Book Junkiez

Ted hands me several folded sheets of information he printed out from the internet. I didn’t notice them in his hand when he came into the room. I take the papers he gives me. The information has strange paragraphs about blood, plasma, platelets, and throm— something… purpura, and TTP.

“T-T-what?”

“Ted, do you know where my cell phone is?”

“I’ve been meaning to tell you. Donna has your purse. Your belongings are safe with her. Since you’re awake, she’ll bring it and your bag with her the next time she comes.”

“I don’t understand the meaning of the print-out you gave me of the description of what has happened to me, Ted. Do you understand it?”

“It’s not you. It’s been difficult for me to understand it, too. I’ve read that you have a rare and unfamiliar illness. Your doctor—Doctor Tan, should come around soon. I won’t leave until he stops in to check on you. He’ll explain it to you better than I can.”

As if on cue, Ted casts his eyes toward the hallway. He sees a doctor passing by.

“There he is now. I’ll try to catch up with Doctor Tan. He’s the doctor

that’s treating you.”

Before I could ask Ted a question about the doctor, he jumped to his feet and hurried into the hallway. Curious, I get up to follow Ted and stand next to him. He and a doctor are talking. I’m confused. Why doesn’t the doctor notice me? I’m right here with them.

The specialist, wearing a crisp, white medical coat, says, “I’ll be in to speak with her soon.”

Why doesn’t Ted acknowledge that I’m standing right here? Neither one notices me. This isn’t a good sign.

“Okay, thanks, Doctor.”

In a split second, I find myself in bed. I’m confused. Ted didn’t escort me back into the room—and now he’s sitting in the chair.

“I caught up with the specialist who’s been treating you. He told me he’s coming in to talk with you this evening during his rounds.”

He must not realize I stood beside them and heard their brief conversation.

Later that evening, the physician walks in, holds out his hand to shake mine, and with a warm smile says,

“Glad to know you are awake. My name is Doctor Tan.”

He seems cordial, given that he acted as if I wasn’t in the hall with him and Ted moments ago.

Ted was courteous to stand and motion for the doctor to have a seat.

The doctor did not sit. Instead, Doctor Tan thanked him and then looked at me.

“Julia– is that correct?”

Ted answers for me, “Yes, sir; you are correct.”

The doctor is not brusque or condescending. I can’t believe this specialist is so pleasant.

“How are you today?”

“I’m exhausted, but otherwise—I don’t know what happened to me or why I’m in the hospital.”

“When I first saw you, you weren’t well. Do you remember seeing me when you were in the I.C.U.?”

“No, Doctor T… T,” I respond while struggling to recall his name. “Doctor Tan,” Ted says.

“Sorry, Doctor Tan.”

“Not to worry,” the doctor says with a note of warmheartedness in his

voice.

I want to show the doctor I’m a cooperative patient: responsive, amiable, and excellent at following directions. I give him a wide smile—because I’m going to fast track out of here and go home to my babies. Dr. Tan is the friendliest doctor I’ve ever met. I share that with him.

“Thank you, my relatives suggest I get my personality from my mother.“

His eyes twinkle behind his wire-rimmed glasses, yet he strikes me as being concerned.

After a pause, he asserts, “What I have diagnosed you with, Julia, is

TTP.”

What did Doctor Tan say? Did I miss a discussion where he thinks someone has spoken with me about it? He’s talking to me like I’m understanding what he means. Had someone else informed me when my condition was critical?

“It stands for thrombotic thrombocytopenic purpura.”

Now I understand why Ted rushed to ask him to talk to me about this thing. I can’t understand any of it.

“You don’t remember because your status was critical. Let’s talk about your treatment.”

“Treatment?” My anxiety looms as large as the graying sky outside my window.

“Yes, the plasma exchange therapy is to increase your platelet count. You have a blood condition that—in effect, reduces the number of platelets in your plasma and destroys your red blood cells. The therapy that helps to reverse this disease is a treatment called plasmapheresis.

Specialized nurses from the Blood Services Network supervise the exchange of your plasma in your body with donated plasma. The donated plasma goes through the tubes—the vas cath—on one side of your neck. And your plasma exchanges through the other tube. The apparatus that is used to do this procedure is an apheresis machine. It exchanges the fluid.”

I cast my eyes on the strange piece of equipment.

Doctor Tan continues, “I ordered plasmapheresis therapy while you were in Intensive Care. The reason you began improving is that your platelets increased, and we could move you out of the I.C.U. Your platelet volume is higher, but Julia, the volume is severely deficient.”

I don’t understand a thing he’s said. I can’t concentrate.

“You were not conscious for the past several days when we began treatment. We will draw your blood every morning. Then, I’ll review your platelet level each day. You will continue receiving plasmapheresis treatments.”

Several days! I’ve been here that long?

“Your blood and platelet volume responded to a degree. It’s the reason you are now in an admitted hospital room. The volume of your platelets when we draw your blood will decide how many bags of frozen plasma you’ll receive that day. Try not to be alarmed when counting the bags. The number of plasma bags will vary each day. It depends on the number of platelets in your plasma that morning when blood is drawn.

You’ll get an antihistamine and acetaminophen for pain before the procedure begins. The antihistamine will prevent an allergic reaction. The acetaminophen is to prevent your temperature from rising. Some patients react to donated plasma—causing a fever.”

He says, “Pooled units of donated blood are safe because they’re pre-tested. But transferring donated plasma could cause your white blood cells to attack because the plasma is not your own, going into your body.”

He’s allowing me time to sink it all in.

“The pill we give you each morning besides blood pressure pills is prednisone. You get sixty milligrams every day. Prednisone is a steroid to help stabilize your immune system. The patch on your chest is medicine absorbed through your skin to help decrease your blood pressure. The other one detects and records your heart rate.”

I didn’t realize that under my gown, there were medical patches attached to my chest.

“Julia, your recovery may take some time. Your state of mind did not allow you to sign the permission for treatment when in the critical care unit. Your niece signed the authorization on your behalf. When you are ready, we will talk further about it and your progress. I will check on you every evening.”

Heplaceshisbusinesscardonthecart.

“Call me if you have questions. I know it’s a lot of information to take

in.”

He leaves the room with the same pleasant demeanor with which he greeted me. It makes up for his not acknowledging me when I was standing with him and Ted. My confusion is out of control. I have other questions, but I

can’t form the words in my mind. This plasma exchange business is too much information for me to get a handle on.

“Ted, how have Fortune and Treasure acted when you come to my house to see them?”

“Julia, I gathered their dishes, a bag of food, and the treats in your food pantry and took them home with me. Didn’t want the police officers to call Animal Control and take them to a shelter. Fortune and Treasure hopped into my car with no trouble. They’ve been at my house since you’ve been here.”

“Ted, I’m happy and relieved they are with you. What would I do if they took my fur babies to a shelter? I’m relieved they’re in excellent hands. Now I can rest easier.”

***

I’m getting a better idea of what’s going on. Early the following morning around 4 am a nurse draws my blood.

Later, during mid-morning, one of the specialized nurses from the Blood Services Network arrives and hooks me up to that odd contraption, uh…the apheresis device. She tells me she was the first to administer the drip when I was in Intensive Care, but I was not responsive. I’m told the other specialized nurses will rotate and different therapists from their company will oversee the plasma exchange.

The nurse is readying the bags of blood products. She reinforces what the doctor told me. She explains the way the medical equipment transfers my