Fever

• Hemoglobin 8.8 (WHO normal 14.0-17.3)
• Absolute neutrophil count 0.5 (normal 1.4-7.5)
• White blood cell count 0.7 (normal 4-10)
• Red blood cell count 2.75 (normal 4.5-5.9)
• Platelet count 110 (normal 150-450)

It's late and I don't have much energy to write tonight. Long story short, went home for a lovely Thanksgiving dinner, but by the time it was over I was running a fever of 101 and had to go right back to the hospital. Been there ever since. Another hellish night. Fever at 3:30 AM, stayed up until 5:30 AM, nurses came in for drugs and blood tests starting at 6:30 AM. Zoned out all day as a result. Working my way through an entire season of Lie to Me on Netflix.

Gabrielle rescued the CD of my chest CT scan from Fedex. The hospital mail service was not open today, so they weren't planning to deliver it until Monday. She brought it in and we paged the docs. That got their attention fast, partly because Gabrielle leaned over the nurse's shoulder while she wrote the page and ordered her to label it "urgent" (respond in 5 min)— as opposed to "routine" (respond in 30 min) or FYI (no need to respond). The two attendings came in together less than half an hour later. They say the scan shows a substantial lung infiltrate, but it does not look like a typical fungal infection. They want to do another CT scan, this time a high-res one.

They've put me on an antifungal in case that's the cause of the pneumonia. Tomorrow's CT results should help them decide whether to keep me on that for a long time — 3 months (!!) — or for a much shorter time. Since antifungals can fry your liver and make you hallucinate, the tradeoff against the substantial radiation dose from the high-res CT seems worth it.

So as of today, my daily drug regime is:

• Zosyn: antibiotic, one of the ones they hold in reserve for drug-resistant bacteria
• Bactrim: antibiotic, prophylactic against certain strains of pneumonia
  
• Acyclovir: antiviral
• Vfend (voriconazole): antifungal
  
• Heparin: to prevent blood clots from all the lying around in the hospital. Given by injection. Burns like liquid fire. They prefer to give you shots in the belly; more effective there, according to the nurse. Ow, ow, ow.
  
• Norco: painkiller, hydrocodone plus acetaminophen. Very nice, but like all narcotics if you use it more than a few times in a row you start having to jack up the dose to get the same effect.
  

Neutrophils holding steady at 0.5. Slight upticks in the WBC, RBC, and hemoglobin. Hope those turn out to be trends.

More tomorrow.