Day -1

 Sometimes I can't remember what I have explained and what is just swimming around in my head! 

Andy had a relatively restful evening.  He thought he might be feeling a little nauseous this morning but turns out he was just hungry!  

Andy's actual day of transfusion of stem cells back into his body is Day 0.  So yesterday, Chemo Day, was Day -2.  Today was Day -1.  

And Day -1 was every uneventful.  Getting to the hospital was more eventful then actually being at the hospital. We ran into unexpected traffic because of a broken-down semi in the middle lane of the express way combined with lane closures for construction.  We were running a little late, so I dropped Andy off at the hospital while I drove around the structure trying to find a parking spot. 

When I got into the room, our day nurse was already in there starting to take Andy's vitals and daily lab draw.  She said based on Andy's numbers from yesterday, she didn't expect much to happen today and boy was she right.  

We saw a spike in the ANC and WBC as a result of the steroid from yesterday.  Everything else was relatively stable.  

Andy received a dose of Dex and Zofran (which will be given for the next few days to stay on top of the nausea from the Melphalan).  

Each day we will meet with whichever doctor is on rotation that day as well - today was Dr. A...but not the same Dr. A as our Dr. A.  She was great, but given how unexciting we were, she basically just sat and talked to us, reviewing what we might expect over the next few days and answered any questions we might have.  A few things we took away from today.  

Friday we will receive an injection of neulasta injection that will help Andy's WBC recover quicker.

Day 3 to 4 is when we will really see Andy's numbers tank - like, some of them will bottom out at 0.  

Day 4 to 7 he is likely to feel pretty crummy.   They describe it as a really bad flu - and just feeling really tired.  

Daya 9 - 12 we will see Andy's numbers start to come back as his cells fully become integrated into his system.  

Hg is not as 'fragile' as some of the other cells and likely won't decline as rapidly.  In fact, with his Hg at 14, they don't expect him to receive any blood transfusions.  But if it drops below 8, we'll get blood.  

Most patients receive platelet transfusions - these are very fragile cells.  Once his numbers drop below 20, he'll receive platelets.  

Once his ANC drops below 1 he'll receive medications to boost that number.  

The Potassium and Magnesium will be watched as part of his electrolytes.  Those numbers are 3.5 and 1.6 respectively.  Also very common for patients to receive Potassium and Magnesium supplements during this process. 

During tomorrow's transfusion Andy's vitals will be taken every 15 minutes and after tomorrow we need to take Andy's temperature every 4 hours while awake.  If it starts to increase, we need to call the number on his bracelet.  TECHNICALLY, our threshold is 100.4, but you better believe that as it starts to creep to 100, I'll be calling.  

IF Andy's temperature reaches 100.4, he'll get admitted.  At that time - WE DON'T PANIC!  He is getting admitted so they can monitor him and give him anything he needs to fight a potential infection.  Fever does not necessarily mean infection - his body is going through a lot right now.  That is why they want to watch him.  

If he gets admitted, it doesn't mean he needs to stay in the hospital until his numbers start to increase.  Just until he starts to stabilize more.  

So those are all my random facts for the day.  So much information and each day and each appointment we are learning more.  We were home by 11:30 and spent the rest of the afternoon working.  

Again, we know we have long days ahead.  But each day, each moment, we count our blessings and thank God that the road to get to this point has been smooth and unadventurous.  We just hope the highs stay high and the lows are manageable.  It's hard to focus right now.  It's hard to do anything that relates to life outside of our SCT bubble.  I can only keep repeating how special and appreciated all your texts, letters, meals, snacks, and well wishes are!