Thursday, September 10, 2015

Drink up. (Not coffee or alcohol)

Looking down at the lobby
Today I went to Dana-Farber early to have a checkup with Melissa before my ECP and got one of the nice drivers, Kenny, from Prevalent, the same company that also sent me Igor the psycho Russian driver.

Kenny is a father of two whose main interest is in music production. We have chatted about this in the past. He is the one who keyed me onto the story about Igor/Alex.

This morning he told me that the company had a scheduling problem, namely that he had to pick some people up in Boston at 2 and bring them back to Springfield, and since they obviously would not want to wait to go back until I was finished at 6:45, he was talking to his supervisor to try to figure out what to do.

Igor was the only driver available in Boston. I said no way was I getting in a car with him again. They would either need to farm me out to another company or figure something else out. Kenny said he would drive the first passengers back to Springfield and then return for me.

When I was reviewing my counts with Melissa, I was surprised to see that my hematocrit had taken a big jump to a normal 35, compared to the slightly lower than normal 28.9 from last week's ECP, which is actually normal for patients getting that procedure since you lose some blood.

I thought that was impressive.

But actually, it was the opposite.

It turns out I had polycycthemia, an abnormally high red blood cell count due to increased concentration of blood. This can happen as a result of plasma volume loss after dehydration, excessive sweating, vomiting and diarrhea.

"Are you dehydrated?" she asked.

Come to think of it, I said, I guess I am.

When you play outside tennis as much as I (and the other crazies) do, you probably don't know how much fluid you lose through sweat. I bring water and Gatorade, and we usually have fruit, but I (we) should be finishing it even my thirst is quenched. Often, that doesn't happen.

I noticed in the past couple of days that I wasn't going to the bathroom that much and thought, hmmmm, I must be getting dehydrated, I should fix that. But I have written about this so I should know: It's hard to play catch-up.

Everyone at photopheresis says you need to be well-hydrated for the big needle to go in smoothly and the blood to run freely; I said I would go drink more at lunch, which I did, but you need to start doing this days before, not day of.

So when my nurse at ECP put the needle in, I felt it catch on something. I closed my eyes and felt her moving it around to try to get the blood to flow. She had to take it out. Dehydration had caused my vein to flatten.

A different nurse came over and applied a hot compress and gave me a a talking to about staying hydrated. She used a different vein and got the needle in. The rest was uneventful. I started to read The New York Times on my computer but quickly got sleepy and took a nap. You might think it would be difficult to fall asleep under the bright lights with so much activity going on, but it is easy. They say the procedure puts a lot of people to sleep. It definitely makes the three hours go more quickly.

My mouth is very dry.

First thing tomorrow I am going to start drinking. Water, that is.

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