08/17/09 Fourth Week of treatment

08/17/09 So Joe is really sick, but the doctor said he still will get sicker his levels are still not down to zero. Today he was almost admitted, he was very fatigued and was having bouts of diarrhea all night. He was dehydrated, so they had to Hydrate him before they gave him his last dose of Velcade. Joe is trying so hard to remain strong. I know some of you don't understand why Joe will get so sick from the Melphalan (High Dose Chemo ) that he had to have before the Stem Cell Transplant so I will try to explain . Before you can do the stem Cell Transplant you have to have chemotherapy to destroy the diseased cells in your bone marrow and the rest of your body. This gets rid of the diseased cells in your bone marrow. Later, when you get your stored blood cells back, those new stem cells will be able to take over the job of making new blood cells. So the normal dose of Melphalan by I.V. is 16 mg administered at 2-week intervals for 4 doses, then administer at 4-week intervals after adequate hematologic recovery. So Joe received 200 mg a day administered in two days. Destroying your bone marrow cells with this much chemotherapy leaves your body unable to fight infection. You become very fatigued, and there are many life threatening infections you can get. Plus you become very ill. How are stem cells transplanted? The stem cells travel from the blood bag through the catheter into your blood, and to your bone marrow, where they will begin to produce new cells in 1 to 3 weeks. During this time: You have to take many precautions to fight germs and stay as sanitary as possible. Stem Cell transplants used to be done under isolation but they find the patient does better if they are not kept in the hospital. You are given antibiotics to prevent or to treat infection. Your blood will be tested often to check the levels of red blood cells, white blood cells, and platelets in your body. Joe may need to receive several transfusions of blood cells and platelets until his body begins to produce its own. Early complications usually occur within 5 to 10 days and include: Nausea and vomiting, Diarrhea, Mouth sores, Hair loss. Also bleeding because of severe reduction in red blood cells, white blood cells, and platelets. Infection, such as pneumonia, shingles could develop. So right now I am taking his temperature every hour to make sure it does not go up to 100 degrees because if it does we have to go straight to the emergency room. Once we get home from the hospital each day Lorrie and I are wiping down the apartment with Clorox wipes and we all are constantly washing our hands and using antibacterial hand sanitizer. So I am not sure how the next few days are going to go if Joe gets admitted to the hospital I will not be able to blog for awhile but I will catch up in a few days. We Love you and keep praying for him.