Tuesday, September 8, 2009

I'm the Decider!

Because of the chance of adverse reaction to antibiotics, each new IV antibiotic that Lynette is prescribed is infused for the first time at the doctor's office as a safety measure.  Lynette's infusion nurse at Dr. J's office is responsible for teaching us how to perform the infusion.  There is usually some mixing procedure involved before the IV tubing can be hooked up to the infusion bag and the drug delivered.  This one was the most involved thus far.  I came with a bottle of saline, a bottle of powdered medicine, a syringe with a scary looking needle and a bag of saline.

As Lisa began our lesson on Friday, she started with a stern warning.  The new drug we would be getting today was tigecycline.  She warned us that this is the one that most of their patients suffer the most adverse affects from.  She encouraged us to call the clinic if the tigecycline was too hard on Lynette.  Some of the affects we might anticipate would be nausea, extreme fatigue and loss of appetite.  Lisa encouraged us to call the clinic if any of these things reached an unbearable state.  She said they could adjust the infusion schedule, if necessary, to try to minimize the impact of the drug.

Dr. J also added his own warning about the harsh affects of this drug.  He continues to be impressed with Lynette's progress.  He pushed harder for Lynette to seek the help of an occupational therapist for the issues she has with her right hand.  He thought that a couple of visits would be sufficient to teach her some therapeutic activities to help regain better mobility, strength, and feeling.  He didn't change her protocol outside of the IV drugs, which now include Levaquin and tigecycline 3 days a week for this week and next.  The Levaquin is once per day and the tigecycline is administered twice per day.

We had a great party at our house this weekend. We had friends over on Saturday afternoon and we made tie dyes.  We ate a great meal and enjoyed each other's company. Most of the guests came back on Monday for brunch and the unveiling of the tie dyes.  We made some really great tie dyes and we had lots of good food and good times.  Lynette hung in there pretty well and had a great time too.
The most exciting event of the weekend occurred on Sunday.  I drove Lynette over to a nearby middle and elementary school parking lot where I proceeded to get out of the driver's seat and let her take over.  It was here that we taught our three oldest children to drive.  I felt like I was teaching another new driver.  After she rode around the parking lot a couple of times I told her to hit the road.  She took us up Stratford Rd. to Thruway Center and back to Hanes Mall Blvd. for a couple more stops.  She knew it was time to start driving again, even if she is not 100% back to her old self.  Lynette understands that she will need to show more caution than she has been used to showing with her previous driving habits.  It was the first time she had driven in 7 months.
Today Lynette drove over to High Point to see her brother and sister-in-law and to go to a work out facility with them.  She did 20 minutes on an elliptical  machine and 15 minutes on another.  That would be enough to wear me out.  She came back to Winston-Salem in the afternoon to Anna's school to attend Anna's Volleyball game.  After the game she brought Anna home.  In North Carolina traffic safety laws recommend that no one under 12 ride in the front seat of a car.  Anna had turned 12 back in May while Lynette wasn't driving, so it was their first time in the front seat together.
About 8 hours after Lynette's first tigecycline infusion on Friday she became nauseated.  Dr. J had prescribed her an anti-nausea medicine a couple of months ago but she had only taken it once or twice to combat the affects of Flagyl.  This anti-nausea medicine makes you drowsy and she took it Friday night it made her very sleepy.  I think she is going to need this more with the tigecycline.
Lynette's day started today with a dose of tigecycline.  She was feeling very nauseous as we were leaving Anna's volleyball game.  She told me she hoped she could make it home without getting sick.  She put in an order for cottage cheese and mandarin oranges because she didn't think she could handle much more.  When she got home she took her anti-nausea medicine.  Then we hooked her up to her Levaquin dose followed by the tigecycline.  During the tigecycline dose she lost it.  Unfortunately there wasn't anything in her stomach, so not much came out.  And she never got around to eating the cottage cheese or oranges.  She also could not stomach her nightly dose of oral meds and supplements, which will have to wait until tomorrow.
This is going to be a rough couple of weeks.  If Dr. J thinks she tolerated the tigecycline OK, he'll be prescribing another cycle of a couple of weeks along with the first IV drug she took, meropenem.
When Lynette was incapable of many daily rudimentary tasks, I made desisions based on what I thought was appropriate and affective.  My command to her was, "I'm the decider!"  She is much more physically able now and it is going to be her decision as to how much she is willing to tolerate with this drug.  It's time for me to let her be the decider now.

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