Thursday, November 1, 2012

Day 138 - day? what day?

It is not entirely clear to me where today went. There was the two hour nap, the one hour nap, the trip to Manchester for labs, seeing my therapist and I'm not sure what else I might have done today, i.e., not much.

Patrick started the day off with an early text asking if I wanted to meet for coffee. At first I thought I wouldn't be able to because I was still in my pajamas, but then I remembered I didn't have to do my hair so I figured I could get dressed and walk there in fifteen minutes.

Next, Tommie and I headed off to Manchester for labs which turned out completely, disappointingly without anything to fix. My hemoglobin is stable at 8.7 (which is low--12 is normal, but not so low that I need a transfusion) and my platelets were 51 (also low, but not so low that I need a transfusion). There is a shortage of blood components now because of the hurricane so I am happy to know that I am not needing any today. I suspect that I will need platelets by Monday, but we'll see. I am wondering if this will be a consolidation without needing red blood cells at all. My ANC was 170 which means that I am correct to be on the neutropenic diet (grumble).

When I got home it seemed like a nap was in order, then lunch (more delicious spaghetti; thank you, John!) and off to visit my therapist. I didn't intend to take a nap when I got home, but I lay down at 2 o'clock and the next thing I knew Ellie was clumping up the stairs at 4 o'clock home from school. I guess I have a lot of repair and rebuilding that needs to go on internally.

I also read this week's NEJM, hot off the press, and found the article about the costs of health care interesting, but did not really find anything compelling enough to recommend. The cost article looked at the expenses of each HSA and each HRR. HRR's are made up of HSA's. They found that not all the most expensive HSAs are in the most expensive HRRs. Medicare is proposing to control costs by adjusting the rates they pay each HRR. If the fees are adjusted at the HRR level and costs are produced at the HSA (or lower) level and there is only a vague correlation between the expensive HRRs and HSAs, the policy is unlikely to work too well. Not the clearest explanation of the article, but it was only marginally interesting to me so that's all it gets.

I didn't mention yesterday because there was no place that it seemed to fit that the anxiety dreams had started up again for this cycle. I bet when the intracellular contents of all my dying marrow cells start circulating that some of them are psychoactive and that is what brings on the anxiety dreams. They always appear and disappear at about the same time in the cycle, along with the time period that I think is the big die off and clean up. Tommie says that she thinks it's my brain just doing its best to make sure I know I've been poisoned which I think is another good way to look at it.

Tomorrow I am spared a drive to Lebanon, which is nice, but don't get to visit Shelley, which is not as nice. Worse, when will she get her "get well soon" present? On the other hand, there is something to be said for home and only my own marrow products.

For me, for tomorrow, I am hoping for more quiet recovery. For you, I don't know; you might not want a quiet day, especially since it's Friday. If you'd like quiet, I wish that for you. If you are hoping for excitement, that is my wish for you.

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