Day 112, Saturday, May 18th, 2013

The last week has seen my cell counts plummet (as they were expected to do), multiple uses of Jake (the pump) to infuse myself with saline and magnesium, daily injections of neupogen, the return of the pain-in-the-butt-butt-pain, dabbling with hydromorphone accordingly, the receiving of two units of type O negative blood (Dad had the same blood type as I did, so while I do have the blood type of my donor, it turns out to be business as usual), the receiving of a giant bag of saline and magnesium, the development of a neutropenic fever, intravenous antibiotics, my first ever ambulance ride, and, finally, my being transferred back to the University of Washington Medical Center as an inpatient.

I'm back inside, and most of my troubles are once again in my backside.

The derriere damage started about a week ago, but it was low ebb. I made my team aware of it, treated it the way I had before, and it mostly quieted down, until a day, where, bluntly speaking, I took three enormous poops. After round three, things were unhappy. I had acquired sadbutt. And if that is TMI for you, then you clearly haven't been following along from the beginning.

This, by itself, was not enough to prompt my removal from the SCCA House to the watchful and ever-wakeful (meaning they wake me up all of the time, not just that they never sleep) eyes of the UWMC. It was on Friday, when, after consecutive days of diminishing cellular returns, as verified by daily blood draws, I was given the aforementioned two units of blood, followed by a litre of saline loaded with magnesium.

As a result of the conditioning regimen and several of the medications that I am on, post-transplant, my body is losing magnesium at a ferocious rate, so I have been and am required to supplement daily, intravenously, through my Hickman line. One of the fun things about magnesium infusions is that they make you feel toasty-warm, from the inside out, as if you had taken an electric blanket as a suppository and cranked that sucker to maximum. This is relevant because my temperature began to climb rather dramatically, after the transfusions, as I was being given the infusion. To a certain extent, this was to be expected, what with all those magnesium-tipped road flares going off in my veins. I'm sure I was glowing; it was hard to see the screen of my phone for all of the glare, and I was certainly radiating enough heat for that scenario to be accurate. [note: I was not actually glowing, but I was throwing off enough heat that my girlfriend would have clung to me like a baby sloth happily clings to a tree.]

During such a lengthy process (total, about eight hours), your vitals are taken periodically, including your temperature, and when mine crossed 38.3 degrees Celsius, it was time for concern - that temperature is the threshold for fever that gets you a hospital stay. It peaked shortly afterwards at 38.8, while antibiotics were being ordered and an ambulance ride to the hospital was being arranged. That part took about two hours. It was almost eleven pm before the paramedics arrived, a full hour after the usual closing time of the Infusion department on the fifth floor of the SCCA, and I felt a little bad about keeping staff there after their shifts were over.

I scampered gingerly (very, very gingerly; not scampering at all, really) from my bed-goes-up-bed-goes-down bed over to their gurney, where they promptly adjusted me to an extremely odd angle, tilted forward so that every ounce of my weight was stretching my unhappy hoop. Need I say more to imply that the trip down to the bambalance was, ah, unpleasant? The ambulance ride itself was rather anti-climatic. It was extremely business-like, whereas I prefer a little banter, and there were no high speeds or sirens. I just winced periodically from my gurney, with its five-point safety harness (they really strap you in), and answered the paramedic who rode in the back's questions, so that he could fill out his forms on the ride over.

I guided the paramedics through the UWMC, having spent more time there than they had, and we ended up at my new room on the seventh floor, where I'll be staying for at least the next week. My fever has resolved completely, and all of the cultures have come back negative for any sort of infectious agent, which is what I expected: the same thing happened during my last transplant. I'm still getting several days of IV antibiotics, just to be on the safe side, and at least I get daily anal supervision, in case things get further untoward down there. Did I say daily? I meant multiple times daily, at least so far. In any event, they're keeping me here until dad's cells (sparkles, sorry) engraft, and my neutrophils and such come back from where they are now, which is essentially zero. This should take seven-to-ten days, and it is only once that starts to happen that the rectum will stop trying to assert its dominance over the rest of the body. "Yes, we get it, you're the asshole in charge; may we stop now?"

For the sake of personal interest, you should know that rice bread, rigid and nonabsorbent as it is, makes eating an egg salad sandwich challenging. It becomes less of a sandwich and more of an egg salad squirt gun. This is relevant because I had one for lunch, since I am once more ordering off of the gluten-free menu at UWMC. I've mentioned this before, but the food here is actually pretty good, though I wish they'd switch their rice bread up with Udi's gluten-free bread, at least. C'mon. C'mon.

Julius Caesar walks into a bar and says, "I'll have a martinus, please."

The bartender says, "Don't you mean a martini?"

And Caesar says, "Buddy, I'm the Emperor of Rome. If I want a double, I'll order one."