Sodium. My diabetes insipidus continues to mess with my sodium levels and we keep oscillating between different strategies to deal with this. Yesterday I went 36 hours without a dose of desmopressin and ended up peeing 40 times in an 18 hour span with a constant terribly dry mouth and unquenchable thirst. But of course nearly every medicine I am taking lists "dry mouth" as a possible side effect. My sodium had been as low as 129 and then had risen to 135, the edge of the normal range.
Pooping. Dealing with constipation is also a perpetual theme. I am not backed up with hard lumpy stool, but I am still backed up. Yesterday evening we threw everything at the problem: Senna, Miralax, Lactulose. Gurgling occurred but no action. At 2:00 a.m., to check out an issue connected to the diabetes insipidus, the night nurse did a bladder scan -- basically kind of a portable echo scan using a wand -- to see how much urine I still had in my bladder once I had urinated. That involved pushing a wand with some pressure over my lower abdomen and bladder. This triggered significant cramps. "Gotta get to the bathroom" I proclaimed. I made it, and after some preliminary tooting, I dumped a massive load. The doctors wanted to be able to evaluate event, so they had put what they call a "hat" in the toilet to capture the stool. It was filled to the absolute brim and looked like pudding. The nurse went in and proclaimed "Wow". I asked if by nursely standards this was impressive. "You betcha".
Potassium. That had been rising, which raises potential problems with cardiac arrhythmias, but now the level seems OK.
CMV. Childhood virus that virtually everyone has. Often this becomes a problem with post-transplant immune systems. IVIG is used to treat it, but that is now off the table because of my reaction last week. Ultimately restoring an immune system will be the way to treat it. The viral load of this particular problem had been cut in half, but this is not yet "under control." That will get remeasured tomorrow.
White cells, neutrophils, platelets, and hemoglobin. Then of course there is a issue at the heart of my illness: white blood cells. That is what the chemo is dealing with while trying to keep platelets (for clotting) and hemoglobin up. So far, almost every day I need a transfusion of blood products.
So, you can see, there is a lot going on, lots of interacting moving parts. I think once I am fever free for a few days and they feel I am in some sort of rough equilibrium on these various concerns, I will be discharged. I'll know more tomorrow.