Saturday, 2 February 2008

What's Next

Starting this blog to help keep everyone up to date on Eric's stem cell transplant.

To back up a bit, Eric was diagnosed with
Hodgkins Lymphoma in August 2006. He received 6 cycles of ABVD and went into remission. In December 2007, a routine CT scan showed enlarged lymph nodes in his abdomen and suspicious spots in his spleen. He had relapsed. He has taken this semester off from the University of Ottawa and has quit his part time job to focus on getting better.

Plan now is to prepare for an
autologous stem cell transplant but we have a detour in the plan.

Eric received a chemo cocktail named DHAP Jan 4 -5. This is a much stronger drug combination than ABVD and the side effects hit fast and furious. Severe nausea was brought under control within a few days but re-hydrating continued to be difficult. By Jan 10, Eric was in hospital (out patient) receiving fluids and running a mild fever. As neutropenia is a serious risk with most chemotherapy, a fever is worrisome. He was finally admitted Jan 12 and started on IV antibiotics. Blood cultures later confirmed bacteria in his bloodstream and CT scans and MRIs illustrated advanced cellulitis and an abscess near his colon. Typical response would have been immediate surgery but with white blood counts continuing to fall, surgery was out of the question.

Eric had several units of whole blood and platelets, the IV antibiotic was changed to Vancomycin and neupogen shots continued while we waited for his white counts to rise enough to drain the abscess. Sure am glad that so many people give blood regularly. It is a real eye opener to see the amount of blood that is needed when you sit around a hematology ward for awhile.

Minor surgery on Jan 21 relieved most of the pain, his fever disappeared and Eric was able to be discharged on Jan 23. He continued IV Vancomycin and Ertopenen as a daily out patient for another week.

So where does that leave us?

At this point, more chemo is too risky as that darn abscess could flare up again when Eric's white counts drop. Dr Huebsch (new hemotologist who leads the Bone Marrow Transplant team at the Ottawa General Hospital) has suggested that we try to harvest stem cells very quickly while Eric's blood counts are good. Because Eric's blood counts have always reacted very strongly to chemo, there is concern that too much chemo will prevent us from collecting enough stem cells for the transplant. Significant is that there are limited apharesis machine (to collect stem cells) and this change in plans for Eric will mean a reschedule for another patient. His case goes to the team review on Monday so we will know more next week as far as the final plan and dates.

So it means we have a weekend off!! We really need to re-celebrate Eric's birthday while he is feeling so good! Poor guy had to have his Senator's birthday cake in the hospital...

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