So sore, eh

Hi everyone:

Although Patty feels much better in many ways than she has through much of this year, she still doesn't feel great most of the time. In particular, she has been struggling with moderate arthritis-like symptoms in nearly all of her joints and muscles--everything from her fingers and elbows to the bottoms of her feet. As you can see, though, it doesn't impede her ability to eat a bowl of soup...and it clearly doesn't discourage me from photographic her in the act.

Patty also battles fatigue much of the time. For example, she awakened late yesterday morning, had a two-hour nap in the afternoon, and had to pull the plug on the evening before 11pm because she just couldn't keep her eyes open. This may not be atypical for some people, but Patty has historically kept much shorter sleeping hours than this. We suspect this may be a rebound of her lupus symptoms, which might be expected with the discontinuation of Cytoxan. Lupus could also explain the bone and muscle soreness.

Our patient will undergo a right-heart catheterization tomorrow afternoon; she already has two under her belt. The purpose, as we understand it, is to measure the various pressures in her heart, which in turn can be translated into an assessment of cardiac output. Doctors then have some form of benchmark against which to evaluate future options, some of which I discussed earlier this week. For the most part, Patty's pressures have been pretty good for a person with a damaged heart. In particular, she has little of the edema (swelling due to water retention) often experienced by those with heart failure. In other words, Patty and I aren't expecting any real surprises; of course, there's no guarantee against one, especially within this somewhat crazy existence.

That's all I have for now...I'll get back to you later if anything else happens.

Love,
Brian