One Hell of a Storm

There are many quotes about the strength or darkness of the storm and the sun that shines afterward or the strength gained through it. It seems like one of those should be a good analogy to my past three days. Thursday was an insanely busy day at work. I was working a deal we’re trying to close Monday, another one we’re negotiating, and stay on top of ordinary matters, which alone are more than I can accomplish in a normal busy week. I worked through lunch and then late, so that I could walk out knowing I had full day Friday with egg retrieval and the afternoon appointments at the Cancer Center. I left work with aspirations to go to the gym, but as I walked through Whole Foods to pick up tuna and a few vegetables, I realized could not (and probably should not) push through the discomfort, bloating, and pressure I had increasingly felt over the past couple of days and power through a gym session. Instead, I went home, groceries in tow, and looked forward to a night of relaxing with Jason and the girls, excited to enjoy one of my last few nights of properly cooked rare tuna prior to chemo, and anticipating the egg retrieval.
When I arrived home, I was greeted by puppy and Jason kisses and an array of extremely thoughtful packages from friends from afar. I was happy and felt loved, and I was embracing every good feeling that surrounded me at that point. I went on to cook my edamame, wheat couscous, and finally the tuna, all the while looking out across the living room to my girls and Jason. In a moment, my heart and breathing stopped. I saw Annabelle stop playing with a toy and fall onto the floor in front one of our living room chairs, and Jason jump up off of the adjacent chair yelling in panic after her. He immediately scooped her up, her back legs unable to move. I turned off the stove off, put Layla in her crate, grabbed both of our coats and shoes and Annabelle’s bag and blanket. We got into the car, and I sped to the emergency surgical vet, all the while assuring all three of us that we were breathing and okay. I called the vet to tell them we were on the way. Within 15 minutes of the fall, we arrived at the vet, and Jason and I tried to our best to recollect what happened and relay Annabelle’s past ACL/patella issues in her right knee, thinking the same was occurring in her left knee. After spending half an hour waiting for the ER vet to examine Annabelle, we were told essentially nothing could be determined until the surgeon could see Annabelle the next morning and perform more tests and likely surgery on her knee that was moving in ways it should not. We made the difficult decision to keep Annabelle at the vet overnight since they could start her catheter, do her blood work, keep her fully sedated, monitored, and mostly immobile preventing more damage. We left the vet, and I continued to fight the urge to break down. I got home, and tried to finally cook the tuna that had been sitting on the stove since we left. I cooked it, without any awareness of how long it had actually been sitting at room temperature, and tried to eat it and made Jason take a bite before realizing that over 2.5 hours at room temperature will spoil tuna. We gagged then spent the next couple of hours before bed exchanging worries about Annabelle and snuggling Layla even more than normal.
Friday morning, I woke up an hour earlier than expected to a thoughtful call from the ER vet that informed me that Annabelle had been well attended, mostly slept, and had all of the pre-examination and pre-surgical work done, and that she was still awaiting her examination from the surgeon in the next several hours. Instead of getting the sleep I intended, I worked for the next hour until I got ready to leave for the fertility clinic. I continued to work in the car on the way over to the clinic. Upon arrival, we were greeted with an ever cheerful Mindy, which was a welcome relief. Her consistent optimism for me has provided me with encouragement and belief, because she knows nothing of me but the few conversations we’ve had, several dozen emails we’ve exchanged, and my medical records, but at every point, she has had the utmost faith in me. She took the medication we were donating and told us they were running a bit behind from the last patient’s recovery, but that they would prep me quickly and end up with an awesome retrieval. I needed this, and at the same moment, I was gave Jason my phone, and unnecessarily instructed him to answer any calls, especially from our vet surgeon. We went back to the prep area, and although I was able to feel excited for the impending retrieval, I kept Annabelle on my mind, knowing that when I got out of the procedure, I should have an update on her.
The anesthesiologist, Mindy, Wendy, Dr. Young, Michelle, and the other surgical nurse, were all optimistic and encouraging before my procedure. They answered the only three questions that I could think of that I didn’t know the answers or hadn’t asked: when to restart birth control, when I could have a CT, and when I could have an ECHO/MUGA. I went in, fell into a babbly state through sedation, and thereafter, and woke up to find out (multiple times, all without recollection) that they retrieved 20 eggs, and I apparently made jokes about the baseball team I could start. Before I could leave the clinic, they needed to know that my vitals were stable and that I had control of bodily functions, so I spent the next 30 minutes chugging about 48 ounces of water just to be able to go to the bathroom. They emptied my bladder prior to retrieval, so this was the first of the next several feats I would face throughout the rest of the day. Feeling very bloated and a constant, aching pain, I took two pain pills, so I could survive the long afternoon I had ahead of me at the cancer hospital and waiting for updates on Annabelle.

During my recovery period, Jason spoke to the vet surgeon. She let us know that Annabelle was going to have to go for a CT scan or preferably MRI to determine the root of her inability to walk. There were another couple of wrenches in the mix: the CT and MRI machines are in the Winston-Salem branch of this animal hospital, which is about 30 minutes west of Greensboro, and Annabelle needed to be transported there. Of course, we were in Raleigh, an hour and a half east of Winston-Salem, and unable to get to Greensboro for the next four to five hours. I do not quite remember the details of the conversation that Jason had with the vet, but due to an explanation of our circumstances, she ended up having someone from the Greensboro animal hospital transport Annabelle to Winston-Salem for us, so she could be evaluated and treated more quickly. The second wrench was that the MRI machine in Winston-Salem was currently being repaired, so they were going to start with the CT to see if they could get a baseline of whether Annabelle’s disk in her spine was ruptured or rule that out and hope the MRI machine was repaired, so they could use it instead of having to figure out how to get Annabelle to Raleigh or Charlotte to another MRI machine. While this process was started, we drove from the fertility clinic to the cancer hospital.

Upon arrival to the cancer hospital, we finally met Elizabeth the clinical trial nurse. Over the past week and a half, Elizabeth and I had been frantically working to figure out what additional and possibly repeat tests were necessary for compliance with the clinical trial standards, and also set the timing for after egg retrieval, because I could not be exposed to radiation or radioactive injections prior to retrieval, and get them done prior to starting chemotherapy on February 2nd. This had added a lot of stress to the process, since the timing of my retrieval would not be known until about 48 hours prior and because the appointments with radiology were only during business hours. Fortunately, Elizabeth had figured out my previous PET Scan and bone marrow biopsy were sufficient, despite being done at another institution. In order to use time efficiently, Elizabeth had overlapped all of my appointments on Friday afternoon, which were initially thought to include the CT, MUGA, and blood work. Prior to all three of us walking over to radiology, I mentioned I had an echocardiogram done on December 31st, and Elizabeth was able to pull the records and confirm they were sufficient and not too old, so she crossed the MUGA off of the list of necessary tests. As I sat in radiology drinking the fluid for the CT, Elizabeth reviewed all of the clinical trial paperwork, and I signed consents and releases. I had to wait one hour after drinking the fluid before the CT could be done, so we went up and had my blood drawn for the additional tests for the trial. The wait for the CT ended up being over 2 hours, and I wasn’t take back until after 4:30pm. I was in pain, exhausted from the egg retrieval, starving because I hadn’t eaten since 9pm Thursday night, and worried about Annabelle.

Just before I was taken back for my scan, we got the call from the vet, and were told the MRI machine was fixed, and they scanned Annabelle. They determined that it was not a knee issue, nor a ruptured disk. Instead, they discovered that she had an FCE, which is when a piece of cartilage breaks off and blocked her blood supply to her lower spine, causing a stroke to her lower spine and extremities. This can cause complete paralysis, but we were lucky because Annabelle had been showing signs overnight and throughout the day of trying to walk and move her back legs. They told us that they expected her to regain at least 80% functionality with therapy over the coming weeks and months.

Relieved with the thought of Annabelle not needing surgery and being able to recover and walk again, I went back for my CT thinking just a few more minutes and I would be done with tests, and we could be on our way to pick up Annabelle. Yet again, another wrench was thrown in the plan. The technician asked me to confirm that we were doing a CT of my chest and abdomen, which was partially correct. Since my lymphoma is limited to the nodes in my neck, my CT had to include my neck, but she only had orders for the chest and abdomen and couldn’t add the neck without the orders being updated. We both frantically tried contacting Dr. Park and Elizabeth, hoping they were still in the office at 4:40pm on a Friday, so they could update the order. Fortunately, Elizabeth was still in her office, so she was able to get the order updated, which had to be reviewed and approved by the radiologist, who fortunately had not snuck out of the office early. With about a 20 minute delay, instead of the hour or days as the technician had first estimated, she did my scan, and then we met briefly with Elizabeth again. She confirmed I had completed all requirements for the clinical trial and was set to start chemotherapy on Tuesday. She gave us a tour of the infusion area, which made me feel much more comfortable, knowing what to expect for my upcoming infusion days. After a big hug and smile from Elizabeth, we were finally able to start our trek over to Winston-Salem.

I was thoroughly relieved to sit in the car and eat hummus and carrots with only an hour and a half between us and Annabelle. Once we arrived at the vet, they explained the physical therapy we would have to do at home with Annabelle and showed us how to use the sling to help her walk. After many minutes of anticipation and watching the door to the back area, I finally saw the tech walk through the door with Annabelle. She was on so many medications that she did not really recognize us, which at that moment was completely heartbreaking. I am used to her squealing and sometimes peeing, because she is so excited to see me walk in the door. Instead, my poor baby had glassy eyes, was shaking with anxiety of not having control of her back legs, and could not keep her tongue in her mouth. We wrapped her up in a blanket and walked to the car with every fear that my little angel was in pain and may not ever recover to her former silly, bouncy, excited personality. We finally walked back in the house, where Annabelle resigned to our chair, wrapped up in blankets, both in pain and anxious. Jason and I spent the next several hours using a syringe to get Annabelle to drink water, and finally before we went to bed, she took her medication and had her tongue back in her mouth, and we spent the night waking up every hour or so due to her discomfort and mine.

I woke up Saturday morning to Annabelle making efforts to crawl across the bed, although she could not really use her back legs, and she had a bit of playfulness back. Shortly thereafter, I received a call from the embryologist. She informed me that of the 20 eggs that were retrieved on Friday, 19 were mature and fertilized! After 36+ hours of worry, frustration, uncertainty, pain, and recovery, we were relieved and overjoyed. The number of fertilized eggs far exceeded what our doctors and we thought we would have, and Annabelle was showing desire and determination to move and be herself. We still have a long way to go on both accounts. We’ve spent the rest of this weekend working with Annabelle on her therapy movements and seeing her make improvements toward walking and having probably 50% of her movement and control in her back legs, and we will continue to work with her at home and see the physical therapist and neurologist to help her regain hopefully 80%+ functionality. Between now and Wednesday, we will continue to receive updates from the embryologist on the development of our fertilized eggs to blastocytes by Wednesday, at which point they will be frozen. Dr. Fritz estimates that generally 60-80% of the fertilized eggs become viable blastocytes, so we’re hoping for the high end of that range.

The only thing I can grasp from this storm of the past three days, (and largely of the past almost six weeks) is to celebrate every glimmer of light, and let the rest of the storm fade into distant memories. Although I am in considerable pain, I have the hope of a future child, of being cured, and of Annabelle regaining full use of her back legs. Now it’s time to watch the Super Bowl, drink a mimosa, and snuggle a pup.


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2 thoughts on “One Hell of a Storm

  • Aunt Betsy

    Thanks for keeping us informed. I think from what you have been doing these past weeks you will actually have more time once you actually get started on the chemo. I know you’re exhausted but hang in there now that all the preliminary tests and procedures are out of the way. Love you much.

    • Kaley Post author

      Hi Aunt Betsy! I am so glad that you are following along and sending love from afar. It is certainly much needed and appreciated. Fortunately, as you mentioned, everything has settled out now that I am going through treatment. Give my love to Uncle Arthur! I love you!