A Quart Low

Most of us an one time or another had an old car that burned a little oil.  Checking the oil level at every fill-up (or perhaps more often) became part of our driving routine and when the dip stick showed the oil level below the line, we'd buy a quart of oil, fill it up and start the process again.

For some reason, this analogy popped into my mind this morning with the Physician's Assistant came by to advise me that Shirley hemoglobin level just under 7 (normal being 12 to 15).  This is classified as anemia and the treatment is to supplement her blood supply with packed red blood cells via transfusion.  Two units of RBC's were ordered and she is currently just finishing the first unit.

Anemia can be attributed to several factors:  first, when you are sick, blood cells die faster than under normal situations.  The PA said that they normal live about 120 days, but when you are sick can last closer to 30 days.  Second, the anti-rejection drugs can slow the development of new blood cells.  Third, they are drawing blood samples daily, which is pulling from the body pool that is already in a deficit situation in terms of blood production.

Shirley is basically over being sick, so that source will go away, and as she gets better, blood tests will be done with less and less frequency.  But the diminished production due to the anti-rejection drugs will be an ongoing issue.  The PA mentioned that some post-transplant patients need transfusions every 2-3 months to counter the affects of the drugs.

Today, when Shirley got out of bed, instead of just a few pivot steps to the chair, it was placed across the room. She successfully walked across the floor with the aid of a walker and then spent two and a half hours sitting upright.  Each day this week has brought an incremental step of progress from the day before.  Dr. Roper says her days here are numbered and early next week a plan for where to go from here will be determined.

Our hope is to return to the Rehab floor at UW.  (Okay, our real hope is to be sent home, but realistically speaking, our choice of a rehab facility is UW).  One of Shirley's favorite nurses from that Rehab Unit stopped by last night with her boyfriend as they were heading down for a long weekend in Oregon. It was great to see her and reinforced the desire to return to 8th floor and the care of a staff that was again this week recognized as one of the top five rehab facilities in the country.