My husband and I are not comfortable with him restarting chemo until we get a clear picture of what is going on inside him, for lack of better words. For some reason, however, the portal still contains chemo appointments, and one is even prior to the scan that had been scheduled for June 6th (on the afternoon of June 3rd after the follow-up appointment with Dr. DA). Either this is just the schedulers leaving the appointments as they were as they had been scheduled well before any of this crisis happened or this is office dysfunction. I also had to remind them, yet again (5th time now), that my husband gets MRIs for liver surveillance and CTs for chest and pelvis.
My husband has set a threshold of at least 14 for what he wants to see his hemoglobin to be before moving forward:
12/26 15.2
2/25 14.8 (pre-surgery and HAI pump placement 3/7)
3/7 13.1 (post-surgery and HAI pump placement on 3/7)
3/8 13.2
3/9 12.1
3/10 12.0
3/11 11.3
3/12 11.6 (discharge from MSK)
3/20 12.7 (pre-chemo check)
3/20 12.6 (2nd lab that day because platelets were elevated as were neutrophils and white blood cells in the earlier lab that day. They remained elevated in the 2nd lab and Dr. K also took cultures and urinalysis. Interestingly, the urobilinogen was 11, which is the top threshold of the range. Because the urine bilirubin was negative and the urobilinogen was at this level, it appears that he was exhibiting signs of hemolytic issues:
https://www.labce.com/spg506382_clinica ... urine.aspx We were offered a follow-up CBC and CMP to do locally when we got home, but they said if he was felling okay, we could just skip it which we did.)
4/1 12.4 (pre-chemo check before 1st HAI FUDR 4/1)
4/15 13.2 (pre-chemo check before 1st folfiri treatment 4/15-4/17)
4/29 11.2 (pre-chemo check before 2nd folfiri treatment 4/29-5/1)
5/6 10.5 (pre-chemo check before 2nd HAI FUDR 5/6)
5/13 Labs at local hospital while hemorrhaging. Received one unit of blood at local hospital, then one unit of blood at Albany Medical Center where he was transported via ambulance at 3am
5/14 7.9 (Received one unit of blood during MSK interventional radiology procedure to place stent in GDA)
5/14 9.2 (check in PACU, showing post-infusion bounce)
5/15 8.9
5/15 8.8
5/15 7.7
5/15 7.8 (here is when I got upset that they were talking about discharge 5/17 with this low of a Hg)
5/16 7.1 (this morning was when I got a bit worked up about the prospect of a 5/17 discharge with continual downward drift.)
5/16 9.0 (gave 1 unit of blood, this is the post-infusion bounce)
5/17 8.6 (the drop made me nervous, even though I understand that there can be drift down after bounce up)
5/18 9.0 (Relief. He was discharged this day after this lab.)
5/20 10.3 (follow-up labs at MSK-Westchester. More relief. The rest of bloodwork looks great, too, except RBC and hematocrit still low which is to be expected.)