Day 1 of stem cell transplant programme
We had an appointment at the chemotherapy clinic today for Jimmy to have a whole batch of bloods taken prior to chemo and harvesting of his stem cells. I can't believe that it is almost one and half months since we last visited the clinic and it was quite nice to see the staff again and some of our fellow cancer sufferers. Some look really good and others taking a bit of strain.
The only blood results that we got back today where his white bloods which have come up nicely to 3.3 (norm 4 - 12). Jimmy also had a cardiac assessment which is called an echocardiogram. This is a machine that uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.
We had about 2 hours to spare between the cardiac assessment and our appointment with Prof so we went up to the restaurant and had something to drink and then went to explore F4 isolation ward. This hospital is enormous! Eric, who we know from the chemo clinic, is working in F4 at the moment so he let us in as far as the second set of doors (as far as one can go without stripping down and putting on scrubs etc). He showed us where the isolation wards are and Jimmy did his level best to try and 'book' the one with the best wifi reception for January. Two of our friends from chemo clinic are in F4 at the moment so we asked Eric to please pass on our best wishes to them and that we are rooting for a good recovery and excellent results. I don't want to mention names here as it is private but our one friend is doing very well, he has been in for 2 weeks now. Our other friend is having a really bad time. He has already been in isolation for 5 weeks and having problems with his platelets. F4 is not a nice place, there are so many side effects of the treatment and you literally feel like you are going to die. We pray that he can summon the strength to fight back and pull through victorious.
We then had our appointment with Prof Novitzky which was Jimmy's usual check-up and then he explained the steps to us of the stem cell transplant as far as harvesting, which is what will be done this year. He had the results of the echocardiogram and noted that Jimmy's heart is slightly enlarged. I questioned him on this and he explained that this is usually a sign that the heart has had some stress. The most common cause is hypertension but he was surprised at this as Jimmy does not have high blood pressure. He didn't really say anything more about it. As I thought, Jimmy does not need to have another bone marrow biopsy tomorrow as his last one was within the last month. On Wednesday Jimmy will have a lung function test and then he will be admitted for pre-hydration followed by 2 days of heavy chemo in high care. He explained that the 5 days between chemo and the start of the Neupogen injections Jimmy will be at high risk of getting an infection and we need to take his temperature every hour. He will be given prophylactic antibiotics whilst in hospital to prevent any infection. Prof explained that you never know what is lurking in your body and when it is taken right down, like Jimmy's will from the chemo, it is best not to take a chance. Although he did warn that the antibiotics prevent most infections, sometimes there is that one. He is going to lose all his hair, probably have mouth sores, lose all taste for food and have nausea and diarrhoea. Once we start the Neupogen injections twice a day at home next Wednesday his body will quickly pick up again as it brings up his blood counts and boosts stem cell production for harvesting purposes. Unfortunately there is a side effect to this which they refer to as an 'explosion'. Basically this means that there will be an over production of stem cells in the spaces in the bones which will not be big enough to accommodate these stem cells and this leads to severe pain in the long bones and flat bones of the body. These would be arms, thighs and pelvic bones. But this is a good sign. On the following Wednesday we need to go back to the chemo clinic for a full blood count to see where his bloods are as this is a good indication of whether or not he is ready for harvesting. Whilst in high care later this week they will also, under local anaesthetic, insert a line in his groin which they will use to administer the chemo and harvest his stem cells from. Once the harvesting is complete they will remove it under local anaesthetic again. He will only have the Hickman inserted under general anaesthetic in January once in isolation.
The good news is that the actual stem cell harvesting does not affect your body so Jimmy should be in a good space over the Christmas week.
So, I think we have a tough 2 weeks ahead of us but nothing that together we cannot handle. It is our wedding anniversary on Wednesday and since his white bloods are sitting at 3.3 and he goes into high care on Wednesday, I think we have an excuse for an outing and a little celebration dinner in a restaurant. Oooh....so romantic :)
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