We are now at day 6 after the stem cell transplant, and George is definitely at a low point. His counts have dropped very low - close to zero for platelets and white blood cells, although red blood cells aren't quite as bad. George woke up at 5:00 a.m. this morning with a fever of 100.6, and the doctors told us to call the blood center if it got above 100.5, because this could indicate infection. So, I called the blood center and the doctor on call told me just to give him some Tylenol and come in for our regular appointment at 8:00 a.m. On the weekends we have been going to the Presbyterian St. Luke's infusion center because the Blood Center is closed. When we told them what was going on, the nurse said, "OK - this is First Fever", as if it is a very common occurrence. She got him on an IV antibiotic (they actually administer it through his port) right away, and took some blood samples to be cultured to figure out if it is an infection or just what they call a "neutropenic fever". The doctor doing rounds today told us that each transplant is unique, and they have to be prepared for all kinds of crazy stuff happening. Since George has no capacity to fight infection right now, any bacteria circulating in his system, even from something as simple as brushing his teeth, could potentially cause a fever.
I guess fevers in transplant patients are pretty common, though, because before we even started this process they made us sign a contract with a home care company who delivered a box of antibiotics and tubes for us to keep ready at home. Today I was told that I would need to administer IV antibiotics to George three times a day at home. So, I learned how to mix the antibiotics, how to hang them from a pole that we have at home, and how to get them going in a line right into George's port. I also have to flush the port with saline and heperin. Yikes - that is a lot for a person who definitely NEVER wanted to go to med school.
So, while George was starting to feel a little bit better yesterday, today has been his worst day yet. He has been extremely tired and it has been difficult to get him to eat anything. At least I got him to drink a big glass of Gatorade tonight. I have to give him the antibiotics tonight at 10:00 and again at 6:00 a.m. tomorrow. I hope these start doing the trick. We should know more when we get the culture back tomorrow.
We're just counting the days until engrafting takes place and Geo can start feeling better again.