How do you spell 'Can't get off the couch'?

Inertia.

Its heavy hand pressed me down on my couch this afternoon. I had my cell phone in one hand and the house phone in the other hand, waiting for the world to somehow rouse me. I had given Katie the newspaper I was reading because it contained a story of interest to us. We had been talking about whether dogs always wag their tails involuntarily or if sometimes they can will themselves to "smile" by wagging. Today's New York Times had a related story headlined, "In that Tucked Tail, Real Pangs of Regret?" It was the opposite emotion, but it raised a similar question about how much control animals have over the signs they give. Katie took the paper into the kitchen, and I thought about getting up to take a walk.

But I couldn't get motivated. I called Katie, who was just one room away, but she didn't hear me. Then I sunk pretty low: I called her on her cell phone. She didn't pick up, but soon after she came back in.

"I have a bad case of inertia," I said. "Hey, that's a good SAT word. I-N-E-R-T-I-A." I then gave her a definition, using my current state as an example.

I guess I had good reason. Yesterday Joe drove me to my clinic appointment, where the bright spot was that my platelets were 21 -- out of the teens. My hematocrit, however, had dropped to 27. I told Melissa I could feel that it was dropping. She said not to worry, that it was OK and I'd probably get blood in the next visit or two. Meanwhile I'm in that limbo where I feel more tired, but my hematocrit is not low enough for a transfusion (they transfuse at 25 to 24).

I slept at Diane's last night because Joe had to leave to get back for his job as an umpire. My friend Chip picked me up Newton this morning and drove me home. I guess the back-and-forth probably added to my fatigue.

I did end up getting the platelets yesterday. My nurse in the transfusion room couldn't get the IV in. She poked me twice, each time jiggling the needle for what seemed like ages while trying to catch a vein. I started getting queasy and considered asking her to get another nurse, but she called for help on her own. The other nurse came and got the IV right in.

Nurse number 1 said, "Sorry, I haven't missed an IV all day." Then, speaking of Nurse number 2, who had left, she said, "I'll have to buy her a Starbucks." I almost said, "How about buying ME a Starbucks?" But I didn't see the point. She said she thought I was dehydrated, making my veins flat instead of plump. This earned me a liter of fluids and another hour at the clinic.

Anyway, today I did finally get up and do the mile around the lake. I was walking so slowly that during the time the dog was on the leash, I felt bad for her. I let her off when we met up with a friendly golden retriever who shared his tennis ball and ran in and out of the water with Maddie. So she got her exercise and I got mine, although mine was a bit of a struggle.

Is that a banana under your Cheerios?

I buried the banana in the Cheerios and put the peel in the trash instead of leaving it on the breakfast tray. It made me wonder if my brain is OK after all.

Explanation: I know that since I am now on the restricted transplant diet, I can't eat any fruit other than that with thick skin. Having gotten conflicting answers about whether I can eat even oranges and bananas at this early point, I took matters into my own hands and felt a little like I was hiding contraband as I did it.

The doctor said I could have bananas and oranges, but they are not on my official BMT menu. Diane brought me a few oranges and bananas, but one nurse said to wait until I get home to eat them and another echoed her. Of course it doesn't really matter if I have the fruit, but maybe wanting it is a way of trying to hold on to part of my old routine. So…I figured a little banana wouldn’t hurt me. When I cut it up, it reminded me of being home, when the dog comes running as I peel the banana and I share it with her. I miss the dog. Too bad she can’t visit.

I am getting a ton of IV fluids with the chemo. This morning when I woke up and looked in the mirror, I noticed that my upper lip had puffed up, Renee Zellweger-style. I know that for some odd reason women pay for collagen injections to achieve this look, but I found it disconcerting, since it isn’t me. A nurse confirmed that it’s from the fluids, and everything will go back to normal when the fluids stop.

My night nurse is often Sergie, a model-beautiful woman from Haiti. I asked her if she had considered modeling; she seemed flattered and said no, she hadn’t. When my teeth started chattering as my fever rose the other night, she got me Tylenol and warm blankets. She covered me with the blankets and tucked my quilt in over them. We chatted for a few minutes and the shaking subsided. She’s the opposite of the rude MRI techs from the other night. Amazing how far a little kindness goes.

Yesterday, though, I had a problem with an inexperienced nurse. A preceptor accompanied this trainee most of the day. When it was time to hang my chemo, both came in, and the teacher led the way. So far, so good.

The IV nurse had to remove one of my IVs and start another, because they’re good for only four days. (I am still waiting to get another PICC line, which should happen today.) After she removed the old IV, blood seeped through the dressing. She applied more gauze, and it seeped through that too. So even though they weren’t planning on it, they ordered platelets.

The bleeding had stopped by the time the platelets came, but I was still anxious to get them in. The trainee came in by herself with the platelets and some other medication, opened the IV pump, and then dashed out of the room saying she had to check on something. It took a while for her to come back, and she succeeded in hanging the platelets. She watched to see that they were running but never came back to double-check.

Meanwhile Nurse Ronni noticed that nothing was dripping into the tube where I thought the platelets should be entering. I have a lot of bags up there – six right now and about the same number yesterday afternoon – and I traced the platelet bag and discovered that sure enough, it wasn’t dripping.

So I put on my mask and gloves and went looking for her preceptor. Sure enough, the IV through which the platelets were supposed to drip had clogged up and gone bad. She and the trainee then came into the room, where the experienced nurse changed IVs and the platelets began to drip. The trainee said, “Thank you for telling us, that was helpful.” (How about, "Sorry about that"?)

I didn’t have anything against her, and she was pleasant and well-meaning, but I think it was too much for me to have had to monitor this. Plus what if I had fallen asleep and I really needed the platelets to stop the bleeding and she hadn’t double-checked?

Later I asked the preceptor to please accompany her trainee when they are hanging something, because “she doesn’t seem to have the confidence and knowledge.”

The preceptor agreed and said she would have been in there, but she had had an unusual situation. One of her patients had bolted out of the pod into the hall and was heading for the elevator, and she had to go retrieve him. Okaaaaay.

Today I have an experienced nurse, so I feel I can concentrate on other things without having to “supervise.”

It’s D-2, the last day of fludarabine. Tomorrow I get the double dose of melphalan. As I said before, my mind drifts into worry-land with the question, “What if the melphalan doesn’t wipe out the leukemia?” (The fludarabine is lower intensity and is intended more to lower my immunities to accept the donor cells, while the melphalan is more intense and has the job of going after the leukemia.)

I must constantly bring my mind back, without getting down on myself for worrying. I need to remember the title of the subtitle of blog: Fighting Cancer One Step at a Time.