Thursday was Day +8. Deb’s doctor had told her that this process would be tough, and he’s right, it is. Deb had a rough night Wednesday night, not much sleep. Her platelets were down to 6 so she had a platelet transfusion, but it was at 3 AM. She asked me to come early on Thursday so I was here at 8 AM when the doctors made their rounds. They have increased her pain medication. Her mouth is swollen and she has sores, and her throat is painful, too painful to eat, drink or talk. She chews on ice for a little bit of relief. She can’t talk so she writes everything, or we do charades. She’s getting really good at that!
This afternoon Deb’s temp went to 100.6. In a neutropenic patient like Deb (low white blood cells or neutrophils), the usual signs of infection (redness, swelling, and pus formation) are absent. When the temperature reaches 100.4, a neutropenic patient is assessed for the possibility of infection. This includes doing blood cultures, urine culture, and a chest x-ray. All this happened this afternoon. We don’t have results yet, and often no infection is found, but because of her very low immunity she has been started on additional IV broad spectrum antibiotics. Tonight Deb will receive her third red blood cell transfusion since the transplant, as her hemoglobin is at 7.4. The transfusion is scheduled for around midnight. It makes it hard to sleep!
The positive news is that the doctors say Deb is right where she is supposed to be in the process. That doesn’t make the pain go away for her, but it helps to alleviate concerns that something is wrong. Deb’s side effects are normal for the treatments she has received.