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JenM's Experience - SCT at Robert Wood Johnson in NJ

by JenM on Mon Feb 23, 2015 10:17 pm

I haven't posted much on these forums but I have relied heavily on them since being diagnosed with multiple myeloma in October 2014. In the four months since, it's been a quite a whirlwind.

I went through three cycles of CyBorD (cyclophosphamide, Velcade, and dex) with a happy outcome - complete remission! I had zero presence of malignant cells when I had a bone marrow biopsy done after those three months. Like many of you, I debated whether to have the SCT now or save that for later. After talking with my husband and my medical team, I decided to move forward. His opinion (the doctor, not my husband ;) ) was that now was the PERFECT time to do this. An analogy that was given to us that was really helpful was this: Think about the treatment plan like a boxing match, with the jabs being chemo and the transplant being the knockout punch. Since I am playing for nothing less than an infinite complete remission (until there is a cure for this .. and I believe there will be), I decided to move forward with the SCT. I recognize this was the decision; it felt right for me, and may not be for everyone.

So today is Day 1 (or -2). I checked into Robert Wood Johnson Hospital in New Brunswick, NJ around 9:30 a.m. and was in my room not too long afterwards. I am in the Bone Marrow Transplant Unit in a private room (naturally). I elected to have a port put in during my induction chemo because I have very uncooperative veins and figured it would make that process, and this one, easier. They took my vitals (height, weight, temp and blood pressure) and then left me alone for a while. A nurse walked us through a calendar of the next few weeks and what to expect, which was really helpful.

Another nurse explained some of the restrictions I can expect in the days / weeks to come, once the white blood cell counts have dropped. For example:

  • No contact lenses
  • No razors (well electric razors are allowed)
  • No typical deodorant / anti-perspirant; must be deodorant only
  • No cold cuts, fresh veggies, or fresh fruit (except bananas, because the outside of the peel hasn't touched the inside)
  • No "real" showers. While there is a shower in the bathroom, you can essentially only bathe from the neck down because you can’t get the lines (in my case, the port) wet. Same with washing hair. If you have a family member or someone else help you rinse it, you can wash it, but with the same precautions
  • No brushing teeth with a typical toothbrush, because of the risk of infection should your gums bleed.
I was on IV fluids for about two to three hours. Then I received pre-chemo medicine and then the melphalan. It is still incredible to me that only ONE HOUR of this has been shown to wreak so much havoc – nausea, diarrhea, and the dreaded hair loss. The melphalan itself was no big deal at all. My husband and I watched TV while it was going. I have been SUPER worried about mouth sores but have read a lot of tips on these boards. I ate ice pops and sucked on ice chips for about 30 minutes before, all throughout, and for probably 30 to 45 minutes afterwards to hopefully ward them off!!

One thing that has been really different than my last hospital stay when I was diagnosed with multiple myeloma is that this time I have my own pillow and comforter. And I got a memory foam mattress topper which makes a HUGE difference. I never would have imagined having a GOOD night of sleep in a hospital! Let’s see if it all works (of course this can’t combat the midnight and before-dawn vital checks).

My hope is to try and report back each day, while I have the strength and energy. I know I have read and re-read about other’s experiences and I hope I can help someone else about to go through this!
#gameon

JenM
Name: JenM
Who do you know with myeloma?: Me
When were you/they diagnosed?: October 2014
Age at diagnosis: 42

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by Eric Hofacket on Mon Feb 23, 2015 11:34 pm

Thanks for sharing your experience with us. I hope all continues to go well and keep us up to date on how you are doing. Best wishes,

Eric

Eric Hofacket
Name: Eric H
When were you/they diagnosed?: 01 April 2011
Age at diagnosis: 44

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by EF11 on Mon Feb 23, 2015 11:43 pm

Hi JenM - Thanks very much for reporting for those behind you! My husband is about the same age and was diagnosed the month after you. We are about a month from his SCT - I think it will get scheduled tomorrow when we meet with both his myeloma specialist and the transplant team.

Great idea to bring your own bedding. Any other words of wisdom or gift ideas for a patient approaching SCT?

Best of luck on your journey!! I Hope the popsicles will keep the mouth sores away!! I look forward to reading your posts to the extent you have the energy to share.

EF11
Who do you know with myeloma?: husband
When were you/they diagnosed?: November 2014
Age at diagnosis: 43

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by KLD on Tue Feb 24, 2015 12:14 pm

My husband is on Day +6 at the University of Michigan. He breezed through the first two days, then experienced nausea for 2 days until they found the right combination of meds and brought out the big guns. He has slept well most nights, amazingly.

Today his numbers are down but haven't bottomed out. He had an appetite for breakfast and so far has avoided the dreaded mouth sores. He has been walking all but one day and doing PT as much as he can. Fatigue is setting in a bit more each day.

We will be watching your journey and wish you the best.

To the other poster - We will be talking about a possible tandem at 100 days. My husband is 59 and entered the transplant without a complete response. Of course, this conversation will be had after new testing and biopsy.

KLD

KLD

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by CARME on Tue Feb 24, 2015 2:32 pm

Good luck! My husband starting his today. Feeling anxious

CARME
Name: Carme
Who do you know with myeloma?: Husband
When were you/they diagnosed?: August, 2014
Age at diagnosis: 63

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by JenM on Tue Feb 24, 2015 4:25 pm

Day 2 (or Day -1)

I had an okay night of sleep. Having my own things definitely helped, but what I hadn't counted on was the dose of dex that would be given with the melphalan. In the past, dex has made me restless and, despite having a long day, I had trouble falling asleep. I'm sure there were other reasons too :)

Today is supposed to be my "Day of Rest" between the melphalan and the transplant / infusion of stem cells. And I took great advantage of that for the earlier part of the day. Caught up on my sleep and then eventually got tired of being a lump and decided to take a shower and get moving! I did 22 laps around the hospital floor (wearing my mask of course!), which is over 1 mile. Not too bad!

Today I am surprisingly feeling nauseous. I say surprisingly because the nausea is not sup­posed to hit for a few more days. They gave me Zofran, which didn't seem to make a dent in it. I just took something else (can't remember the name - I'll find out), and I am hoping that will work. If not, the nurse said they would give me something around the clock. I have been on IV fluids all day and will get another dose of dex today.

I'm having a few visitors today (my husband and two of my closest friends). I wanted to get in the visits before my WBC plummets and I wearily look at everyone as if they are a waking germ!

As for other tips (other than bringing your own linens), I would say that I've already realized on Day 2 that I WAY overpacked! And mostly toiletries so far. Because of the restrictions I will have and, I imagine, just my general energy level, I don't think I'll need all that I brought. Luckily, my husband comes back and forth every day (we live about 40 minutes away) and brings a bag so that he can bring stuff up and bring stuff back as needed.

That's all for today. Tomorrow is the BIG day. Healthy cells are coming in! I'll definitely report back how it goes!

#gameon

JenM
Name: JenM
Who do you know with myeloma?: Me
When were you/they diagnosed?: October 2014
Age at diagnosis: 42

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by Eric Hofacket on Tue Feb 24, 2015 5:58 pm

In the past, dex has just made you restless? That would be a big understatement for me! Seems you are progressing well. I remember cycling though the anti-nausea medications till we found something that worked. I recall I used one in the daytime and another for night, but I forget what they were.

It is good to see you can get out and do laps around the floor. You are doing a lot more that I was able to do. Getting out of the room also gives the nurses and staff the opportunity to change the linens and clean the room without being in the way.

Best wishes and it is good to see you are doing so well. If you lose the energy to keep us updated, do not feel so bad. I could not have done it, and others who had plans to keep posting found later that, as the effects of melphalan started taking effect, they also could not do it.

Eric Hofacket
Name: Eric H
When were you/they diagnosed?: 01 April 2011
Age at diagnosis: 44

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by mikeb on Wed Feb 25, 2015 1:23 pm

Hi JenM,

Best wishes from someone else who also lives about 40 minutes from New Brunswick! I live in Monmouth County.

My main advice to you is to continue to exercise as much as possible throughout your trans­plant experience. You're off to a good start with that 1 mile walk in the hallway.

Mike

mikeb
Name: mikeb
Who do you know with myeloma?: self
When were you/they diagnosed?: 2009 (MGUS at that time)
Age at diagnosis: 55

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by JenM on Wed Feb 25, 2015 10:10 pm

Day 0 - SCT Today!!
(Day 3 in hospital)

Today was the BIG transplant. Such a fancy word for what is, frankly, a pretty underwhelming process. NOT the idea of what the cells are doing, of course, but the actual process itself. :)

There was a lot of activity before the cells themselves actually made their debut, including vitals being taken several times, and Benadryl (diphenhydramine and Ativan (lorazepam) in my IV. The Benadryl (which is to help prevent any possible reactions to the preservative put in with the cells while they are frozen) knocked me out before the 3rd bag of cells were finished.

The transplant happened with a nurse, transplant doctor, and transplant tech in the room - and my husband. I harvested 8+ million cells, so they gave me 1/2 today, or approximately 4 million cells. They were broken into three bags which were frozen and then given a warm bath in the room just before they were hung from the IV pole. I have a port and luckily they were able to use that for the infusion / transplant. We had been warned there could be a smell in the room during the process, but I barely noticed anything.

The rest of the day was pretty quiet. I was tired and slept on and off throughout the day. I still have an underlying feeling of nausea despite the fact they have been trying different things to bring me some relief. I was able to eat almost a whole bagel this morning and then a sandwich this afternoon, but tonight nothing is appealing to me at all, even water. I'm still getting tons of IV fluid, so no worries about dehydration or anything like that.

Tomorrow I will start Neupogen shots again to help with the white blood counts. I'm hoping it will hurt a smidge less when a trained nurse gives them rather than my husband! :)

Off to try and sleep now. Three days down and probably 12 - 16 to go (average length of stay here is about 17 days). Already bored, but I know that it will get tougher in the days ahead once the counts drops. And I'm guessing the last thing I'll be complaining about is BOREDOM!

#gameon

JenM
Name: JenM
Who do you know with myeloma?: Me
When were you/they diagnosed?: October 2014
Age at diagnosis: 42

Re: JenM's Experience - SCT at Robert Wood Johnson in NJ

by Eric Hofacket on Wed Feb 25, 2015 10:54 pm

Funny how our experiences are so similar. Three years ago, getting to SCT was the big event hanging out there in my future.

I remember when they came into my room with the melphalan. I knew it was coming, but did not know when, so it was a big surprise and I was nervous and had some anxiety. I watched as the melphalan started dripping into my IV line, knowing this was a lethal dose of chemotherapy, Without the stem cells that would follow later, I would likely die. And then nothing happened. It was anticlimactic.

Then the next day they brought in the stem cell bags. I was relieved that nothing had happened to them, no one accidently kicked the cord out on the freezer. This was it, the big event. In they went, which was also anticlimactic. It was done and over.

I did feel that this marked a new phase in my myeloma treatment and life going forward, which it was. No more high-dose induction therapy. Going forward, it was recovery and low-dose Revlimid for maintenance therapy.

In a few months, I was riding my bike again and managed to get some skiing in before the winter ended. The following summer, I climbed Half Dome in Yosemite National Park.

I hope all goes well for you too. Best wishes,

Eric

Eric Hofacket
Name: Eric H
When were you/they diagnosed?: 01 April 2011
Age at diagnosis: 44

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