Endurance Run

Time to report about how my father is doing and just a few minutes before this post was started I had to perform the Heimlich maneuver on him when a cyclovir pill tried to kill him. No, this isn’t an attempt to be humorous.

Fortunately for him, I was in the bathroom next to the kitchen when I heard him choking and found him doubled over. Concerned that his stomach might have perforated, I quickly ascertained that it was simple choking and asked him if he needed me to Heimlich him. A nod was all I needed and I very carefully made an escalating trio of attempts very conscious of the dangers of rupturing the cancer stricken stomach. The third time the pill popped out and he was able to breathe again.

After that, I made sure he was okay and that there was no pain in the abdomen. I’ll be checking periodically, but the force used was carefully measured so I don’t expect complications. Heck of a way to end the day, yet it is consistent with how difficult the entire week has been.

I tend to be cold, calm, and collected in an emergency, so I finished what I had started and stopped in midstream. At this point in life, one does what one simply has to do without a lot of handwringing or after effects. Of course, being tired all the time may play a part.

Where to begin after that little incident. Probably best to begin with Tuesday and the second cycle of chemotherapy. We ended up running late to the early morning blood sample pulling when it took two tries to get up the slippery driveway. Well, that and neither one of us slept well the night before. Bad road conditions on County 4 contributed a bit to the slowness of the journey, but all worked out since nobody was running on time. It was simply one of those days.

Sometimes it’s nice to not be the only one lagging behind.

The blood results along with the previous batch indicated a problem with white blood cell counts. Even though the first cycle of chemotherapy had been at half dosages, my dad’s counts dropped radically. Even with a bounce back, it was below the minimum which meant a new drug had to be introduced to the therapy, Neupogen aka filgrastim, in order to boost white blood cell production in the bone marrow.

This meant a lesson in self injection had to be given to Dad while sitting in the infusion chair. I suppose it would be prudent to describe what intravenous chemotherapy is like for those who haven’t witness or undergone it.

In the oncology wing of Gundersen’s East Building is an array of semi-private rooms, some with shared bathrooms, but all with bathrooms. A toilet is a must because all the fluids being pumped into the circulatory system cause the bladder to fill up rather rapidly and often. Each room is furnished with a couple of chairs for family, a computer terminal for the staff, sometimes a bed, and all of it is secondary to the chair for the patient.

The chair is a well padded recliner that can be a bear to get upright if you don’t know the trick and also has a monitor on a reticulated arm that can be tuned to TV channels. Scooting about on casters is the medicine pump that can be unplugged to run on a battery so that frequent trips to the john can be made without interrupting the course of treatment.

Infusion time is not exactly exciting, taking hours and basically not being able to do much. Snacks and a lunch are provided, with the latter only available for the patient. Family are on their own for that, though a café resides in the basement of the building where you can buy lunch.

So much of Tuesday was uneventful, though a full dosage was infused into the bloodstream. That didn’t last past the actual chemotherapy, however. Attempts to get the injectors of Neupogen at the in house pharmacy led to our finding out that the insurance company had to have the doctor’s prior authorization processed and it would be some time before that was resolved. Since Dad didn’t have to have it until Thursday when it needed to be started, we headed to Walgreens to get his other prescriptions filled.

That went awry when the prednisone one turned out to have no refills and things were running late. Phone calls and faxes had to be exchanged and it wasn’t until we were nearly home that was straightened out. Of course this meant having to go back to La Crosse the next morning.

Snow was in the forecast, light snow to be precise. When a fresh six inches of the white crystalized water greeted us in the morning, I knew it would be a problem. A big one, because the prednisone had to be gotten and there was no way the Ford Freestyle was going to make it up our treacherous driveway.

After digging my way to the car and around it, my initial assessment was confirmed much to my chagrin. I told my father to call our elderly retired school teacher neighbor for a ride and then went back out to see how bad walking up the drive would be. Finding the consistency of the snow to be treacherous, I did something most would consider foolish and in my case, dangerous.

I took the snow shovel and dug a narrow pathway up the entire driveway. To my surprise, it was not difficult and the snow weighed nothing to me. It was slow going, which turned out to be important later. While not fun, the view provided along the way was breath taking and not just because of the high winds. Conditions were such that the snow shimmered and moved across the ground like thousands of winking stars falling from the sky.

That was my only immediate reward, for the snow drifted over half the trail I blazed by the time I got back down the driveway. It didn’t put me in a good mood thank to exhausting me and I admit to being very stern in forcing a hiking stick into my father’s hand for the ascent.

Never once did the shoveling cause my heartbeat to rise, but that hike back up had it slamming to the point I wondered if I’d make it all the way to the top. Yep, it was going to be a long day. Little did I know how long it would seem.

Picking up the prednisone didn’t take up a lot of time, but stopping by Gundersen to find out if the Neupogen injectors were covered turned into a minor nightmare. Aside from stranding our ride in the parking lot for a long period of time, the horrors of a high copay hit to the tune of $775 plus on the $2100 drug. Copays have to be paid upfront now as part of all the changes to healthcare rippling out from Obamacare (aka ACA).

Despite the valiant efforts of one of the social workers there negotiating with the insurance company, we left without the needed Neupogen with everything still up in the air. Descending down the driveway, all we could think of was the options we’d been given of contacting local social services for medical assistance (MA) or the local Social Security office.

Phone calls filled my father’s afternoon on Wednesday leading to the discovery he makes too much to qualify for MA. During the period of time digesting that news, he got a call from Gunderson that he could come in for a single large dosage injection Thursday afternoon and that odds were it would be better covered.

Why such heartache over the drug? The white blood cell counts were so low for him with a half dose of chemo that a full course would lower him to the point where an infection would kill him. Sobering to say the least.

Arrangements were made to have the driveway plowed Thursday morning and when that was accomplished, Dad drove the car to the top to park it. Since temperatures have risen to a thawing point, the driveway was going to be slick by midday. So once again we had to hike up it to run to La Crosse.

Once there, things went smoothly for a change. It sounds like the drug will be nearly completely covered in the single dose form after all. A shot to the arm, in both a literal and metaphoric case in this instance.

Of course things had to go bad at some point and that’s when my father choked on the pill later in the evening. Well, it’s now after midnight having taken hours to write this post due to being far too tired. Time to post this and get some rest.