This is apparently Day -1… hospital terminology for the day before the stem cells are transplanted. It’s actually the early hours of Day 0, as I’m awake in the middle of the night. (SCT = Stem Cell Transplant).
Day -1 is the day they have given me the high-dose chemotherapy (Melphalan).
Day 0 is the day they transplant the stem cells, 24 hours after the chemotherapy. So that will be happening around 16:30 today (Thu 4 August).
I’ve just realised that Day 0 will be exactly 6 months to the day from the day I received the multiple myeloma diagnosis.
I find it interesting that the focus is very much on the transplant of stem cells – as though that were the main treatment… As I understand it, the main treatment is actually the high-dose chemotherapy, but that can only be given successfully if it is followed by a ‘rescuing’ transplant of stem cells.
And the word ‘transplant’ is kinda weird too… For me, it sounds like an operation where an organ is implanted. In actuality, it is a very simple procedure, I believe – I will let you know… But I think it is just like a blood transfusion. I sit/lie on my bed and a nurse gradually pushes a syringe into my line, over about half an hour.
I believe it is also called stem cell rescue… because that is what it does. If the stem cells were not given back to me, whether my own or someone else’s, my body would not be able to recover from the high dose of chemotherapy. Scary, eh?
I have to say, I prefer the word ‘transplant’ to ‘rescue’ in this context.
So, yesterday I arrived at 2pm, my room was ready. Big phew! This time the room is on the opposite side of the ward from a few weeks ago, so no weathervane to watch through the window. But later on, I was pleased to have late afternoon sunlight pouring through instead. And if I get out of bed and look out the left side of the window, I can see trees on the other side of the hospital road.
While settling me in, taking obs and filling in paperwork, they started me on an IV drip of fluids. It is important to keep fluids flushing through my system in order to protect the kidneys from the harsh effects of the chemotherapy.
Along with Potassium and Sodium, they also gave me a diuretic to encourage me to pee. They had to wait until I passed 500ml of urine before ordering the Melphalan. That was almost immediate!
The whole time I’m in here, they will be measuring my liquid intake and output to ensure I maintain a good fluid balance and don’t retain too much.
Around 4:30pm, the nurse came in with the most enormous syringes, like something out of a comedy sketch. These contained the mighty Melphalan. The nurse sat with me and gently ‘pushed’ the drug into my line over a 20 minute period. I didn’t feel a thing!
For ten minutes before, during and for ten minutes after the chemo was given, I had to suck ice. Ordinary ice cubes, like you’d put in a drink on a hot sunny day. Some of them were heart-shaped. Sweet!
They were COLD!!!!! And BIG!!! If I wanted to speak, I had to take it out of my mouth – that kept me quieter than usual! 🙂 I almost choked on one of the wee buggers!
The ice is given to close down the blood vessels in my mouth and upper oesophagal tract, so the chemotherapy has less of a damaging effect on these sensitive little cells… ultimately giving me less problems with sores and ulcers in my mouth.
There were some other protective drugs, given both intravenously and in tablet/capsule form – I can’t recall the names. I am now also taking drugs to protect me from viruses, fungal and other infections, along with stuff to protect my stomach, stop me being/feeling sick and try to eliminate acid reflux.
I have been told that people don’t usually start to have any of the nastier side effects, like sickness, diarrhoeia, feeling weak and fragile, until 4-5 days after they have the chemotherapy. I’ll let you know how that goes…
I’ll post this now before it gets too long, and I’ll probably post short-ish updates most days to keep everyone informed, on the medical/technical stuff, but hopefully also thoughts and feelings, if I could only corral them.