I have been vindicated!

So I'm sitting in Bob's room today, just hanging out when a voice at the door yoo-hoos in, "Hellooo! I'm Jan, the social worker—may I come in?" Bob says sure, and suddenly my mind snaps to attention. Jan. Social worker. . . Could it be . . .

A woman appears in Bob's room and in an instant, I knew it was her. At last . . . we meet again . . . (insert a crescendo of orchestra music here) It's the Jan, the social worker who dissed my handshake back in January, when Bob was doing his first in-patient gig of chemo. It's like a showdown at the OK corral . . .(The Good, the Bad and the Ugly whistling goes here . . .) I'll show her—I will be the first one to not offer my hand this time. And I don't. I sit sweetly in my chair, arms folded across my chest and look her directly in the eye. I'm sure she doesn't remember me, but that's not the point. The point is that I will be the first one to not offer my hand in greeting. And if she does happen to outstretch her hand, I will not take it. I. will. not. take. it.

She waves a stack of papers in our general direction and says, "Someone told me you were interested in getting information about a health care directive, so I brought one for you." Huh? Does she know something we don't know? There has been no discussion at any point since Bob was admitted that we were interest in that. I mean, such a document is important, but we've not talked about it with anyone. I told her this, and that we've been given the form several times previously, and that I thought we'd filled it out already, but what the heck, what's one more time for good measure . . . she kind of stood at the foot of the bed for a moment in a brief awkward moment of silence until I smiled again and said, "Thank you. If we need anything, we'll be sure to call." Hands still folded across my chest, smiling, but still not offering my hand. She finally says, "Well, here's my card. Call if you need anything." I just said that, dummy. . . and she was gone.

"Did you see that, did you see that, Bob?" I turned to him, giddy with passive aggressive excitement. "That was the social worker who blatantly disregarded my outstretched hand back in January! Did you see how I dissed her first this time? That I did not offer my hand first?!?" Bob appears to be ignoring me, eyes closed, no response. Don't blame him, I guess . . .

So, not a whole lot has happened with this recent admission, which was the point, really, to avert a crisis. He's been given continuous IV fluids and has had blood work and a host of other tests. His heart is still recovering remarkably, his appetite is better (not great, but better), pain is fairly well-managed (without turning him into a zombie), no more diarrhea, white blood cell count is not alarmingly high . . . But now we really have to get a grip on this every-other-week hospitalization thing, figure out just why and how Bob seems to have such a disposition to getting dehydrated so quickly to the point where he can get incredibly ill, but then rebounds so well with some IV fluids and a few days in the hospital. He eats better, sleeps better, gets more exercise when in the hospital . . . I have joked before that he likes coming up to 7D because the nurses are much nicer to him than I am at home (though I'm pretty sure it's no joke), but the more I think about it, the more I think there's some truth to that theory. Given all Bob's gone through, I think he feels very safe in the hospital, that being 20 minutes from the nearest ambulance, should something go wrong, is firmly planted in Bob's mind. . .

So we're trying to come up with a plan to help Bob feel safer at home, to put his mind at ease, and to keep up with the hydration and nutrition. He's still very malnourished, and we've had countless dietitians and nutritionists in, talking about what, how much, and how often Bob should be eating. Thing is, we know what he has to be doing, there just happens to be several obstacles getting in the way, first and foremost, the cancer itself. It kicks the metabolism into hyper-drive, it diminishes appetite and thirst, it can cause nausea, changes in taste, lowers satiation . . . which then, in turn affects electrolyte balance, over-all feeling of wellness, energy level . . . we've talked about a temporary feeding tube, as we have to get him as strong and healthy as we can for the pending surgery. He's absolutely adamantly against that, but we've had this conversation every time he's hospitalized—dietitians, nutritionists, everyone comes in and tells Bob what to eat, to use Boost, Ensure, etc. to supplement, to constantly drink fluids, to bulk up on high-calorie foods . . . then we get home and things don't happen. I ride that fine line between being his "food coach" and just being plain and simply annoying to him, nagging relentlessly about eating, drinking . . . the feeding tube may be his only hope to help get adequate calories and nutrients in him, because quite honestly, he'd have to eat like an elephant to even maintain, not to mention actually gain weight. . . we might see if going in on an out-patient basis, for bi-weekly IV fluids, start there and see what happens . . .

And on top of that, Bob's been on a steroid for pain for several months, which over time interferes with the adrenal glands ability to produce hormones, among other things. On the one hand, they give him energy, supposed to increase appetite, and some pain control, but they also can cause infections, mood swings, puffiness, other issues if on them for long periods. So he started tapering off it this past weekend, and after researching it online all night (that's what I do with my time when he's not around . . .), I do believe some of the symptoms he's experiencing are being caused by the steroid taper—the extreme exhaustion, overall feeling of crappiness, but nothing specific . . . adding to the layers . . .

Oh, before I forget, I got a surprise visit by my "oldest" best friend, Lisa, today at the hospital! We've known each other since grade school, her big, joyous family lived around the block from us ("daviddannymikemarkmarylisalona!!!" was how her mom would call the brood home for dinner, the seven kids' names all smooshed together into one word.). Lis was in the cities for a photo shoot (she's a photographer, lives in Alexandria) and called me on the spur of the moment to see if I could meet her for lunch. I told her we were in the hospital, that if she wanted, she could meet me here . . . she jumped on the offer, and joined me for lunch in the cafeteria. She got to see Bob briefly, gave us a ridiculously generous goody bag full of all kinds of fun things . . . It was so awesome to see her, as it's been too long. We had a totally disgusting, uber-salty-greasy lunch in the cafeteria, talked more than we ate, and before we knew it, she leapt to her feet, realizing that her meter must be expired by at least 20 minutes, so she had to make a quick exit. I felt blessed that we were able to make the last-minute get-together work out in the first place, and we did get to spend a good hour and a half playing catch-up, so it was a wonderful treat to see her.

Anyhow, just wanted to throw that in there, as it made my day, and put a smile on Bob's face, to see an "outsider." Bob should be discharged tomorrow, with yet another game plan in place. Stay tuned.