High dose chemo

Today was the first of two days of the high dose chemo. The chemo drug is Melphalan (aka Alkeran) - it has been around a long time and has been called the "mother of all chemo". We are told that Doug is getting approximately 5 times the standard chemo dose. This is going to destroy most of the myeloma cells but will also wipe out his bone marrow along with other normal cells. On Thursday he will get his stem cells back to "rescue" him. Right before the chemo started, while we were waiting for the Dr. to come in, I asked Doug what feelings he had, thinking maybe he would say something philosophical. He answered "boredom". So much for deep thinking. Better to be bored than anxious. I think I was anxious enough for both of us. Its not every day that one voluntarily takes a lethal dose of poison. We know that many other people have had stem cell transplants and have done well, so I try not to worry.

There was really no drama today. The Dr. came in to check Doug's vital signs, the nurse drew blood for the many tests they do each day. Two different "pre-meds' were given by I.V. (using Doug's central line) -- Kytril (nausea prevention) and Decadron. The actual Mephalan was a very small bag and only took about 30 minutes. Then a flush of saline. As you can see in the photo, during the infusion Doug played with his Nintendo D.S. We were in the clinic for three hours.

We left with prescriptions for 7 different meds:

• Lansoprazole (Prevacid) to prevent heartburn


• Fluconazole (Diflucan) to treat/prevent fungal infections


• Levaquin to treat/prevent bacterial infections


• Acyclovir to treat/prevent viral infections


• Kytril for prevention/treatment of nausea


• Compazine for prevention/treatment of nausea


• Lorazepam (Ativan) to relieve nausea

As you can see, he is well medicated. Those of you who are praying for us, please pray for no infections. We know those prayers are powerful!

We are to take Doug's temperature several times a day and record it. If his temp goes above 100.5, we have to call the clinic. If this happens during the night, they will send out a home care nurse. They really do not want the transplant outpatients to come into the hospital via the emergency room; that would mean exposure to unknown germs. This afternoon, a messenger delivered two large packages to our hotel room: one was an I.V. pole, the other was a box of medicines. These are in case the home health nurse needs them for urgent treatment of a fever. Makes me think of the Boy Scout motto "Be prepared".

So all is well. Doug has had no nausea yet - those drugs are working! We go back to the clinic in the morning for the second and last round of high dose chemo.