jm's Adventure with Multiple Myeloma: Neutropenic Precautions

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Showing posts with label Neutropenic Precautions. Show all posts
Showing posts with label Neutropenic Precautions. Show all posts

Wednesday, March 27, 2013

Pomalidomide (Pomalyst) Update For Relapse After Cycle 1- 21 Doses - March 27 2013

Drove to St. Luke's Hospital in Twin Falls to have my blood tested after Cycle 1 Pomalidomide (Pomalyst) 4 mg for 21 days, plus 2 days off. Each Cycle 1 consists of 21 days of Pomalyst with Dex 40 mg on Days 1 ,8, 15, and 22 of each 28 day cycle.

I divided my Day 22 - 40 mg Dex in to two doses over 2 days (12 mg and 28 mg).

My white blood cell count remains quite low at 1.5 (norms 4.5-11); ANC (absolute neutrophil count) remains quite low at 0.89 (norms 1.9-8.8), so I'll be living in my N-95 mask when out in public; hemoglobin is as low at 8.1 (norms 12-16) as it has been for a long time and it is no wonder I get out of breath when I walk. They do not give packed red blood cell transfusions for low hemoglobin until the value drops below 7; platelets are real low too at 34 (norms 140-440) and I will keep my daily anticoagulant Fragmin Injections at 7,500 units. They don't give platelets transfusions until the platelets drop below 10. When and if I would need transfusions, I would require irradiated cells because of my 2 failed autologous stem cell transplants.

Communicating via email, both Dr. Smith (UCH- Aurora, Colorado) and Dr. Padavanija (St. Luke's Hospital - Twin Falls, Idaho) do not think I should go off the anticoagulant Fragmin injections vs the new oral anticoagulant, Xarelto - so, I'll continue using the DULLEST NEEDLES in the world that come on the pre-packaged Fragmin injections!

My LDH (an broad indicator of inflammation) has been within the normal range for the last two assessments. 505 (norms 313-618) on 22 Mar 2013 and 535 on 27 Mar 2013.


My kidney function tests are NORMAL today. Creatinine 0.81 (norms 0.52-1.04); BUN 11 (norms 7-17); and GFR >60 (norms >60). This is good news.

My calcium was tad low today at 8.1 (norms 8.4-10.6). And I was experiencing a bit of tingling of my lips - very similar to when I had low calcium during apheresis collecting my stem cells prior to my autologous stem cell transplants. I ate some pudding and had cheese stick which helped some.



Received my 30 mg monthly dose of Aredia (bone building medication) intravenously. I took Claritin 10 mg and 500 mg Tylenol with it to help prevent the flu-like aches and pains Aredia can cause.
I was at St. Luke's 4 hours (10 AM to 2 PM), but they gave me lunch and snacks.
 My Dex look (steroid).
Drove back home to Mackay arriving about 4:30 PM. 
Stopped to check on Dad who has been complaining of a sharp pain in his right knee area, but he told me it was gone now.

Ron brought Kemmer home with her feet COVERED in BLACK MUD - they went rock hunting! We hooked up the hose outside and washed her feet the best we could. I'll have to check Kemmer for ticks as it is that season again.

I had a salmon steak and canned spinach for dinner and fell asleep on the sofa! With my ANC (absolute neutrophil count) so low at 0.89, I have to be careful about my diet again and not eat things like salad, cold-cuts unless they are heated, and no left overs. The St. Luke's Hospital nutritionist Alisa came to talk to me today - she is so knowledgeable.


Monday, May 14, 2012

2nd ASCT Day Minus 4 Update Afternoon - May 14 2012

Dr. Han Myint and NP Shannon came by early to visit. Dr. Myint said I could expect the worst of my symptoms beginning May 21-25th next week. 

Right now, I continue okay today and I'm still able to eat between naps. I did the treadmill for 15 minutes. The nurses give me Maxidex eye drops 4 times a day to prevent some chemo related side effect from Cytarabine. I also have to sign my name each time to make sure I have no fine motor neurological sign effects.
One of my blog followers sent me the nicest greeting card today. Cheryl lives in Charlotte, North Caroline and somehow her card found me here at UCH today.
Shawn and Tom Egle stopped by for a visit to day too - but, I forgot to get a photo. Shawn looks great and continues to search for the best course of action for her myeloma relapse in mid-January 2012.

I had several visits from physical therapy today and nutrition. Everyone is trying to hard to make this stay good for me. Even the head of nutrition called me and he is really going to try to improve my food choices while here.

My 4 PM blood values drawn by RN Nicole are still doing well.
My 4 PM lab values show a norm white blood cell count at 4.8 (norms 4-11.1); almost normal platelets at 145 (norms 150-400); and low hemoglobin at 9.1 (norms 12.1-16.3).

Jani arrived this afternoon and I rode the exercise bike for 5 minutes. 
Had some dinner and promptly slept through the shift change.
Signs on my door warning of neutropenic precautions.