Sleep Watching

Some people can sleep any time and anywhere. I envy them.

Take the 20-something young woman I saw at The Coffee Gallery the other day. She plopped herself down on an overstuffed couch while she waited for her boyfriend. Since she had nothing to do, she stared up at the fans spinning lazily overhead. Soon, she was as mesmerized as a six-month-old. The next thing I knew, she was sleeping like a baby.

“Oh, to have such a simple life,” I thought as I pretended to write. And then I realized that I was entertained by watching someone watching spinning blades. And then I stared some more as she slept. And then I Twittered about it. And now I'm blogging about it. Does it get any simpler than that?

Apparently so. Today I watched a patient at the City of Hope fall asleep while he leaned against a wall. I hopped up, tapped him lightly on the shoulder and offered my seat. He refused and I insisted until I had offered and he had refused three times (that’s the secret number of times one must insist, in case you were wondering). I felt a little bad about waking him and slinked back to my seat.

Within seconds, he was asleep again. I spent the next ten minutes watching him sleep standing. At one point, his head jerked violently back, but, otherwise, he was as unmoving as a corpse. I thought only horses could do this.

I took a break from my sleep-watching to have my vital signs taken. When I returned, I was happy to see the man still slumbering . . . in my vacated seat.

Warning: The next few paragraphs may cause drowsiness and should not be read while operating heavy machinery. However, if you or someone you know is taking Rituxin, the information may have the opposite effect.

I recently read that Rituxin, the monoclonal anti-body that I take every quarter by I.V., can lower resistance to infections, especially pulmonary infections. A blood test can measure the number of infection-fighting immuno-globulins, and, if the numbers are low, patients can receive a special transfusion.

I asked my doctor about this today, and he agreed that it was a good idea to draw a little more blood so that we could look at the immuno-globulin numbers. He also said that oncologists continually debate the merits of maintenance Rituxin because a) it can lower resistance b) the efficacy is debatable and c) Rituxin can no longer be used in relapse cases after it's used for maintenance. I knew about the efficacy debate, but I didn't know about the other two issues.

If I wasn't insured, I would skip the Rituxin. I called billing recently because the cost for one dose of the drug was $18,000. I thought that had to be a mistake, but it wasn't.

My EOS are creeping back up again, so we've delayed any further tapering of the Prednisone. Something else I learned today: I'm my doctor's only patient with eosinophillic issues. Oh, how I love being the one and only.

Alright. You can wake up from that snooze now. I'm just sorry I wasn't there to watch you.