Tuesday, July 3, 2012

Day 17 - update #2

Tuesday, July 3 starts with some wild eyed speculation. I do not know the results of my biopsy yet and will not until 3 pm.

My nurse came in about fifteen minutes ago and casually says, "I just got orders to draw some bloods on you."
"OK, what are you drawing?"
"HLA testing."
"O, what is that for?" (full disclosure at this point, I am thinking the main reason I know of to draw HLA is if I need a bone marrow transplant.)
"I'm not sure. They just ordered it and didn't mention why."
We talked a little more, but let me summarize the thoughts that were going thru my head: "I need a transplant. My marrow was so bad that they can tell without even having their meeing about it that I need a transplant. It's so bad that they don't want to waste a second trying to find me a match. They need to get going right now on a match for me because maybe my marrow shows really really bad leukemia or maybe the leukemia is gone and they can see that there is breast cancer in the marrow besides the leukemia (and somehow this means I need a transplant). They need to get going now because I am going to be such a difficult match because of the platelet antibodies that there is probably not even a match anywhere in the whole world for me."
Then the nurse says "o, the indication for the lab test is here on the slip "as discussed with blood bank for platelet antibody matching."
O. I guess I don't have breast cancer and leukemia and need a transplant. Deep breath.

This was a very interesting lesson for me. I don't usually spin out of control so fabulously, but somehow the idea of a bone marrow transplant has me totally freaked out. Clearly.
So, class today's lesson is on informing the patient about what you are doing to her and why. Speaking about in-patient care, I can't enter labs in the computer for patients. I either have to go to the floor and enter them in the chart at which point I may as well pop my head in the patient's room and tell them what I'm doing and why or I call the nurses and give them a "verbal order" and I try-I intend-to always tell them what to tell the patient about why I'm doing the test. Again, Universe, I understood that that was important already. Maybe not 100% understood but did I really need the experiential learning component? How about if I just do an extra paper about the topic--a really short one? O, I guess I already did.
The after thought is that I wonder if this problem will get better or worse now that orders can just appear at any moment on the computer without any human interaction required with the nurse. The computer will not let you enter an order without an indication, but it will also not check if the indication has any real meaning.
update #1
The first piece of info is back on my marrow and that is the flow cytometry. There are still about four or five more pieces of inforation to come. The first (the flow) says "no leukemia."
update # 2


  1. we like that first bit of information :) my own note to self... make sure patients know why you are ordering something so they are at least LESS freaked out. GOT IT! :) praying for the rest of this news to be as good as the first little bit.

  2. Ok Ms. Mary...it didn't take me long. I knew I would track you down. I am so so sorry that you are having to endure all of this. I knew something was seriously wrong when I received the "form letter" from the big guy stating your extended leave of absence. My heart was heavy when I heard that you were diagnosed with leukemia. You, my friend, are such an example of courage, strength, fortitude and grace in the presence of such adversity. You are in my thoughts and prayers, Mary. I'm so happy to see that Diane has been such a supportive friend, as well and just for the record I make a mean chicken soup should you be craving a few more gallons of that stuff. I will follow your daily blog. Lots of Love, Mary......Marian

  3. Thrilled about the bone marrow results. Yippee!

  4. I am still doing silly songs and dances with wheaten terriers.
    Point taken about always informing patient. At detox we do screening blood work--standing order--and we inform about results, but it might be a nice teaching moment for patients--especially the young opiate users--to go over what is being looked for. Not that you can scare anyone, but information sticks, even at detox.
    Love and later.