Thursday, February 16, 2006

day+14

My WBC went up to an amazing 3.4 today (although my Hgb and platelets haven't changed). As a result, I'm no longer considered neutropenic eventhough my body is still immunosuppressed. The plan is that I should be discharged by 2pm. Of course, in my experience one can never bet on a set time for discharge from a hospital regardless of what the staff tells you. But perhaps tomorrow will be different, especially since they knew of my planned discharge since yesterday.

Scott and Bita, the BMT nurse practitioner, reviewed with me the do's and don'ts of my discharge and immediate post-transplant life. Many of the same guidelines that I have been following as an inpatient will continue to apply to me once I leave the hospital tomorrow. I must avoid crowds and sick people as well as plants and animals. Construction sites or areas where dust or soil is being exposed or lifted into the air are also to be avoided. Since my platelets are still low, I must continue to use the oral swabs or a baby toothbrush. It's no surprise that flossing is still prohibited due to the low platelet count. Strenous exercise or rough activity is also prohibited due to my low platelet count. With regard to food, I should continue to follow the same dietary guidelines that I have been doing although by my follow-up appointment late next week, I might be able to adopt a relatively normal diet. Sushi, however, I bet will be off my eating list for awhile. I forgot to ask them about immunization, an important topic. I read in the literature that BMT patients may need to be reimmunized, so I'll be sure to ask them tomorrow about this. I was surprised to learn from that I don't need to wear gloves and a mask when outside. Again, my WBC is high enough.

For the next six months, I'll need to continue to take acyclovir, the antiviral pill that I have been taking three times daily here. Bita told me that acyclovir will help against the development of shingles, which can rise in people recovering from a transplant. Dormant viruses, like chicken pox, could reawaken in people with immunosuppressed systems. But interestingly, that's the only drug that I need to take once I'm out of here. I had the impression that there would be many drugs, but that's reserved for patients who have undergone an allogenic transplant (stem cells from a donor). Since I received my own stem cells, I'm young and otherwise healthy, the recovery time is much shorter than that of an allogenic transplant patient generally. Of course, it's possible Scott noted that a fever, diarrhea, or bleeding for example may occur unexpectedly in the coming weeks, but that it's very unlikely since I am an autologous BMT patient. These and other complications are rare, though not impossible, in autologous BMT patients. If any unusual problem arises, I must contact the BMT office immediately.

During the weekly check-ups, my blood will be tested to make sure all is well. Since the red blood cells and platelets are the last to grow, it's possible that I may need a transfusion at some point.

Bita told me that to not be surprised if I become fatigued or burned out easily while at home during the next week or so, but that within a relatively short time my strength would begin to come back. Well, I'm going to just take it easy while at home. Other than the weekly or so follow-up appointments with Dr. Schuster, my BMT doctor, I don't have any plans. I'll just take it easy (as I should). I feel no immediate rush to go out and do anything.

3 Comments:

Comment Anonymous Rayna said...

I just wanted to say I'm so proud of you. I've been thinking about you everyday. My mom recently gave me the link to your blog, so I could send some love to you. You're such a fighter and I love you.
::much love from the little brat that you let play your nintendo, even when you and Daynan didn't want me around::

9:52 PM  
Comment Blogger Duane said...

Wow. What a pleasant surprise! Thanks Rayna. That was so thoughtful of you. Thank you.

10:02 PM  
Comment Anonymous Anonymous said...

Get well soon! I'm so glad to hear you're on your way home. And make sure you take that anti-shingles medication because I don't know if you've ever had shingles, but they SUCK. I had them in undergrad and they took almost a month to go away, and I could barely sit down in a chair for a few weeks because it hurt my back so badly. you know, just in case you were planning on contracting shingles or something. ;)

Enjoy home! Sleep, rest, and watch some excellent movies! And be thankful you won't be in Chi-town tomorrow, because it's only supposed to be 13 degrees.

Cheers, Sarah

1:44 PM  

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