Tuesday, August 28, 2012

Day 73 - more on coordination of care

I felt so horrible yesterday that all I could think about was my virus. I completely neglected to update everyone on Ellie's first day of sixth grade. She is at the middle school now. The way our school district works is grades K-5 are each done in the towns and grade 6-8 (middle school) and 9-12 (high school) have kids from 5 surrounding towns. This means there is a huge influx of new kids for Ellie this year which should be nice. Some of the towns have like 40 kids to a grade so the middle school will probably be a bit of a shock for those kids. The Lincoln Street School where Ellie was last year has (I think) like 200 kids to a grade so the 120 kids in her 6 classroom "team" is not overwhelming at all. She knows a few of them already and should do fine at getting to know more. She was happy with her back to school outfits both yesterday and today and had a little bit of homework both days. I think it will be a good year. She likes her homeroom teacher so that's a good start.

The other news of my life is that today Emily left for college. She drove her Subaru station wagon to Amherst, MA all by herself and moved into her room all by herself. She is getting to move in early because of her job and her roommate is still on vacation in Maine so she had to arrange the furniture all by herself. Last year when she moved in, we all drove up with her and helped move furniture, carry boxes up the stairs, etc. In fact, Ellie got to miss a day of school to do it. This year, she just backs down the driveway and is gone. She called to let me know she got there safely which was much appreciated.

Otherwise, today was another largely quiet and uneventful day. I tried to do last Friday's NYT puzzle on my own and it just wasn't any darned fun. I found out yesterday that Will Shortz shares my birthday. He is a little bit older than I am, but was also born in the MidWest.

I wanted to talk a little bit about coordination of care. You will easily draw the conclusion, but let me tell you the story. So, on Monday, my labs were really good (it turns out I misread my lab results and my ANC is actually almost 4,000--so that's normal). I asked if I should keep taking my anti-fungal, anti-bacterial and anti-viral. Dr. Manno told me he thought yes, but that I should ask Dr. Hill. I called up and by the time they got back to me, it was today. They said no more anti-this, that and the other and that I didn't need any more labs until my next visit to start chemo jail on September 14. Then about 40 minutes later Dr. Manno's office called me and asked me to come in next week for labs and a visit with him. They pointed out (rightly) that my platelets and hemoglobin are not normal yet and that they would like to follow them to normal. Of course, it's all a matter of what one worries about; there really is no reason my hemoglobin and platelets should not continue towards and into the normal range, but it's always nice to witness and prove these things.

The conclusion, which I think is pretty self-evident, is that NCCC in the north and south would end up looking a lot more smooth and coordinated if they shared their plans with each other. It is kind of awkward to have two fully independent hematologists. They are well coordinated in that Dr. Manno is clear that he defers to Dr. Hill in my case on all things directly related to the treatment and I have been impressed with how well they do that piece, but it would look so much nicer if the little auxillary pieces were in place. I don't feel my care is compromised in any way, just the elegance and style.

I spoke with my friend Linda from Minnesota today and we reminisced about when Ellie was born. Her family were our first visitors in the hospital and she agreed that it was so nice to have a loving, happy thing in their life at that point. I think Ellie had not even had her first bath at that point and was a little less than pristine, but, o, so cute!

My cold is about the same. Last night I woke up with a stuffy nose and whenever I wasn't blowing my nose or sneezing, I could hear Emily coughing. What a contageous household we have here.

I am hoping for a day without excessive mucous for myself tomorrow. That is a fairly prosaic wish, but I will wish it for you, too.

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