Saturday January 7th 3 pm

Detlef had a pretty good night last night. He is a bit of a night owl, so even after Juergen left, he was up walking around, playing video games, and chatting with the nurses. The night shift nurses probably appreciated having a conversant patient in the ICU to help keep them awake! :). Everyone continues to be amazed and awed by the amount of food Detlef is putting away, and Detlef is really enjoying the fact that he can order whatever he wants, whenever he wants. For the Bean clan it's "fast and delicious!" (This is a reference from a movie called Defending Your Life, that our family is obsessed with).

This morning when I talked with Jennifer, Detlef had texted her some updates about his lab tests. The reason he is in the ICU getting chemo for the first time is to make sure that his body is handling everything okay. Some of things they are monitoring are his kidneys, his platelet count, his hematocrit (the percentage of red blood cells), and his neutrophils (how well the body can fight infection). Let's look at each of these individually:

1. Kidneys: When they are killing the cancer cells, some of the by products of the cell death have to be filtered through the kidneys and the bladder. Some of these things were elevated overnight, but now they are coming back into the safer range.

2. The electrolytes in his blood stream were also a little out of the normal range as well. They are watching his Sodium, Potassium, Calcium, and Phosphorous levels. They are all coming back to the appropriate range this afternoon.

3. Platelet count: Your platelets help your blood clot. These were low, and so they have given him an infusion of platelets. (This is something that happens with chemo very often). They are carefully monitoring his blood clotting capabilities, because they don't want him bleeding in places that shouldn't be bleeding.

4. Hematocrit: He has not had a blood transfusion yet since starting chemo, so currently he doesn't need this.

5. Neutrophils: One of the components of our blood that fight infection. When your neutrophil count is low, you are more susceptible to infection. The risk of getting a fever and an infection is pretty high right now. We are all being fastidious about wearing masks (especially me, because I have lost my voice), and also using hand sanitizer before we enter the room. Detlef has felt empowered to tell us if we forget, and also to make sure the nurses carefully clean all the IV connections when they are drawing blood from his central line, or giving him IV medications. I told him that he should be willing to tell anyone to wash their hands or be careful when they are doing any procedures, and he has taken this to heart. He realizes how important this is.

6. Steroids: Detlef is getting steroids to help prevent the side effects of the chemo, as well as it being part of his regimen too. Steroids can really make your blood glucose go crazy, and it has a little bit with Detlef. They gave him some insulin earlier, and will be watching this closely. This doesn't mean he has diabetes, it is just a side effect of the high dose steroids he is receiving

Doctor Kogel, the oncologist came in this afternoon to give us an update. She is pretty amazed at how well Detlef is doing. He has been going for walks around the hospital, which is pretty rare for anyone in the intensive care unit. He took us on a tour this morning, and showed us all the pictures on the walls that he liked, and then showed us (out the window) which restaurants were close that had great food. We will be trying Thai Basil soon, because I love Thai food, as my family can attest to.

We asked Dr. Kogel about what the plan is over the next few days, and she said that if he keeps doing well, tomorrow he will be moved back to the 10th floor, which is the oncology floor. Currently the oncology floor nurses have to come to ICU to administer the chemo, so it would make things easier for them. The rooms are also bigger, so it would be better for Detlef as well. Once he is back on the 10th floor, Dr. Kogel said that he can walk anywhere in the hospital he wants. Detlef's response, "Can I go jogging? Do you have any treadmills for patients to use?" Stunned looks from the nurse and doctor, followed that request. Karma asked if Detlef could walk out to the curb, and see Chance. Dr. Kogel's response, "As long as I don't know about it." Detlef decided that he wouldn't do that because he doesn't want to risk an infection.

We also asked about the possibility of Detlef going home next week instead of staying in the hospital for 3 weeks or more. She stated that the decision would be made based mostly on whether or not he gets a fever over the next few days due to his low neutrophil count. So we are all keeping our fingers crossed, that he keeps doing as well as he is doing right now. If he does get discharged next week, he would need to come into the outpatient clinic every other day to have blood work drawn, and to get blood or platelet transfusions as needed.

Right now Detlef is snoring (yes Detlef you do snore), while Karma and I are watching the end of Secretariat, and crocheting. Detlef said that he would be able to sleep with us in the room, as long as we didn't try to be quiet. If we have the movie at the normal volume, and we talk in our normal voices then he will sleep soundly. Again, the memories of Detlef being a baby, sleeping wherever we were, came flooding back. . . . . he's just a lot taller now! :)

We love being here together, chatting, and laughing, and talking . . . . the doctor and nurses are enjoying the yummy german cookies and treats that Karma and Juergen have given them. Everything so far is going better than we could have hoped for. We are hoping for continued better than expected progress! We love all of you, and appreciate all of your care and concern. Dietmar and Jennifer will be coming in soon, and will bring the "Lord of the Rings" trilogy to watch, and then Juergen will stop by after work. Lots of great family support for an incredibly great guy Detlef Juergen Grimm.

Love you all,

Lisa