Tuesday, July 19, 2011

July 18: The Lasix Experience

What interesting thing is there to talk about today? Well, there's no doubt about the answer to that question.


No, I'm not misspelling Lasik. Nor am I talking about eye surgery.

Lasix is also known as furosemide. It is a "loop diuretic" that treats fluid retention.

Uh huh.

It is the scourge of the chemotherapy wing.

The doctors drip 3 quarts of water into my bloodstream to keep me hydrated. They drip another quart of water to deliver the chemotherapy I'm getting. That is an entire gallon a day in addition to whatever I drink during the day.

As a result, I do not sleep through the night. I don't need the nurses to wake me up for vital signs and pills. My bladder wakes me up regularly.

But even that's not enough.

There's danger of fluid retention, which is very dangerous and can throw off your electrolytes. So the doctors have us urinate into a measured container. They also have us keep track of the ounces of liquid we drink. At every shift change, they compare in vs. out to make sure that we're not retaining fluid.

I read in Runner's World that every year a marathoner dies, not from dehydration, but from drinking too much water. Usually, it's a small blond girl. She sweats out electrolytes for 3 or more hours, and she thinks that drinking a lot of water is a good idea. But the water dilutes the low electrolytes even further, leading to a condition called hyponatremia, or low sodium.

Dehydration is dangerous; it can slow a runner down and put him or her in the hospital. Hyponatremia won't just slow you down; it will kill you.

I should have figured out what I was in for the first day. The nurse said, "Make sure you keep good track of your urination. We tell everyone it's important, but some people don't take it seriously. Then it looks like they're retaining fluid, and they end up needing Lasix."

Then she added the ominous words, "You don't want to take that unnecessarily."

For me, there was nothing unnecessary. I checked in on Thursday, began chemo on Friday, and by today, Monday, I had gained 7 pounds. I was going to the bathroom a lot, but apparently not enough. This morning, the doctor pressed on my leg and said, "Hmm, looks like you're retaining fluid."

So there was my weight, my leg, and the numbers on my chart.

I needed Lasix.

No big deal.

The nurse came in with the syringe. "They ordered Lasix for you. Are you sure you kept good records?"

I said yes, but I was thinking. "What's the big deal? I've gained 7 pounds. The doctors think they can feel the fluid in my legs. The numbers on your charts must agree. This is correct. We don't have it wrong."

The nurse shrugged. "This may work really fast."

My "care partner," who checks my vital signs and makes sure I have everything I need, said, "Honey, I am so sorry."

Then she walked out.

The nurse walked out.

They had just woken me from a nap. I had to go anyway. I headed to the bathroom.

Then the Lasix kicked in.

In Mixed Martial Arts competitions, it is illegal to hit someone in the lower back. That is because there is the spine in the middle of the lower back, and hitting a man there could cripple him. On either side of the spine are the kidneys, and hitting a man there is like kicking him in the crotch. It's really painful.

Lasix kicked me in both kidneys at once.

I stopped in my tracks, 3 feet from the bathroom.

Then I realized I'd better not stop.

I set a one-trip record for my time here on that trip to the bathroom. 750 milliliters, or about 3 cups, in one trip.

Five minutes later, I added 575 ml.

Within 45 minutes, I had reached 2625 ml.

I put the amounts on Facebook. A couple of moms I know told me they got out their measuring cups so they could get a visual.

After an hour and a half it seemed to be over.

3100 milliliters. 6.5 pounds.

I was back to my admission weight ... in 90 minutes ...

Better not tell any anorexics about that drug.

Some Better News

I had really good talks with a number of people today. I told a couple of nurses about "The Leukemia Tapes" (3-minute or less Christian video teachings I'm putting on YouTube). They were very interested, A couple of them said they were looking at this blog.

That's really nice.

For the record, I want to say that the staff of 11 North could teach any customer service staff in any organization a thing or two about customer care. I have never been better taken care of and cared for in my entire life.

There is either a huge line of applicants for the positions on this floor or Vanderbilt has the greatest customer service training the world has ever known.

If you ever get a chance, you should get leukemia and come here for treatment.

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