Day 19--Oh, the Magnesium!

Well, it turns out we don't actually have a home healthcare nurse coming in daily to administer Torger's IV magnesium infusion. The nurse came by Thursday morning and taught me how to hook Torger up and run the equipment, then left us with a fridge full of IV bags, some rubber gloves and a pump. Now it's one of my jobs to make sure he gets his 6 gram dose of magnesium every day, even though he really, really hates it. When he's not getting magnesium infused, he feels energetic and good. But when he's getting the infusion, all he can do is sit around and moan. I feel like I'm torturing him every time we have to administer it--he says it makes him feel like he's burning inside and he can hardly stand it. Friday's infusion was so painful for him that we called Dr. Tse yesterday to ask whether we could reduce the dosage, since 6 grams is an awful lot and Torger's levels were all good when we went in for his bloodwork on Friday. Dr. Tse let me slow down the pump so Torger gets the dosage over the course of six hours instead of three, which has helped some. But he also told me that I have to be the bad guy now and make Torger follow his medical regimen even when it's hard on him. He reminded me that we still have a long way to go in the treatment process, and even though Torger feels good, he's far from well. Apparently, Torger's body is just chewing up magnesium and potassium right now, and Dr. Tse said if the levels get too low, the complications could be life threatening because magnesium is necessary for heart and muscle function. So we're doing as we're told, and Torger's just suffering through it.

In addition to being on the magnesium pump for six hours every day, he has to take the following medications now:

At 8 a.m. --Pantoprazole, 40 mgs, to prevent ulcers; voriconazole, 200 mgs, to prevent fungal infections; tacrolimus, 1 mg., an immunosuppressant; ursodiol, 300 mgs., to protect his liver; acyclovir, 800 mgs., to prevent viral infections; amlodipine, 10 mgs., to treat high blood pressure (from all these other medications); potassium chloride, 40mEq., to treat low potassium; benzonatate, 100 mgs., to treat his persistent cough; metronidazole, 500 mgs., to prevent diarrhea; and a multivitamin.

At 2 p.m.--Another 300 mgs. of ursodiol for his liver; another 40 mEq. of potassium; another metronidazole; and more of the cough medicine.

At 8 p.m.--Yet another 300 mgs. of ursodiol for the liver; still 2 more of the potassium pills (which are huge and have remarkably sharp edges); another 200 mgs. of voriconazole, the anti-fungal; another 800 mgs. of acyclovir, the anti-viral, another 1 mg. tacrolimus; another metronidazole; and another cough pill.

Then twice a day on Mondays and Thursdays he gets Bactrim to prevent pneumonia.

It's quite a cocktail! And it's a big adjustment for Torger, who doesn't even like to take aspirin normally. Our days are pretty well structured around administering various medications, although he did manage to have some fun on Friday. The 11th floor BMT unit had a little Halloween party, so he put on the mask he's required to wear whenever he's out, we wrapped around the rest of his face with gauze, then he donned sunglasses, a suit, gloves and a fedora to be The Invisible Man. His voice his so hoarse that he did a nice Claude Raines imitation! The nurses and other patients got a laugh out of him showing up, although they wouldn't have been able to tell who he was if I hadn't been with him! I did try to take his picture for the blog, but it didn't turn out (because he was invisible).