On the up swing!

This is day 12 if you count the stem cell transfusion to be day 0. We saw a HUGE change today in the way Carla felt and her blood counts. Last night she was able to eat real food for the first time since day 2. She has been wearing a 24 hour infusor each day to help her with nausea. I think it has helped.


Since I posted last she has had to have the nausea infusor each day, one bag of platelets and an infusor for potassium and magnesium. Since she was having nausea even taking her large number of pills, they started giving her medications as IV's. This have meant that we have to stay at 7C blood lab about an extra hour or more but we know she gets her meds. We were afraid that if she threw up soon after taking her pills, then she would not be getting her meds.

Today her white cell count jumped from 0.8 to above 3! Her platelets also came up from about 30 to 54! The nurses said they wished Carla could help the other patients with their platelets.

As yet, the growth factor shots have not caused excessive bone pain. This bone pain in her back was a huge problem in transplant #1 and she didn't have much nausea. This time those side effects were just reversed.

I think today was her last time to get the meds as an IV. I think she can take her pills tomorrow. Tomorrow should be the last day for her growth factor shot.

We have a scheduled appointment with Dr. Barlogie on Monday, May 3. I anticipate that he will discharge Carla and we can go home. We both want this break to be longer than the last breaks as we feel we both need some recovery time. This means I will have to pack up all of our stuff as we will release our apartment so we don't have to pay rent over a longer break.

Same ol', Same ol'. Not!

We thought the second stem cell transplant would be similar to the first.  Boy were we wrong!  Carla got the high dose melphalan on Thursday and received two bags of her stem cells on Friday.  She felt good on Saturday and we did some shopping at Walmart.  Sunday she felt OK until the evening.  She was very nauseated and didn't feel like eating much.  I didn't think much about it until when she got up Monday and said it was one of her roughest nights.  She had medicine for nausea so she took that and went to the blood lab.

She is basically still nauseated and not hungry.  She has forced some chicken broth and Jello down today.  They gave her some nausea medicine both yesterday and today.  Her blood pressure has been lower every day and they have given her a liter of saline solution.  Today  they gave her 2 liters.  They also attached an infusor to her catheter that runs for 24 hours.

She isn't running any fever and her white cell count and platelets are dropping just like transplant one.  Her electrolytes have been great and everything is going great except for the nausea and lack of appetite.

The APN said she thinks patient's bodies don't get back to normal and they get hit with the second high dose chemo and stem cell transplant.  It might be similar to being knocked down and then when you try to get up you get knocked down again. 

Regardless, we both are glad there isn't a third stem cell transplant scheduled!

Back in Little Rock

Wow!  The four-week break flew by and we are back in Little Rock for Carla's second stem cell transplant.  The drive down was beautiful.  The red bud and dogwood trees put on quite a display for us.  I didn't stop to take pictures but I will post some pictures from our yard in Springfield.

Carla started today off with a 7:00 a.m. MRI that took 2 1/2 hours.  This was followed by a full body bone density test, and a blood and urine test.  We also met with the data manager concerning the research protocol. 

Tomorrow Carla is schedule for to for that dreaded bone marrow procedure at 7:45 a.m.  This is where they go in through the pelvis in the lower back and extract a sample of bone marrow.  A gene and chromosome analysis is performed on this bone marrow sample.  At 11:00, Carla's breathing is checked.  At 12:00 we are scheduled to meet with a research nurse.  At 12:45 her heart is checked.  We get a break to come back to the apartment before getting a 90 minute PET scan performed at 6:00 p.m.

The PET scan requires a six hour fast before it and Carla can't eat many carbs after tonight.  This has trigger severe migraines for Carla is the past.  Hopefully we can prepare by taking meds prior to this procedure.  It is also difficult for Carla to lie on her back for this 90 and 120 minute procedures.

The doctor should have the results of these two-days of test when we meet with him on Wednesday.  If she is deemed ready for the stem cell transplant, she will get the tri-Lumen catheter implanted on Wednesday afternoon, get the high dose of melphalan on Thursday followed by her stem cells on Friday.

Here are some pictures of our backyard.

Home Sweet Home!

I haven't been keeping this blog up to date.  Basically Carla was able to come home last Thursday after meeting with two neurologists.  They couldn't promise that they could get her back to be pain free but Dr. Pait said he could improve her quality of life.  He would have to extend the metal rods further down her back and pin them to better vertebrae.

While at home she has to get blood work done on Mondays with the results faxed to Little Rock.  She gets an IV of Zometa today.  Zometa is a chemical that facilities bone repair.  She had Zometa last September and again in October when she was being treated in Springfield.  I have the task of giving Carla her daily Lovenox injection.  Carla has an appointment with the Springfield neurologist who did her back surgery to see what he thinks would be the best solution to her back's hardware problem.

We plan to return to Little Rock on April 10th or 11th.  Starting on Monday, April 12th she will have two days of tests.  She starts the week with a 7:00 a.m. MRI.  On Wednesday, she has an  appointment with Dr. Barlogie to go over the test results.  If there are no problems she will get the catheter implanted that afternoon, get the high-dose melphalan on Thursday and get her second stem cell transplant on Friday, April 16th.

Most likely I won't have any updates to this blog until we get back in Little Rock.  We are enjoying the warm spring-like weather, the green grass and dafidills.  We are enjoying having Carla's daughter, Carissa, with us and we appreciate her cooking!  It gives Carla a break from my TV and heat-and-serve dinners.    

Great News!

Carla's blood test results today were excellent.  Her white blood cell count jumped up to 4.41!  She got a 1/2 L of saline and then headed off to see Dr. Balogie.  Our appointment was for 11:30 but it was 2:00 before we got to see him.  We didn't get out of MIRT until after 5:00.  It was a very long day.

Here are the graphs...

Dr. Barlogie was pleased with her results.  He said her multiple myeloma was in remission.  He wanted us to return in about four weeks for the second stem cell transplant. 

Most of our talk today centered around making plans to get the hardware in Carla's back repaired.  He doesn't want any invasive surgery until after the second transplant and the completition of the two consolidation chemo phases.  This would mean the fall at the earliest.

We want to meet with some neurologists and see how they proposed to repair her back.  We meet with one at 9:00 tomorrow morning and Dr. Barlogie is atempting to get us an appointment with another one on Monday.

Carla is scheduled to get her CVL Triple Lumen catheter removed tomorrow morning at 8:30.

Now we have to decide if we will continue to rent our apartment for these four weeks or move everything back to Springfield and then hope we can find another one when we return.  Right now, I lean towards continue renting it as the rent is reasonable and there are more patients coming to the Myeloma Institue all the time. 

We had quite a storm last night.  Southwest of Little Rock (Benton) and northeast of Little Rock a tornado was on the ground.  The wall cloud passed less than a mile west of our apartment.  A TV Station near our apartment has a picture of the wall cloud on their web site.  http://arkansasmatters.com/mymedia/view.php?id=72822

Carla's daughter, Carissa, drove down from Springfield.  She drove our Honda and the oil light came on near Harrison.  She couldn't find any mechanic open as it was after 6:00 p.m.  She had to spend the night in Harrison and get the car checked out this morning.  It looks like it was the sensor that was a problem and not the oil pressure.  She was able to get it checked and still made it in time to meet Dr. Barlogie.

Carla's birthday is tomorrow.

Comin' On Up

Carla's blood test results looked GREAT today. She had a lot of bone pain last night so she didn't get much sleep.  The growth factor shots causes so much bone growth that it hurts.  She especially notices this in her spine. 

We have more blood tests tomorrow and then an appointment with Barlogie at 11:30.  We have learned to try for morning appointments with him.  His appointments are scheduled as late as 4:00 but are often backed up.  I heard that one night this week he didn't finish his appointments until 9:30 p.m.  Most of the other doctors in the Myeloma Institute are young and he ends up seeing the bulk of the patients.  The number of patents per week has increased since he presented his research results last year.

I think Carla will be released to go home in the not too distant future!

Going Up?

Today's blood test results may indicate the stem cells have engrafted and are producing.  The WBC was up to 0.22 from yesterday's 0.08. 

The RBC also showed a slight increase.  The platelet count was back at 30 so Carla had to get a bag of platelets and the Lovenox shot and growth factor shot.  The increase in platelets shown earlier in the graph was due to an earlier bag of platelets.  We are very thankful for blood donors!

The CRP rose to 21.40 from yesterday's value of 15.4 when the normal range is 0 - 10.  This indicates inflamation but could be due to rapid bone marrow growth.  Carla had this same problem during Induction I.

Carla has been very uncomfortable the past two days.  Her back bothers her more and she can't get comfortable in bed or in the new recliner.  I think part of this might be attributable to bone pain due to rapid bone growth.

We hope the upward trend continues tomorrow.  Her immunity will be considered low until the WBC gets above 2.