Smart Mouth

(written by Mel)

Things are pretty rough for Stacey right now.  She is feeling incredibly nauseous again, her counts are low (white blood cells-0, hemoglobin-10, platelets-26), and her blood pressure is really high. (152/105 was the last reading)

The nausea is from the chemo/radiation and also from the anti-rejection drugs she is getting through her iv.  Right now she is on 4 different anti-rejection drugs, one of which makes her feel like her insides are hot.  (sounds similar to the way magnesium sulfate feels, if you have ever had that while pregnant)  They are running the ivs slower, in the hopes that it decreases the nausea a little.  But right now, it seems like not much is helping. 

This morning she felt ok in the am, and was able to shower and eat a bowl of cereal, but by the afternoon she was feeling horrible again.  Her glucose level is also very high… they think this is a side effect of being on liquid nutrients again.  They put her back on liquid nutrients because she doesn’t have an appetite, and feels so queasy all the time. And now because of the liuid nutrients, she has to have her gluclose tested and get insulin shots as needed. She is also getting transfused if her platelets are lower than 30.  She is getting red blood cells transfused too. 

Today she is supposed to be getting a growth hormone shot, to help with white blood cell growth.  Her doctors describe her immune system as being extremely fragile right now, non-existent, like a baby’s immune system.

This stage she is in now is called “engraftment”, I found this definition of it that will explain it better than I can…

ENGRAFTMENT

“The two to four weeks immediately following transplant are the most critical. The high-dose chemotherapy and/or radiation given to the patient during conditioning will have destroyed the patient’s bone marrow, crippling the body’s “immune” or defense system. As the patient waits for the transplanted bone marrow/stem cells to migrate to the cavities of the large bones, set up housekeeping or “engraft,” and begin producing normal blood cells, he or she will be very susceptible to infection and excessive bleeding. Multiple antibiotics and blood transfusions will be administered to the patient to help prevent and fight infection. Transfusions of platelets will be given to prevent bleeding. Allogeneic patients will receive additional medications to prevent and control graft-versus-host disease.

Extraordinary precautions will be taken to minimize the patient’s exposure to viruses and bacteria. Blood samples will be taken daily to determine whether or not engraftment has occurred and to monitor organ function. When the transplanted cells finally engraft and begin producing normal blood cells, the patient will gradually be taken off the antibiotics, and blood and platelet transfusions will generally no longer be required. Once the bone marrow is producing a sufficient number of healthy red blood cells, white blood cells and platelets, the patient will be discharged from the hospital, provided no other complications have developed. BMT patients typically spend four to eight weeks in the hospital.

WHAT A PATIENT FEELS DURING THE TRANSPLANT

A bone marrow transplant is a physically, emotionally, and psychologically taxing procedure for both the patient and family. A patient needs and should seek as much help as possible to cope with the experience. “Toughing it out” on your own is not the smartest way to cope with the transplant experience.

The bone marrow/stem cell transplant is a debilitating experience. Imagine the symptoms of a severe case of the flu – nausea, vomiting, fever, diarrhea, extreme weakness. Now imagine what it’s like to cope with the symptoms not just for several days, but for several weeks. That approximates what a patient experiences during hospitalization.

During this period the patient will feel very sick and weak. Walking, sitting up in bed for long periods of time, reading books, talking on the phone, visiting with friends or even watching TV may require more energy than the patient has to spare.”

Stacey wanted me to tell everyone that there were some pictures taken of her during the transplant, and she is trying to get them uploaded and posted.  It may not be until she is feeling a bit better.  She said she looks red-faced and puffy (that would be because of the flushing that occured during the transplant) and she wanted me to warn everyone.  Don’t worry though, I told her that it wouldn’t matter to any of us, because we all think she is beautiful.

Keeps those cards, letters and drawings coming.  Stac needs all the encouragement we can offer right now!

Thanks, Mel