Saturday, January 2, 2010

Day +4 (Neulasta administration)

Today my leukocytes dropped to 140 and the platelets are at 68. The numbers are now scraping the bottom (click to enlarge). . . .

Today I had my Neulasta injection. An important event for getting back on the road to recovery. Should start to show improvement in blood counts by next weekend. I really hope.

I still feel sick as a dog. I have to force myself to eat even the most minimal amount of yogurt. Understandably I'm losing weight. I'm down to 63kg (normal weight 68kg) and based upon my (lack of) eating it is likely to drop a lot more. The nurse told me that they'll start me on a nutrition IV if I remain this way.

Also, my temperature has risen to 38.8C, a fever. The standard procedure as a precaution is to start people on IV antibiotics if this happens (90% of people fall into this category and are nearly always given IV anti-infective agents). I have been fitted with an IV cannula in my forearm and am being administered the antibiotic Ceftazidime at regular intervals around the clock. It's a third generation broad-spectrum anti-bacterial agent known as a cephalosporin and is commonly given to those that are febrile neutropenic. This is just a precaution to help gaurd against the possibility of an underlying infection that would be very dangerous with my current state of having no functional immune system. But for the vast majority of people that get a fever during this phase of HSCT, there is usually no specific identifiable cause of the fever. Hence it is an idiopathic (cause unknown) fever, which is quite common in this situation and is why nearly all people receive IV antibiotics at this time during hospitalization. The fever normally resolves by the time successful engraftment manifests. [Post transplant note: My immune system showed initial signs of successful engraftment coincident with fever reduction by day +9. So in the end, everything worked out fine with no unexpected complications (except for a temporary skin rash/urticaria).]

Sorry. I feel sick as a dog right now and can't write anymore.

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