The Handoff - Day +6 & +7 - 5/13/2022

It's Friday the 13th and it has definitely struck as unlucky for John. Today was the day he handed over the baton and put me in charge of updates until further notice.

We knew this day was coming when he felt less that normal Thursday.

Day +6 was certainly the roughest day since the transplant process started. He had started a fever at 4:00 a.m. and the team was on high alert to start precautions. He was having small fevers throughout the day which were controlled with Tylenol pretty well. He had very little appetite and he didn't even feel like getting up for his normal laps around the nurses' desk. He managed to avoid a transfusion today but was on the verge. He still had enough energy to have short conversations when the phone rang but you could tell he wasn't himself.  

His Day +6 nurse was Russ who said this was the time when they start really watching patients for infection and neutropenia and not to worry. His blood counts had already dropped to a level that warranted antibiotics and they were taking cultures to identify the origin of the fever. He was in great hands; he was at The Mayo.

Day +7 - if you believe in superstition, you know Friday the 13th is the day to expect bad things. I called his night nurse Ebonee at 6:00 a.m. to see how the night had gone. She told me it had been rough and his fever had stayed high through the night, but that is when people generally run higher temps. His hemoglobin and platelets were below the threshold of transfusion and he would get them when they took him across the hall for dialysis at 6:30 a.m..  

I had a busy work morning so I hadn't checked in after the morning call, and I knew he would be away from his room for at least 4 hours. I tried texting him a few times between meetings just to see how he was feeling and had no response.  Finally I had a break at noon and I called. Russ was back on duty and said it had been a really rough morning with his fever over 103 repeatedly. While at dialysis they had to call the Rapid Response team to check him out because his BP was in the 210s. His heart rate was in the 120s and he had uncontrollable shakes and wasn't responding. They weren't too worried that the BP or heartrate were anything more than the response to the temps so they started him with ice packs under his armpits, his chest and back of his neck, continued the Tylenol, ran a lot more tests and added another IV antibiotic. Now you all know what the pros do when you run a fever, ice packs. They also turned the A/C as low as it would go on full blower. When I went in around 3:00 p.m. it was like a meat locker. He was communicating but not much and couldn't remember anything from the morning. He didn't feel like eating anything all day but agreed to let me help him into the chair since he wasn't up for a walk. He told me to turn on the TV and proceeded to zone out. 

I called Russ in and again his fever, BP, and heartrate were all extremely high but nothing was culturing for infection so we got him back into bed and started the ice packs while he shivered. 

Yesterday we had talked about this and he said if he wasn't able to write an update in the next few days that I should let everyone know that this is to be expected. His body is in overdrive trying to recreate his bone marrow. That he is in the best place possible and he has an amazing team watching over him. Most importantly that if you call or text and he doesn't respond, he isn't intentionally ignoring you. He greatly appreciates all of the prayers and thoughts. This may continue for the next couple of days but when he is feeling more clear and able, he will respond. 

If you'd like to understand more about the Stem Cell Transplant and what it does to your body, check out this simplified explanation by the International Myeloma Foundation. 

Thank you, Julia