I got a call from my mom last Monday afternoon around 2:00. She was at the hospital with my dad, who was going to be admitted to the ICU. I told her I wanted to come visit, but she said to wait until she called back when he was settled into a room. He hadn’t been feeling well since his second round of chemo the previous week (Rituxan and bendamustine) and his condition had rapidly deteriorated over the weekend. He wasn’t able to keep food or even water down. By the time my mom updated the oncologist on his condition at home on Monday, the oncologist said not to waste time stopping into the oncology clinic or at the nearby emergent care facility, but to go straight to the hospital emergency room.
It was a good thing, too. My dad went into septic shock. His blood pressure was down to 59/49. His white blood cell count was at 700. (Normal range is 4,500-10,000.) His kidney function was low. My mom thought she was going to watch him die that day, and it turns out it was a close-run thing.
When I hadn’t heard back from my mom by 4:45, I got tired of waiting. I called patient information, and they had a room number for him in the ICU. My husband called his mom and asked if she could watch our kid and feed them while he drove me to the hospital. (It’s never a good idea for me to drive when I’m upset.) The Beulah T. Hinkle Intensive Care Unit at Ellis Hospital is pretty incredible. We had to chill in the waiting room for 20 minutes because my dad was still going through the admissions process when we got there after 5:00. The ICU ward is locked, so his nurse had to come out and let us in when he was ready to see us.
We had to put on masks. The nurse told us that he was already doing much better than he had been a few hours ago. I guess dumping mass quantities of antibiotics, saline, and other assorted fluids into his bloodstream via four IV lines can do that. He didn’t look good, of course; he looked exhausted, pale, wilted. But he could talk, hoarsely, and his sense of humor was still intact. My mom hadn’t eaten all day, so we sent her to the cafeteria to get some food. Our visit was as much to look after her as it was to visit him. While she was gone, they brought my dad’s dinner in. It was the first meal he’d had in days. He was very weak, and it was difficult for him to move, but he enjoyed the chicken broth so much that he finished it before my mom got back, and he ate half of his Jell-O. It was good that he could eat now, because that would help him get his strength back.
By the next morning, his blood pressure was back to normal. They wanted to keep him until the end of the week so they could figure out what sort of infection had caused this in the first place. By Tuesday evening, he had improved enough that they said he could be moved out of the ICU once they found him a single room. He couldn’t have a roommate because his WBC count was still low enough to keep him in isolation. This would actually keep him in the ICU until Thursday evening, because there were no suitable rooms available until then. All the medications they were giving him apparently caused some bizarre behavior, and he doesn’t really remember all of the things he said and did.
E. coli ended up being the culprit. Not from any sort of contaminated food, but from the naturally occurring E. coli that everyone has in their gut. A healthy immune system can handle this bacteria. But the chemotherapy had nuked his natural immunity, and his bloodstream got infected.
My dad was given the green light for discharge on Friday morning when his oncologist came in for rounds, but it was about five hours before the floor doctor made her way to him to actually discharge him. I visited him at home that afternoon, and if I hadn’t known he’d been in the hospital all week (and he wasn’t regaling me with hospital stories) I wouldn’t have guessed it. He was sitting up and talking like his usual self. (Well, his usual self with cancer.) So grateful for the excellent care he received during his week-long stay at Ellis. The doctors and nurses weren’t just competent, they took really good care of both him and my mom.
There was some unexpected good news through all of this ordeal. They gave my dad a CAT scan as part of his workup, which showed that his lymph nodes had shrunk significantly in his abdomen. Translation: the chemo is working, and his cancer is disappearing. It was still too soon to be seeing results from his second round of chemo, so all of this progress was thanks to his very first chemo treatment this time around. Because of this, his oncologist is revamping his course of treatment so that each round of chemo will take place on a single day from now on, instead of two consecutive days like it was originally. This should help preserve more of his immune system during the rest of his treatment so there are no more life-threatening infections creeping up on him.
[Update: This was false hope.]