This being the day after my big Methotrexate infusion I was eagerly awaiting the results of the testing of the blood draw from the night before. A level lower than 1.0 (units unknown) would mean that I would be allowed to go home. Of course, this being the weekend the lab over at Children’s Hospital was closed for the night shift. Then at 9 am Marianne my nurse brought me the news that the machine for testing methotrexate levels was broken. It seems they got it fixed in short order, however, because I got the news by 11:30 that the level was 0.44, and they could send me home with a scrip (prescription) for leucovorin. Mo and Miranda picked me up and we dropped off the scrip at the CVS drive-thru pharmacy in Maynard. Here’s where an error entered into the process. I have no idea what CVS thought they were doing, but they provided way too many pills. I called the hospital back to confirm the dosage. 30 mg every six hours precisely for the next 24 hours. Since I’d already had a dose at the hospital, I was expecting a total of 90 mg – and since each pill is 5 mg, that should have been a total of 18 pills. Instead they gave me 72 pills. The instructions on the CVS container had it right about “6 tablets every 6 hours,” but they missed the fact that this was only for a 24 hours. The defense against this potential overdose was the discussion I’d had with the nurse back at the hospital, plus the overall schedule of medications that Dr. Jacobsen had provided me with back in November. Not to make a fuss, but I’ll give CVS a call on Monday and let them know of the mistake – and ask them what to do with the excess medication!

While in hospital, my room was next to that of an elderly woman. I was only in for two days, but I could hear through the walls that she was obviously in some distress on both evenings that I was there. I asked one of my nurses about this, and she referred to her as a “sundowner.” I’d never heard this term before, but a quick search on Google (ignoring the derogatory definition on Wikipedia) reveals that this is a well known condition, otherwise known as “Sundowner’s Syndrome,” where a person with neurological impairment becomes confused as the sun goes down. Now, I assume that the term is not a precise medical definition, but the distress was clearly real, and it brings to mind yet again the degree of undeserved misery there is in this world. To be a nurse or a doctor working in a cancer ward you are faced with this every day. I suppose you get used to it and just do what you can to alleviate the misery.