It’s eighteen minutes past eight in the morning here in Greifswald, and Adam is currently on his fourth pair of pants since waking up urgently just after 6am. We have moved into a new (and exciting) phase of antibody side-effects. The pendulum has swung from constipation to diarrhoea, the lactulose supplanted by imodium. The first Adam knows about it is after it’s already happened, it’s that fast. We are gathering a nice collection of soiled underwear in the bathroom to take back to the parents house to wash. At this rate we’ll be needing them again before the day’s out. Forewarned is forearmed, but nobody told us to ‘bring lots and lots of pants’ before we came out here! One more little thing to note down in preparation for round two; bring suitcase full of pants to therefore ensure we most likely won’t need them.
Just prior to the doctor doing his final ward check yesterday, sometime around 5pm , Adam’s morphine syringe driver started alarming that it was empty. As he hasn’t felt even the slightest twinge of pain since treatment began, it was decided we would try to stop the morphine altogether and see what happened. It’s the withdrawal of the morphine that has, to a large extent, resulted in the diarrhoea he is now experiencing. It is often responsible for constipation by slowing the bowel muscles, and now that it’s been withdrawn things have gone into hyper-drive. Imodium is actually another opioid drug (which I didn’t know until I just looked it up) that also slows things down, but not to the extent that morphine does, and without all the other effects (at least not unless it’s administered in huge doses).
Some of the fluid retention has reduced since Adam came off the morphine, he weighed less this morning than he did last night. Unfortunately, it’s just coming out of the wrong end at the moment. He still looks like he’s been beaten up, however. He’s had no fever for 48 hours now, and his blood pressure is stable, though still on the low side (and lower than what we consider normal for Adam). Over the course of the weekend the fluids and other supporting meds will be taken down, and Adam will then be fitted with an osmotic pump delivering the antibody only. The pump, which is housed in a small shoulder bag, will be his constant companion, day and night, until next Thursday when the infusion ends.
We are still hoping to be discharged and on our way back to England on Monday. It depends on Adam remaining pain-free, how this bout of diarrhoea develops, and whether anything else crops up over the weekend. We will make sure we keep him well hydrated, and well stocked up on clean underpants, the rest is out of our hands. I have a feeling that come Monday it might just be that the Porta Potti we bought for the camper van turns out to be our star purchase.