Transplant on Tuesday
Kevin's admission to Abbott to start the transplant process has been delayed one day. He now needs to be there Tuesday morning instead of Monday. We also now have a better idea of the timetable of events leading up to the actual transplant itself. On Tuesday after Kevin is admitted, we will be meeting with a number of medical professionals. The nurses on the transplant unit will be reviewing information on the heavy chemo drugs and side effects, oral care to try to prevent the horrible throat and mouth sores that are so prevalent with transplants, and the routines on the transplant unit. Then medical residents will be seeing Kevin since they will all be involved with his care while on the unit. Last but not least will be a team of infectious disease physicians which will also be working closely with Kevin throughout his stay.
The heavy chemo will also be started on Tuesday and will continue for 6 days. The cocktail will consist of 3 of the nastiest drugs--BCUN (Carmustine) on day 1, Cytoxan on day 2 & 3, and VP-16 (Etoposide) on day 4, 5, & 6. These drugs are too toxic to take together. They are also very hard on the body. During the 6 days of heavy chemo, the unit nurses will be getting Kevin up to void every 2 hours around the clock to remove these toxins and prevent permanent damage to the bladder. Other side effects Kevin will have the joy of experiencing are infections, loss of appetite and nausea/vomiting, mouth/throat sores, severe diarrhea, liver/kidney damage, lung injury or difficulty breathing, prolonged fatigue, and extreme tiredness. Sounds like all the necessary ingredients for a fun party!! Can you imagine battling all of this while you are sleep deprived because every 2 hours you have to get up to go to the bathroom! When Kevin was undergoing his regular chemo rounds his best coping mechanism was to move as little as possible and try to just sleep because movement caused more nausea. He will also be sleep deprived since he will not be able to sleep for longer then 2 hours at a time for 6 days.
After the 6 days of heavy chemo (hopefully we will still have a live victim at the end of that), Kevin will receive 2 more days of heavy IV hydration to flush the toxins out of his system. Then the magic day 9--the actual transplant day! The stem cell infusion will take place at his bedside and usually only takes about an hour. Prior to the stem cell infusion, Kevin will be given a medication to help him relax. Just before the procedure, the cells will be transported on dry ice from Memorial Blood Center. The stem cell bags will be thawed outside the room in warm saline. Once thawed, Dr. Flynn will begin the infusion through Kevin's central line. Before and after the stem cell infusion Kevin will be given IV fluids at a rapid rate along with other medications that help to prepare his body to receive the cells.
Then it is a waiting game. It takes from 10-14 days for the stem cells to begin growing new blood cells. This is a very critical time because Kevin will have no immune system and will be at great risk of infection. Right after the transplant on day 9, Kevin will be getting daily injections of Neulasta to help build up his immune system. When the WBC's reach 500, he can go home--average stay is 3 weeks.
I'll be posting daily blogs after next Tuesday so everyone can keep abreast of how things are going. Please keep Kevin in your prayers during these next 3 difficult weeks. He will also appreciate your guestbook entries--just knowing that people are thinking of him gives him encouragement and support.
Also, does anyone out there know a GOOD Irish joke? Dr. Flynn challenged Kevin to come up with one that he hasn't heard!