There is a cardiothoracic fellow who is younger and Asian; Amanda calls her Yang. If you are a Grey’s Anatomy fan, you get the reference. She came in while I was out and said there would be six total rounds of steroids. So that was a little shocking. We don’t think there will be a continuous dose. The first side effect of the steroids is she lost a little sense of taste. She noticed it when the Starbucks was a little off. I know hers was okay because I sampled it several times on the long walk back!
I had my credit debit card number stolen this morning. I received a fraud notice of a charge for $570 to Best Buy online. I checked an email from Costco this morning; they had a good deal on Uber Eats gift cards—two $50 cards for $75. We’d previously done the same deal after the transplant when we were ordering out a lot. My Costco membership expired because I hadn’t updated with my new card. I updated it and renewed my membership, and within 30 minutes, I had the fraud charge. I haven’t used that card since we have been here, so I assume it was from that. The email was legit, and I was on their website, so who knows?
My stirring the pot about the medication timing summoned the transplant pharmacist. It turns out the adjustment in the timing of the medications isn’t a big deal. It’s not as big of an issue as they made it out to be in our training. There is no need to step up or down an hour a day. I think it was a scare tactic to make her compliant!
The rounding hospitalist team came by; the one I thought was a Spaniard is Greek! At least I was on the same continent. He mentioned that the echo results showed that Amanda’s ejection fraction (EF) was low. EF is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. She was 20% lower than her last check, which was in the formal range.
A transplant nurse came by; we know her well, and she likes to stay and chat. We’ve seen her more in the hospital than in the clinic. She mentioned how much new antibody labs have changed things; new transplant recipients only receive five biopsies. Amanda had that many within the first month! We keep asking if Amanda can get up and walk to the bathroom, but they said she was bedbound for now, not even letting her get up and use a bedside commode. We’ll keep asking, hoping they will let her at least stand up at some point. Thank goodness for PureWick, the pee-pee sucker, it’s a lifesaver for this. It is a little weird, though, I was asking Amanda to check something on her Mac. She didn’t respond, and I said it again, looking at her; she said, “Don’t look at me I’m peeing!!!” We had a good laugh over that.
Once the PLEX was started, Amanda’s fingers began to tingle a bit. She didn’t get the sensation around her mouth that they mentioned, but her tongue felt weird. The machine was crazy, and a nurse had to man it the entire time it ran, about an hour and 45 minutes. I thought plasma exchange (PLEX) and Plasmapheresis were interchangeable, but I assumed wrong. Plasmapheresis is the process they use to obtain plasma from blood. PLEX is when they use plasmapheresis to replace plasma. They exchanged it with albumin and not plasma this round. They are trying not to use the blood products like plasma just yet. They may switch later on. Albumin is a protein in your plasma. I’m telling you we are learning some things this stay!
While the PLEX treatment ran, we had our first visitor. Amanda became friends with two girls from her PT team after her knee replacement and subsequent redo. One of their sisters lives in Katy, so they had her get a few things together for Amanda; it was too sweet. It was cute they were asking me specifics on a few things to get last night. Then we even got lunch out of the deal. So it was Amanda’s choice of HEB veggie sushi, a nice break in our lunch routine.
As I was walking to grab coffee this morning, I called my Aunt. Since my parents passing, I’ve been talking with her more and more. We were planning on seeing them over the Christmas holiday. As someone passed by, I announced to her that I was officially out of clean undies. The passerby may have lengthened their gait after that! I will buy new undies, a few shirts, and a sweatsuit tomorrow, then find a wash-and-fold or borrow a washer and dryer later on.
Amanda had a flushed face a little while after the PLEX. It was red, then splotchy, then a litter lighter, then back to red. It looked like an allergic reaction, but pathology didn’t want to do anything about it. He mentioned they might have a Benadryl round with the PLEX, but they didn’t. She finally became itchy, so they gave her the Benadryl.
Our nurse from last night is the same tonight, so it will be an eventful evening with her on shift! Nurses like her are a blessing to have; they lighten the mood and give you someone to have a good time with. It’s a break in the monotony of hospital days; I was glad to see her back on duty.
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