Music of the Intestines

The latest adventure for Faina has been that of eating real food. In the quiet of the night, and even sometimes with all the noise of the day, the tune of her intestines is abundantly audible. Last night, I got to listen to the melody of a somewhat benign biscuit working its way through the system.

I've been asking people, what would you do if you were in a new place, all foods were new to you, some were yummy and went down well and others made you violently ill? Would you find a few things that work and stick with them or experiment with new and different things? Faina is abundantly in the later category. No surprises there.

Yesterday, Faina got to turn around the bikur cholim (visiting the sick) obligation making a visit to a friend recovering from ACL surgery.

Fistula, after a period of silence, has resumed a low level of perkiness. We see Dr. Schulick next week for a scheduled appointment. We keep in contact with the oncologist, Dr. Koutrelakos, maintain a correspondence with a specialist at Sloan-Kettering, and keep networking with professionals in San Francisco and Haifa. Limbo, it's the new normal.

Sheherazade

Saturday night we went to the Baltimore Symphony Orchestra. They performed what feels like our theme song Sheherazade. This story has not quite been a thousand and one nights, even though it feels that way. Looking back, the preface to this story began in the Spring, with stomach discomfort, an appointment with a gastroenterologist, an endoscopy, and the discovery of "something common that you need not worry about." Dateline - April 6, the 12th of Nissan, a few days before Pesach, Judaism's three millenia challenge to the GI tract. Chapter one began with, "I'm sorry to have to tell you, but ... " That was just over six-months ago.

To the right are the accoutrements of TPN, the source of Faina's nutrition since August 12th. Since coming home from the hospital, every day it has been the exercise of organizing a sterile work area, pulling the TPN bag from the refrigerator, adding: 6 ml of Zantac, the pre-filled Ascorbic Acid syringe, and 5ml from each of the two MVI (Multi-Vitamin Infusion) vials. This last ingredient's package takes a magnifying glass to read, but on close examination the ingredient lists vitamins A, B1, B2, B6, B12, C, D, K, and more. The next step is attaching the IV tube, priming the pump, cleaning Faina's PICC line, injecting a saline wash, attaching the tube to the PICC line and starting the infusion. This whole process is pretty meditative. It is about the only block of the day that nothing breaks my focus as I proceed from step one, to step two, to step three, and on. There is a beauty to filling the syringe with the two vials of MVI. Vial 1 is a clear solution and Vial 2 is a light yellow. I push 5ml of air into the vial and then the pressurized vial pushes back and fills the syringe itself. With the second vial I slow down the pushback. The vitamins are suspended in an oily solution so the yellow streams in and swirls into the syringe, a bit like a three dimensional paint spinner artwork, except with a higher purpose. Sometimes as the fluid streams in, the yellow goes to the bottom of the syringe and slowly the two mix together, like a rising tide; other times the mixing seems to go from the center of the tube toward the outside, like a growing tornado.

My dwelling on this procedure borders on the nostalgic. In reality, I look forward to it being a part of the past and as of this Shabbat morning, we will put this daily exercise to rest. Other than a monthly vitamin B shot, for life, Faina's nutrition, will all be the old fashioned way. Over the past few weeks she has been testing the culinary waters, yogurt, cottage cheese, potatoes, pasta, kasha, salmon, and tuna, pretty much easing into everything she ever ate before our personal Sheherazade began telling this story for 203 American Nights and counting.