Endless Emesis......

 Babygirl began vomiting shortly after Christmas. We assumed it was a stomach bug, and that the vomiting triggered the rejection episode. 

But the vomiting never, ever stopped. Even when she was intubated and heavily sedated, she vomited. While she was in the hospital, she got around-the-clock ondansetron (Zofran), with haloperidol for breakthrough nausea.  They tried a bunch of other things as well.

Ondansetron is still a daily thing. Vomiting is still an almost daily thing.  Decreased appetite is, for sure, a daily thing. 

This is NOT a little thing.  Since the beginning of January, she's lost FORTY pounds, more than 3 pounds a week.  A week or so ago we had to buy an entirely new wardrobe, as she was reaching the "If I sneeze my pants will fall off" stage of the game. 

It was especially bad Tuesday-Thursday.  Not only was she not eating, she was also unable to keep fluids down, so we had a discussion about whether or not it was time to go to the ED.  The tie-breaker? "Well, last time we waited a little TOO long, so...."

We went. But not until after I had dinner. I've learned a thing or two: NO one benefits if I'm the hangry advocate. 

I don't spend a lot of time in ER's if I can help it. So when she was assigned a bed in the hospital's LECTURE HALL I was a bit nonplussed (she told me when she called me that she was in "the electrical hall." Took me a minute to puzzle THAT one out). Turns out, to handle the busy nights, they immediately do Covid testing on everybody, and put the less-critical negative patients in emergency cots and recliners in 15-18 curtained-off sections of a large room.  I arrived to find her in a chair, between a post-morphine woman who was chattering loudly at 100 MPH on her right and an elderly gentleman who was retching non-stop on her left. The curtains separated the patients but not the visitors. There was definitely not 6 feet between me and my neighbors.

We'd been there about 20 minutes when the area's RN arrived, clearly having had a quick review of Babygirl's problem list. "She's on dialysis? AND she's still on transplant meds??" Yes, Ma'am. "You'd be more comfortable if we put you in the corner by the Hepa filter." YES, Ma'am. Six feet all around and more complete curtain separation.  

IV ondansetron, a liter of fluid, blood work and a CT scan later: Labs unchanged from previous. No evidence of blockage or tumor. Doctor asking, "Has she seen GI? Has she tried Phenergan, Compazine, Haldol?" Yes, yes, yes, and yes. "I got nothin'." Well, okay, that's not what he said, but it's what he MEANT, LOL.

She felt better, and got through the next 12 hours without further symptoms. GI is doing endoscopy in a couple of weeks. I called her primary and asked if she could try dronabinol (synthetic THC, used for chemo/AIDS patients with vomiting and weight loss. You know, "pot pills"). He checked with the transplant team, and sent in a prescription. I'll get them today. 

DeeDee