Post Transplant Day 4
A more eventful day for sure...
After I left the hospital last night Karl called me to report that he had been sick. The nurse had given him something through iv for the nausea and he was feeling a little better. This morning we talked before I got to the hospital and he told me that he hadn’t been sick again, but he had to have the anti-nausea med three more times, and hadn’t slept much.
By the time I arrived at the hospital Karl also had diarrhea. None of this was unexpected. Nurse Practitioner Charlene came in around ten. She examined Karl’s mouth and said that he was also showing the first signs of mucositis, another expected side effect. Basically the malphalan (chemo) killed the Myeloma cells and bone marrow, but also damaged his digestive tract, which would eventually result in nausea/vomiting, diarrhea, and sores throughout the mucous membranes of his mouth and digestive tract. So we were expecting these symptoms, and were told they would occur around now. Charlene started him on Gravol every six hours, plus another anti-nausea drug as needed. She also gave him something to alleviate some of the esophageal gas he was feeling. She told him to ask for magic mouthwash as soon as his mouth became any worst, and said that he would also have Ativan tonight for nausea and to help him sleep.
Shortly after Karl took the Gravol he became drowsy, so I left for a while. When I returned this afternoon there was a sign on the door that stating that no one could enter without wearing a gown and gloves. I asked the nurse, and she explained that they had sent some of his feces to the lab for culturing. Even though diarrhea is an expected side effect, before they can treat the diarrhea they have to be sure that he doesn’t have an infection, because an infection that causes diarrhea would be treated quite differently than diarrhea caused by the malphalan. This test was also something that we expected, but we didn’t realize that until the results come back in about 24 hours I would have to wear gloves and a gown. I had the makings of our supper in the small fridge in Karl’s room, but since I couldn’t leave to use the microwave without degowning and then gowning again with each exit, supper had to wait. Karl took one look at the hospital tray and decided he wasn’t eating that either, but said it didn’t matter because he wasn’t hungry. He hasn’t eaten much today other than a few light snacks because of the nausea and tiredness.
So that was our day. Karl’s white blood cells are now below normal, but his neutrophils were 1.7, which is below the normal range, but still considered ok for a chemo patient. If they fall below 1.0 tomorrow I will wear a mask when I am in his room. Since I will also have to wear the gown and gloves until the feces culture results come back, if you see me you won’t recognize me!
After I left the hospital last night Karl called me to report that he had been sick. The nurse had given him something through iv for the nausea and he was feeling a little better. This morning we talked before I got to the hospital and he told me that he hadn’t been sick again, but he had to have the anti-nausea med three more times, and hadn’t slept much.
By the time I arrived at the hospital Karl also had diarrhea. None of this was unexpected. Nurse Practitioner Charlene came in around ten. She examined Karl’s mouth and said that he was also showing the first signs of mucositis, another expected side effect. Basically the malphalan (chemo) killed the Myeloma cells and bone marrow, but also damaged his digestive tract, which would eventually result in nausea/vomiting, diarrhea, and sores throughout the mucous membranes of his mouth and digestive tract. So we were expecting these symptoms, and were told they would occur around now. Charlene started him on Gravol every six hours, plus another anti-nausea drug as needed. She also gave him something to alleviate some of the esophageal gas he was feeling. She told him to ask for magic mouthwash as soon as his mouth became any worst, and said that he would also have Ativan tonight for nausea and to help him sleep.
Shortly after Karl took the Gravol he became drowsy, so I left for a while. When I returned this afternoon there was a sign on the door that stating that no one could enter without wearing a gown and gloves. I asked the nurse, and she explained that they had sent some of his feces to the lab for culturing. Even though diarrhea is an expected side effect, before they can treat the diarrhea they have to be sure that he doesn’t have an infection, because an infection that causes diarrhea would be treated quite differently than diarrhea caused by the malphalan. This test was also something that we expected, but we didn’t realize that until the results come back in about 24 hours I would have to wear gloves and a gown. I had the makings of our supper in the small fridge in Karl’s room, but since I couldn’t leave to use the microwave without degowning and then gowning again with each exit, supper had to wait. Karl took one look at the hospital tray and decided he wasn’t eating that either, but said it didn’t matter because he wasn’t hungry. He hasn’t eaten much today other than a few light snacks because of the nausea and tiredness.
So that was our day. Karl’s white blood cells are now below normal, but his neutrophils were 1.7, which is below the normal range, but still considered ok for a chemo patient. If they fall below 1.0 tomorrow I will wear a mask when I am in his room. Since I will also have to wear the gown and gloves until the feces culture results come back, if you see me you won’t recognize me!
I got sick, really sick at first. I purged everything in my system, stomach and bowels. I was down over 4 pounds the next day when I was weighed. This sounds bad but it is probably a good thing. With my gi tracts inflamed and irritated, I think it was easier to deal with the discomfort when they are empty. As for being hungry, I can nibble on some things, but when your mouth and throat is irritated, you don’t have much of an appetite anyway. Better days are on the way. Oh, did anyone see Denise, I don’t see her anywhere.
ReplyDeleteHang onto your sense of humor Karl. If you’re looking for Denise in the sea of gowned people, I’ll bet she’s the one that is the most caring, loving and most attentive person there and you will recognize her quickly. Stay positive, hang onto each other and know that you have an army of people praying for both of you. - Sandy & Frank
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