What Goes Around Comes Around

My friends in America might not realize that after 9/11, Canadian Blood Services (CBS) set up extra donation locations from the Pacific coast to my home on the Atlantic coast in Nova Scotia. Along with many colleagues at Dalhousie University, we lined up to donate blood for the expected victims. A sea of beds filled the McInnis Room in the Student Union Building and those waiting to donate were students, staff, professors and administrators. Many were first-time donors and I suspect, like me, continue to donate to this day.

Personally I switched to Plasma a few years ago and for some time visited the clinic weekly. That can deplete your iron reserves, so earlier this year I changed to bi-weekly. I’ve been poked a lot of times since 9/11. Like all the regulars, when I walk into the clinic, I’m known by my first name. It reminds me of the TV show Cheers, “where everyone knows your name.” I feel good every time I donate and the team at CBS make me feel like a hero.

If you’ve been thinking about becoming a blood donor, this selfless one-hour of your life will potentially save someone else. Other than a bit of your time, there is no cost. And there is the benefit of having your blood tested regularly which might surface a health problem needing attention.

Elbow or Head? Unknown

Today (Monday, January 20, 2020) the tables turned. Last night I didn’t sleep well and was in the bathroom hourly. I thought I was getting a cold or the flu. During my 5:00 am visit, I had a good movement but really wanted to clear my stomach. The nausea was driving me nuts. Now no wants to hurl in a toilet they used so I leaned over the sink. It gets a little blurry from here as I blacked out and collapsed. I don’t know what dented the wall: my elbow or my head; neither appear injured. The crash was loud enough that Janet called out to ask if I’d I had fallen and I replied I had and I needed help. She cracked the door to find my crumpled body on the bathroom floor. She got down to help and I said wait. I knew I wasn’t ready to stand up. I needed a few moments to catch my breath. I really had no idea what happened and less of a notion why. I have never passed out in my life, with the notable exception of self-induced from the consumption of an adult refreshment or three. After a few minutes, Janet helped me crawl to our bed. I simply wasn’t ready to stand up on my own and even though I’ve lost a lot of weight, it would be too much of a challenge for Janet to lift me to my feet. With her help, I was able to drag myself onto our bed and flopped on my back. I was exhausted.

I laid there flat on my back as we discussed what to do. It was too difficult to even sit up. I had a 9:00 am appointment to see my Chemotherapy Oncologist, Dr. Pierre O’Brian, for the first time. I didn’t want to miss that. After a while, I had enough energy to get to the bathroom, brush my teeth and take a quick shower. I was pretty weak in the shower so got out, wrapped a towel around me, shuffled to our bed and flopped on my back again, exhausted. Janet dressed me; I didn’t have the energy.

It was close to 7:00 am and I clearly couldn’t drive. We decided to call Janet’s sister Marlene who lives just up the hill from our home. She arranged for her husband Ron to drive us to the cancer clinic. Thankfully he has bench seats in the back of his van so I could lie down. We chit-chatted on the way which helped the time pass quickly.

The short walk from the van to the entrance was excruciating but Janet kept me on my feet until I got into a wheelchair. It was all I could do to sit up and thankfully there was no one ahead of me at the check-in desk. I shared that I had passed out earlier and was struggling sitting upright, felt light-headed and was there somewhere I could lie down. I was taken immediately to case room 88 and helped onto a bed. A nurse followed me in and took my vitals and offered water and wafers. That helped. I didn’t know what was wrong but was of the mindset I was coming down with a cold or the flu.

So lying down I was okay and the water and wafers seemed to perk me up. The nurse, Evelyn, was part of my Chemotherapy team. She took an extensive history and shared what I can expect during my cancer treatment. One new thing I learned during this meeting was had my cancer been just the tumor and had not infiltrated three surrounding lymph nodes, the protocol would have been immediate surgery to remove my esophagus and stretch my stomach to re-attach to the top of my esophagus.

Bad Hair Day

A short time later, Dr. Pierre O’Brien joined me to provide additional details. He is a Chemotherapy Oncologist Fellow in the final stages of his studies and has my complete confidence.

Since my cancer is localized, there is no value to bombard my body with high-dose drugs to seek out and destroy all rapid-duplicating cells. In my case, chemo is a treatment to augment the radiation. Consequently, the side effects from chemo will be minimal. Odds are I will keep my hair but I already promised Alexis I would shave it if that proved to be the case so it will be coming off.

The treatment plan is that each week I will have radiation for five consecutive days, followed by two days of rest. On one day, likely Monday, I will also have chemotherapy. The chemo will be on the same day each week. This will repeat for five weeks. Should I be in relatively good health during week five, an additional week will be added to this part of my treatment.

On completion of the chemo/radiation treatment, I will have a rest of four to six weeks to allow my body to recover and be strong for the surgery.

I was provided with a lot of literature so I have more homework. As well, I have requisitions for blood work to do at the end of the appointment as well as the day before each chemo session.

The clinic has a secret entrance to the blood collection service so we were in an out pretty quickly. Ron picked us up at 11:30 to head home. I was exhausted so it was good to lay down on the trip home.

Walking up the driveway was tough and like earlier, once I got in the door I flopped on the floor at the bottom of the steps to rest. It took me three efforts to get to the top of the steps and down the hall to our bedroom. I crawled into bed. Eureka … I could rest.

Janet brought me a tray with soup, crackers and water. It was on a plate so I asked if she could get a tray. By the time she got back upstairs, my phone was ringing. It was Dr. O’Brien and he had some of my blood work results back.

My hemoglobin was critically low and I needed to go to Emergency right away. I asked if I could eat the soup and he said no, go immediately. My count was 55 (which is the US would be referred to as 5.5). A normal count for a man my age is between 120 to 140. I could expect a transfusion of whole blood.

Janet helped me get dressed, I called Brad’s son Brady for a drive, and I headed down the stairs. Once again I was exhausted and flopped on my back waiting for Brady to arrive.

The ER at Dartmouth General wasn’t as busy as usual. There was only one person ahead of me. As earlier, it was tough sitting up. The volunteer pointed out that there is a room just off Emergency for people in cancer care. I thanked her for the offer but it was almost my turn so I’d pass on waiting in there.

The triage nurse was efficient and thorough. I was registered and in a bed very quickly. It was so good to be able to lie down. I was further exhausted.

Cat Getting My Transfusion Started

Once in a bed 10, a nurse wired me for vitals, took blood to get up-to-date numbers and put a butterfly needle in my arm for a blood transfusion. The blood was on its way from CBS in Burnside. Before the blood arrived, the results were back from the lab and my count was showing as 52. It may have dropped or this number may be a result of how it was processed at the Dartmouth General Lab. Regardless, it is critically low.

Just a Double Check – Note the Skin Tone Difference between me and Kymris’ handsThis was after the 1st. tranfusion

In the picture to the right, the 1st unit of blood is on the rack. It takes three to four hours for the pump to empty the unit. The nurse stays for the first fifteen minutes to double-check that I’m not rejecting the blood, having an allergic reaction, shortness of breath, a rash or a variety of other symptoms indicating I was having a problem. Transfusions can cause heart problems given that a reduced ability to transport oxygen, the main role of the hemoglobin, is suppressed. The body frequently responds by speeding up the heart rate and potentially increasing the blood pressure. In my case, my heart rate was never above 70 bpm and blood pressure was always around 120/60. I’m sure that my stable heart is a direct result of my transformation to a healthy lifestyle. After the first fifteen minutes of continuous monitoring, the nurse dropped in every ten minutes or so to take my temperature and do a quick double-check. I had no problem and the 2nd unit was set up for transfusion. It took about six hours for the two to drain. The blood work was repeated. To my disappointment, my hemoglobin count only increased to 62.

Although I have no idea why, it took a while for the 3rd unit to arrive from CBS in Burnside. By the way, the hospital keeps a small supply on hand for critical cases like someone bleeding out after a car accident, but a critically low count like mine isn’t a crisis. The 3rd unit was hooked up and started. This unit took almost four hours and the blood work was then repeated. I was already showing improvement. The most noticeable change was the colour of my skin. I was almost yellow when all this started and extremely pale. I was still pale but to a much lesser degree. At the end of the 3rd unit my hemoglobin count was now at 69. The point below which people are considered critical is 70 so I’m still on the wrong side of the milestone.

An additional unit was ordered. I learned that four is the maximum allowed by treatment protocols. It would be another four hours to empty that unit. I at the Dartmouth General Emergency around 1:00 pm on Monday. I finished the transfusion of the 4th unit around noon Tuesday. I had been in the hospital for 24 hours. Eureka, after the 4th unit, my count was at 85. My colour was normal. My energy seemed good. My lightheadedness was gone.

But the question remained why had my hemoglobin tanked. If you don’t know, hemoglobin are the blood cells that transports oxygen so it’s kind of important to live. Most people know that iron is important too. It serves as the building blocks for hemoglobin cells.

So why am I losing hemoglobin or put another way, losing blood? My urine is clear so it’s not from that system. My stool is dark but not black so that is an unlikely source. I’m not vomiting blood.

We stayed to see Dr. Shepherd to get an appointment for an endoscopy to see if my tumor was bleeding. There is a possibility of a stomach ulcer. We waited for almost eight hours after the 4th unit but didn’t have this meeting. We’ll head back Wednesday morning. So I was there a long time but in the big scheme of things, the care was outstanding and I felt safe and cared for throughout the experience. I suspect this was a run-through for things to come in the months ahead. Bring it on! I’m ready for the good fight.

As always, thanks for reading. I hope this brings you up-to-date. After all the years donating plasma, today I found myself to be a recipient. It is truly the gift of life. I encourage you to join me as a donor. You will feel like a hero too.

To help out, Brad made our bathroom a little more comfortable for my next tumble … ha ha.

8 Replies to “What Goes Around Comes Around”

  1. After all what has happende it is admirable how you can write about this. You kustbewoners a strong and positive man, that will certenly help a lot with the rest of your recovery.

  2. All the best Phil, hopefully this is just a ‘bump’ in the road to healing. I remember the ‘curveball’ events, hopefully there arent many of them!! Thankful you have a great supprt team!

  3. Keep writing… in the meantime I can tell Christine to “put a rush on” if blood is required again – She works in that Dartmouth.

  4. Glad that is behind you Phil and hopefully you’ll have some answers soon.
    I too am a blood donor and I encourage everyone to get out there and give.
    Take care and tell Janet I’m here if she needs to reach out,
    Rita

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