It's amazing how a relatively intelligent person--in this case, me--can be so dense about important matters.  After endless complaining about lack of energy, by last Wednesday things had reached a turning point.   I couldn't dress myself without resting between each item of clothing.  I'd be thirsty, have a glass of water on the table in front of me, but not be able to summon the energy to bend forward and pick it up.   I could talk only in a raspy whisper.  Luckily, I wasn't alone, and Mohamed insisted that we go to the ER.  I called the oncologist in KC, but we agreed that a trip to KU Med would be too much, so we went to the ER at Stormont-Vail, Topeka's largest hospital, where I began a three-day stay.

Saying the words 'stage 4 cancer' got me to the front of the triage line in the ER. Since I had had uncontrollable diarrhea for several days, the first test was to eliminate clostridium difficile (or C. diff), a dangerous infection that is common in some cancer patients.  The tests for that were negative, which was good news indeed.  I was suffering from acute kidney failure and severe hypotension (80/40 when I entered the hospital).  Because of the diarrhea, the kidneys had nothing to process and had shut down.  For the next three days, I was pumped full of various fluids.  I kept thinking of the scene in Catch-22 with the soldier in white who has one bag of fluid pumped in, one drained out, and the two bags exchanged every several hours. 

Once the diarrhea had stopped (I'd quit taking the chemo), the kidneys began to respond, and after a couple of days, they were functioning normally again.  The blood pressure was a little slower to respond, but it's now back at normal levels.  The Votrient raises the blood pressure so much--this an immediate effect over three years ago--that I've been taking three different anti-hypertensive meds to keep it under control.  For the moment, I'm off both the chemo and the blood pressure meds.  Tuesday we go to KU Med to consult with the oncologist and see what the next steps will be.

Wednesday was an extremely scary day.  Even the normally unflappable Mohamed was alarmed.  As always, he took good care of me, beginning with his insistence that we go immediately to the ER.   The hospital experience was decent enough.  The bed was too short ("it doesn't fit anyone 6' or taller," said one of the nurses).  The food was passable when Mohamed wasn't bringing in nourishment from outside.  Friday night, our friend Laura brought in lamb biryani for me, so at least I had something spicy, and my appetite seems to have improved, as has my energy level. 

Saturday was frustrating as I waited all day for discharge, getting testier and testier as the day progressed with no sign of the doctor.  Finally, around 6 p.m., I was leaving when I felt warm liquid running down my left arm and hand and saw blood spots trailing through the hospital lobby.  Because I take an anti-coagulant every day (that's the morning shot to the stomach), the place where the IV port had been removed was bleeding.  That taken care of, we headed home. 

I'll blog again on Wednesday after our appointment in KC with Dr. Van.  In the meantime, we're just monitoring things like blood pressure, but I'm feeling much better and actually have a little energy.