Tuesday, June 29, 2010

No Blood Clots

The best news today was they could not find any blood clots in Carla's legs.  In January, Carla had one in her left calf and an older clot in her right leg.  She had a pain in her left thigh and her blood test the past three days had shown her CRP which measures inflammation and infections was up from 5 to about 30.  They couldn't find any new blood clot nor could they find the previous two clots.  The Lovenox shots must be working!  Her platelets were at 37 so she didn't have to get any platelets.  Those two bags of platelets yesterday must have helped.

Due to the elevated CRP, they administered two antibiotics via IV's.  Her white blood count was only slightly higher going from 0.21 to 0.25.  We need for that WBC to get up over 2.0 before we see the top doc on Thursday. 

Monday's rest seemed to help with Carla's fatigue.  A migraine headache has plagued her the past two days.  Hopefully she will get relief from the headache and her WBC will shoot up.

Not much has changed otherwise only that the weather finally cooled down some with about a half inch of rain last night and this morning.

Monday, June 28, 2010

Low Point

It looks like Carla has reached her low point where she feels she is "walking through the valley of the shadow of death."  Her white blood count was 0.23 today and her platelets were 10.  They want to keep her platelets above 30.  We went into Myeloma Infusion Center at 9:30 and got home after 4:00.  She has been running a low grade fever of 99 - 100 and therefore they have taken samples for blood cultures the past three days.  Yesterday with a WBC of 22 she should have been called back to get a platelete transfusion but wasn't.  Today they had to get blood samples, do the lab work, order the platelets, administer the transfusion of platelets, get another blood sample, have the sample run, order more platelets and administer the transfusion of these platelets.

Carla has had a pain in her left thigh.  Today the APN nurse ordered a Doppler test on that thigh which will be done tomorrow at 1:00.  This will show if there is a blood clot in her thigh.  This is similar to the problem she had in January when she had a blood clot in her left calf.  Hopefully it is only a strained muscle from Carla doing her stretching exercises.  The Lovenox shots have been given to lessen the probability of blood clots. 

This evening, Carla did not eat any dinner.  She was running a fever of about 99.6 and just couldn't eat. 

We were given an infusor just in case her fever goes up overnight.  I am to call the myeloma doctor on call if her temperature reaches 100.5.  The infusor could save us a trip to the emergency room.  We have had these infusors a couple of times before and they just expired in our refrigerator.  Hopefully this will be the case this time.

Hopefully extra rest will help her body rebuild and she will be much better in the morning.

Wednesday, June 23, 2010

On Track for Consolidation #1

As I posted last time, Carla is being treated in the Myeloma Infusion Center this time rather than 7C in the hospital as 7C does all of the stem cell transplants and they are full up doing those.  The Myeloma Infusion Center (MIC) is in the Arkansas Cancer Research Center.  We had walked by a large full waiting room many times not realizing that all of the patients were myeloma patients.  One of the big differences between 7C and MIC is MIC draws your blood and bases most of what is does on yesterday's blood test results.  They draw blood samples and send them to the lab.   If there is something critical when they get the results they call you back to MIC so they can respond to the test results.

Yesterday Carla got her black bag of two pumps and IV bags off.  She doesn't have to walk around with her anchor attached.  Today we discovered more about UAMS.  When the tech came to get Carla he said she was going to MIC Express.  They have a separate smaller room that is MIC Express.  If they anticipate very little treatment, patients go here.  Carla's sodium and potassium levels had been low yesterday in spite of the huge potassium horse pills Carla takes twice a day.  They attached an infuser (baby bottle size plastic bottle with a balloon containing the IV solution).  Her blood pressure dropped below 95 upon standing so she had to get 500 ml of saline solution.  Carla became nauseated after breakfast so she hadn't drank enough to keep her hydrated. 

Yesterday's white blood count was 3 when the two previous days the WBC had been 9 and 5 respectively.  I imagine she dropped below 2 today and is neutropenic.  She is acting like she is at least.  She didn't want to eat at noon so she drank an Ensure.  Tonight she wanted soup and sliced pears.  She is resting almost all of the time.  This apartment has a new comfortable recliner and Carla is resting there for a break from the bed.

Carla received a growth factor shot this morning as well.  In the previous treatments she did not receive growth factor shots until her WBC was near zero.  I guess this is one of the differences with consolidation phases.

It is hard to see someone go from feeling rather well to being so sick.  We just have to believe that it will be worth it once she is on the other side of this therapy.

There are still a lot of sick coughing patients at MIC.  Carla wears her mask every time we go to MIC.  Fortunately, MIC Express handles fewer patients and you aren't in there as long.  The sicker patients don't go to the express lab as they probably have to get more treatments.

Hopefully by Saturday or Sunday Carla will be on the upswing.  I really dread her growth factor shots as this has caused her lots of bone pain in the past.  Her back was just feeling better and now will probably ache from the growth factor.

Hopefully we will get a break from the hot weather tomorrow.  The temperature has been between 96 and 100 and the heat index has been 105 - 110 since our arrival. 

Saturday, June 19, 2010

Back for Consolidation #1

Wow!  We really enjoyed our six week break back home.  We saw Carla's back improve and she quit wearing the brace.  We enjoyed having Carla's daughter, Carissa with us.  My brother-in-law, Arden, and my son, John, helped us build a small storage shed in our back yard.  My sister was able to spend nine days with us.  My daughter and her family moved to Springfield from Fort Worth.  A college friend, Valo, was able to drop by for a visit.  It was a great and badly needed break!

Our prayers were answered when we were notified on Thursday, April 10 that there was a one-bedroom apartment available to us through the Home Away From Home program of the Little Rock Church.

On Monday, June 14th, we returned to Little Rock.  Carla had the painful bone marrow procedure and long MRI on Tuesday.  Wednesday she had a CT scan.  We saw Dr. Barlogie on Thursday and Carla got a triple lumen line implanted in her chest.  This time we are scheduled to go to the Myeloma Infusion Center (MIC) rather than 7C at the hospital because 7C does all of the stem cell transplants and they are booked full.  So Friday saw Carla go to the MIC to get her "black bag" containing two pumps and IV bags.  She also started taking the dexamethasone and thalidomide pills.  She will take the pills and have the black bag for four days.  She has to go to MIC each morning to get blood drawn for tests and get her black bag refreshed.

The main chemo drug this time is Velcade which is given as a shot.  Velcade generally does not make patients as sick as the melphalan that she had in preparation for each of the two stem cell transplants.  Hopefully she will not get as sick this time as she did during transplant #2.

One prayer request is that Carla will be able to avoid getting any infection during her low immunity.  There is some respiratory viral infection going around MIC.  Carla wears a mask when she goes to MIC.  Several patients have had extended therapy as they got some infection.  We visited with a friend and his wife who are from Valley Forge.  He got a GI infection and had to spend time in intensive care.  He was excited to finally be going home.

If Carla doesn't get any infection, we might be able to go home as early as July 1.   At least that is when Carla's next appoint is to see the doctor.  Usually he has been able to predict when Carla will need a discharge appointment.