms to subside before changing his filter to a pricier type that doesn’t clean as quickly but is also unlikely to cause a reaction. 

The whole episode was probably about fifteen minutes from inception to the time he began to recover, but I'm sure it seemed much, much longer to Cam.

Brandy also suggested that he might have been having mini reactions for awhile, but that they were small enough to go unnoticed.  He did in fact, have an awful, full-body flush that was hugely disconcerting to him some time around treatment #7 . . .

And the reaction may solve one of the mysteries about why he’s had continued nausea to the point of vomiting four different times in the past week . . . something his surgeon told us yesterday morning should NOT be occurring.

So far today, no vomiting.

As Cam says about the tiniest of good news: I’ll take it.