Post Stem Cell Transplant --
I won't be getting personal tonight about the 5.25 millions babies Poppy birthed today. He had two bags that began at 10:00 a.m. and finished up at 10:21 a.m. I'm not going to share tonight about us deciding where we are going to sleep because of his odor. A shower doesn't help and he will smell the next few days. I'm not going to share today about his BP peaks that were as high as 155/72. I won't share with you today about our argument about a thermometer and as a result he slept downstairs much of last night and then we switched about 4:00 a.m.
I would just like for you to read the post stem cell infusion information. Then, I will share the above humorous stories tomorrow... He has about 17 days to recovery.. That means it will take that long for his WBC, RBC and platelets to get back to normal...
Enjoy the following -- I may give you a test later......
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There is an odor sort of like creamed corn, which is from the solvent (DMSO?) that the stem cells are stored in as they are frozen down to the temp. of liquid nitrogen. IT is very pronounced on one's breath and through the pores after the infusion of stem cells.
The big day: infusion of stem cells
After the conditioning treatment, you will be given a couple of days to rest before getting the stem cells. They will be given through your IV catheter, much like a blood transfusion. If the stem cells were frozen, you might get some drugs before the stem cells are given. This is done to reduce your risk of reacting to the preservatives that are used in freezing the cells.
If the stem cells were frozen, they are thawed in warm water then given right away. For allogeneic or syngeneic transplants, the donor cells may be harvested (removed) in an operating room, and then processed in the lab. Once they are ready, the cells are brought in and infused (given to you). The length of time it takes to get all the stem cells depends on how much fluid the stem cells are in.
You will be awake for this process, and it doesn’t hurt. This is a big step and often has great meaning for recipients and their families. Many people consider this their rebirth or chance at a second life. They may celebrate this day as they would their actual birthday.
Infusion side effects are rare and usually mild. The preserving agent used when freezing the cells (called dimethylsulfoxide or DMSO) causes many of the side effects. You might have a strong taste of garlic or creamed corn in your mouth. Sucking on candy or sipping flavored drinks during and after the infusion can help with the taste. Your body will also smell like this. The smell may bother those around you, but you might not even notice it. The smell, along with the taste, may last for a few days, but slowly fades away. Often having cut up oranges in the room will offset the odor. Patients who have transplants from cells that were not frozen do not have this problem because the cells are not mixed with the preserving agent.
Other short-term or immediate side effects of the stem cell infusion might include:
- Fever or chills
- Shortness of breath
- Hives
- Tightness in the chest
- Low blood pressure
- Coughing
- Chest pain
- Less urine output
- Feeling weak
Again, side effects are rare and usually mild. If they do happen, they are treated as needed. The stem cell infusion must always be completed.
Recovery after infusion
The recovery stage begins after the stem cell infusion. During this time, you and your family wait for the cells to engraft, or “take,” after which they begin to multiply and make new blood cells. The time it takes to start seeing a steady return to normal blood counts varies depending on the patient and the transplant type, but it’s usually about 2 to 6 weeks. You’ll be in the hospital or visit the transplant center daily for at least a few weeks.
During the first couple of weeks you will have low numbers of red and white blood cells and platelets. Right after transplant, when your counts are the lowest, you may be given antibiotics to help keep you from getting infections (this is called prophylactic antibiotics). You may get a combination of anti-bacterial, anti-fungal, and anti-viral drugs. These are usually given until your white blood cell count reaches a certain level. Still, you can have problems, such as infection from too few white blood cells (neutropenia), or bleeding from too few platelets (thrombocytopenia). Many patients have high fevers and need IV antibiotics to treat serious infections. Transfusions of red blood cells and platelets are given until the bone marrow is working again and new blood cells are being made by the infused stem cells.
Except for graft-versus-host disease, which only happens with allogeneic transplants, the side effects from autologous, allogeneic, and syngeneic stem cell transplants are much the same. Problems may include gastrointestinal (GI) or stomach problems, and heart, lung, liver or kidney problems. (We will talk more about these later, in the section called “Problems that may come up shortly after transplant.”) You might also go through feelings of distress, anxiety, depression, joy, or anger. Adjusting emotionally after the stem cells can be hard because of the length of time you feel ill and isolated from others.
Good Night and Love -- Pepper
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