Thiotepa

Day 131 (D - 7)

Each morning at about 6am a technician comes to Ann's room to collect blood specimens for the lab work done each day. Typically these specimens are collected through Ann's CVC. However, this morning there was a problem getting a blood to flow out of the chatheter, or "blood return", so they had to call in the IV team who placed the CVC to diagnose the problem. This happened yesterday as well, but the event was pretty anti-climatic so we didn't include it in the blog post.

Yesterday the problem was treated with clot buster drugs. However, after this morning the IV team nurse decided that the real problem is the placement of the CVC line. It is probably laying against the wall of the artery it is installed in and every now and then it gets blocked. I'm really hoping that this does not mean that the CVC needs to be replaced. The less invasive procedures we have to do at this point in time the better. The IV Team Nurse tended to agree and thinks that the problem may resolve itself.

Prior to mobilization Ann talked to a few transplant patients to get an idea as to what to expect. They had various bits of advice to offer, but one thing that they all agreed on was that the effects of the mobilization chemo really didn't kick in until a week or so after Day 0. Ann it seems is the exception the the rule. The Melphalan she got yesterday has really started to do a number on her. On top off that she was introduced to Thiotepa for the first time today.

The Melphalan is killing her appetite and making her nauseous. To boot her energy level is dropping really quickly. Yesterday we managed to go for a mile walk with little prodding on my part, where as now I'm going to have to harass her to just get out of bed.

The Thiotepa is leaching out of her skin and causing uncomfortable burring sensations on her skin. She has taken three showers today to clean it off, and will probably take two or three more before the day is over. If she doesn't there is a chance the effected sections of skin, mainly around the joints, could get a chemical burn and become infected.

I think that its too early to say if the quick onset of what I call "chemo fatigue" is a a bad sign or not. It could be that Ann has been free of the Hyper-CVAD chemo regiment she started treatment with for leukemia, for over a month now and she could just need to get over this rough patch. On the other hand on thing I have learned is that it is inherently difficult to read anything quantitative from vague symptoms like fatigue or being overly sleepy. After all considering what the chemo is doing to her on the inside she should be feeling tired, awful or both.

In other news I think Ann's bank finally got straightened out today. It will be nice to be able to fully concentrate on Ann and getting her better, rather than get distracted by that mess.