19 May 2014

            David had a good day yesterday. I slept on the pull-out bed in his room again. We were awakened at 6:30 a.m. by the 6^th year surgery resident. Better than the 6:00 a.m. wake-up call the 2^nd year resident usually greets us with. A first year resident arrived in the afternoon, with a med student in tow, and competently removed the wound vac sponge and replaced it with a smaller one. The wound looks really good. There are only 4 or 5 holes, each ½ to 1 inch long, and several areas of closed up skin, including one that’s a few inches long. I’m not at all squeamish about looking at the incision. From the first unwrapping of the dressing a few days after surgery, I’ve been fascinated. Of course, there’s no blood involved.

            David sounds like himself again. The speech therapist arrived to check in and decided to do a final assessment to close his case. I thanked her for her help. Her coaching, on Friday, and concrete strategies for speaking clearly, helped David transition into normal speech rapidly. I’m guessing some medication or mix of medications finally wore off and his slurred speech and leg tremors disappeared, quite dramatically, over two days.

            David has no appetite, but is forcing himself to eat so that they can wean him off of the TPN (Total Parenteral Nutrition), which was delivering 2000 calories and 100 grams of protein by IV each night. He has absolutely no appetite and had vomited three nights ago, after no stomach problems for about three days. Monday evening, May 19^th, they decreased the TPN to 1600 calories and 90 grams of protein and decreased the length of time it ran, from 14 hours to 10 hours.

            David’s visual acuity is still poor, a side effect of chemo. Even with his glasses, everything’s a bit blurry. Reading is slow and tedious. He’s lost 30 lbs over this 8 week hospital stay. (Hey, maybe we should market this weight loss method.)

            He developed a cough, but only coughs about three times a day. Two nurses have listened carefully to his lungs, and it seems to be higher up. Of course we’re all monitoring it, and everything else about David, carefully.

            David looks much better than when I saw him in the SICU (surgical intensive care unit) Monday evening, 5 May. Then he was unconscious and ghostly pale, with unworldly perfect and smooth face and tubes sticking out of his body at several sites. Now he has color in his cheeks and facial expression. His face is still gaunt, and the cheekbones prominent. The swelling of his ankles and feet (yes, cankles) has disappeared, thanks to the added protein, which allows the blood vessels to hold in the fluid. His feet look downright skinny.

            We walked around the oncology ward, four short laps, which is an accomplishment. It’s all about resetting expectations.