Day + 4

The last couple weeks have managed to both drag and somehow become a blur.  Maybe this is because I am just tired.  That said, I didn’t fully comprehend how much has happened in the last couple weeks since the last blog.  That’s the danger of taking things one day at a time…each day is its own entity full of crap that ranges from being worth blogging about to being nothing more than an annoyance best forgotten.  When John said I might want to update the blog, I was more than dismayed by the fact that updating everyone would entail writing a freaking novel.  So people be warned…it’s a long one.  Grab a beer and be entertained, or take your laptop to the crapper and accomplish two things at once.  Either way, sorry if you get bored and start to nod off…hopefully it won’t be mid you-know-what if you're trying to kill two birds with one stone. 

Here is a snippet of what went on prior to him getting admitted into the hospital.  He got a shot of Neupogen each evening Saturday (4/7) – Tuesday (4/10).  Tuesday morning they put the central line in his chest, and he is now walking around with two IV tubes hanging out the left side of his chest.  The main portal into his chest is covered with a dressing that has to be changed periodically, or immediately if it gets wet.  See picture below…

The same evening of the day they placed the central line, he got his last Neupogen shot.  Then based on a preliminary estimate of what they would be able to collect for stem cells they also decided to give him a shot of Mozobil which is something akin to the “bulldozer” of shots for stem cell collection.  The next morning I dropped him back off at Moffitt and they hooked his IV tubes up and began the stem cell collection.  For those of you who have ever donated plasma, it is similar to that.  Basically, they suck out blood through one of the IV tubes, send it through this HUGE spinning machine next to him, keep the stem cells in one bag, and put everything else back into him via the other IV tube.   See picture below…

Stem cell collection took from 8 a.m. until 3:30 p.m.  Then we had to wait for them to count the cells to make sure they collected enough.  It took about 4 hours for them to count, and they won’t let you leave because if you didn’t collect enough, they have to give you another Mozobil shot so that you can come back bright and early the next day for another full day of collection.  He needed 4 million and fortunately they were able to collect 5.2 million!  We went home and the remainder of the week was just some easy breezy visits to Moffitt to get his line flushed.  Fortunately my sister flew in during all of this and took over as CEO of the Herbst household for a week.  Only a sister would wait up until midnight, reheat the dinner you missed, and sit with you to make sure you didn’t face plant into your food.  

Monday (4/16) was hospital admittance day, and having been through a few different hospital stays with him I can safely say that there is nothing like checking into the bone marrow transplant unit at Moffitt!  It’s like the flood gates to Rome open up…nurses were in and out, hooking him up, weighing, measuring, evaluating, quizzing, and instructing; social workers were stopping by to introduce themselves; transition nurses stop by; and physician assistants come in and review everything you just told the last six people.  Once things quieted down, John took a shower…which might seem like a small insignificant detail.  However, it is worth noting that John solidly refused to shower since the placement of his central line, which I might remind you all, was the prior Tuesday…yes you did your math correctly…six days and no shower.  Apparently, he was a wee bit worried about getting the central line dressing wet and having to race up to Moffitt to have it changed.  Suffice to say, that shower was a relief to us all. 

After his shower and dinner, we settled in to wait for chemo to begin which was scheduled for 10 p.m.  The original plan was that I would stay until about 9ish and keep him company via Skype during the Melphalan drip.  No dice.  I stayed to the last dang drip!  The two brown bags at the top are the Melphalan.  So John…when you get excited to point out that Sean posted (and possibly self-declared) that it was husband appreciation day…there you go buddy!  J 

The next day, Tuesday, was an uneventful day of rest for him.  Wednesday was Day 0 – transplant day.  While it sounds like it is a surgery, a bone marrow transplant is really something like a blood transfusion. See the pictures below for his stem cell transplant bags.  He got 6 bags and it took about 15 minutes per bag. 

They say that since transplant gives you a new lease on life; every day after transplant is a new day.  We are officially at Day + 4!  Since the chemo, John has been feeling increasingly crappy which will probably continue for another few day.  His white cell counts are continuing to drop and we are just waiting on engraftment to happen where he begins to grow new stem cells.  Right now he is neutropenic (http://en.wikipedia.org/wiki/Neutropenia) and will probably be in the hospital another 10-12 days or so depending upon his numbers.  His biggest problem continues to be the neuropathy in his feet as the Melphalan seemed to aggravate things.

For my part, here are some important lessons I have learned during this process.  Hospital pull-out couches suck and will not give you a good night’s sleep.  Running is really good therapy, but running when you are dog tired is much easier after a couple cups of coffee…however it is really important to use the bathroom first.  And making casual conversation with people while you are leaving the hospital and walking to the car can sometimes be the most terrifying thing you can do.  Even if there is some mysterious reason that your paths crossed, it can completely derail you, so just avoid random conversations.