The Workup

Next week's schedule arrived yesterday and it's quite a workup.

Starting midnight on Sunday, there's to be no eating and only moderate drinking of water. I've an appointment at the Phlebotomy lab at 9 am Monday morning for some more blood letting followed by a visit to ... The 13th Floor (pretend that text is undulating like the credits for a scary movie) where they'll sample my blood for hairy buggers. I've got a surprise waiting for them, though. You see I replaced my regular blood with Folger's instant crystals. They won't believe it's an instant!

After the blood letting, nurse R will bring me my "urine bucket". Oh joy! I get to collect pee for 24 hours to make sure my kidneys are functioning properly. Even if I could head back to work for a half day, I don't think the logistics of the "urine bucket" would work out too well. Right now, disturbing images of the homeless guy from "In Living Color" and his "pickle jar" are racing through my brain. Those of you who know what I'm talking about just had a disturbing laugh. Those of you who don't should be thankful. I just hope the bucket has a lid.

At 9:40, I head down to Radiology, chug a quick mix of strawberry flavored Barium (note: based on prior experience, it tastes more like @*!) and then get my CT scan. They'll inject contrast agent into my vein right before I go into the imager -- makes you feel all warm and cozy inside. I'm not a stranger to CT scans. I had my first one back in 1991 shortly after suffering debilitating migraines right after my first wedding. Funny how they started upon getting married and stopped after getting separated. Seriously though, I think it was the damn Liz Claiborne perfume she wore.

Next, I get an EKG. I've always wanted one ever since seeing episodes of Emergency! as a kid. I just thought the circumstances would be a bit more heroic, you know -- like collapsing after saving a bus full of orphans from falling off a cliff while Johnny Gage and Roy DeSoto show up just in the nick of time.

Monday wraps up with a chest X-ray. I expect my skin will soon glow in the dark with all the radiation I've gotten over the past two months. On the bright side, I won't have to turn on the light to fill my urine bucket in the middle of the night...

Tuesday isn't quite as busy. I start off with a ultrasound of my abdomen at 9:00 to check out the old spleen, followed by one last pee in "Ye Olde Urine Bucket" before handing it back to nurse R. I head over to Building 5 at 11 for an echocardiogram, then I'm done for the day.

On Wednesday, I suffer without food until I meet with Dr. K at 2:30 for my physical. If all goes well, I'll get admitted and the PICC line will get installed at 3:30. The meds will be administered shortly thereafter. If I'm selected for Rituximab, it will be injected first over about 4 to 5 hours, followed by the Cladribine. So far the other patients have had slight fevers and shortness of breath, but nothing too serious. After that, I hang out and get daily injections of Cladribine for 4 more days. If there are no serious effects after day 3, I may switch to outpatient for the last 2 days.

If selected for Rituximab, I'll head back to NIH once a week for 2 months to get those injections. CBC's will be measured weekly until July. Bone marrow biopsies, and standard image sets will be run once every 6 months for some time thereafter.