Jodi's life in the hospital

Jodi is on Hospital Day #3 today but Day 0 for her stem cell transplant. Let me explain:

A quick note about what kind of patient Jodi has been:

She has received excellent attention and care. Many of the staff on the stem cell unit have sent me emails, voicemails, calls etc and they all share the theme that she is their favorite patient and so pleasant and funny and an "amazing person". I knew that this would be the case and actually I am proud that she is at my place of work not only because it is a great hospital but also because I knew she would be a pleasure to treat as a patient and this bodes well for me in multiple ways. I will have less resistance when admitting to their unit from the ER and already many of the nurses and doctors who have interacted with her have already made my work easier. They genuinely like her and Ed and ask a ton of questions about both of them. It is beyond the level of just feeling sorry for me, which without a doubt has some effect but their level of interest and concern is far beyond the "I feel sorry for you" point. 

Thanks mom and dad for making me proud. Is so nice to have a pleasant and wonderful patient when you have a stressful shift and 80% of the patients are not that way. 

What is Jodi going through in the hospital and what is her treatment? 

Melphalan:

Monday and Tuesday she received a chemotherapy medication as preparation for her transplant. She had not received this medication in the past and this medication has a side effect list that is a mile long like many of the chemotherapy medications she has already been taking. The medication  is called Melphalan.

Melphalan is used to treat multiple myeloma, which as we have already discussed, is a cancer in the bone marrow .

Melphalan is an alkylating agent. Basically it works by interfering with the growth of cancer cells, which are eventually destroyed. The medication seeks out rapidly dividing cells (cancerous cells). The cancerous cells have lost their inhibition and keep dividing and growing out of control so this medication recognizes these out of control cells and kills them. Melphalan is used as part of the Stem cell transplant process to blast the remaining cancerous cells before the new healthy cells are transplanted.  The dosing and length of treatment varies depending on many things. Jodi only required 2 days of this medication on Monday and Tuesday which is a very short cycle as she has continued to respond very well.

Wednesday 6/23 Jodi Started the Stem Cell Transplant infusion

Stem cell transplantation. This treatment involves using high-dose chemotherapy —high doses of melphalan — along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells in Jodi’s case came from her own body and were harvested from her bones a couple of weeks ago.

A stem cell transplant is the infusion of healthy stem cells into your body. A stem cell transplant can help your body make enough healthy white blood cells, red blood cells or platelets, and reduce your risk of life-threatening infections, anemia and bleeding.

Although the procedure to replenish your body's supply of healthy blood-forming cells is generally called a stem cell transplant, it's also known as a bone marrow Stem cell transplants can use cells from your own body (autologous stem cell transplant), or they can use stem cells from donors (allogenic stem cell transplant). In Jodi’s case she has bee fortunate enough to use her own cells which means no need for anti-rejection medications that are notorious for causing complications and worse out comes.

Next:

Stay tuned for further updates. Jodi will be monitored and evaluated to see how her body handles the new stem cells and integrates them into her system. Her weakest day or most immuno-compromised day will be this Saturday or Sunday as all of her bone marrow will have been shut down and the new stem cells will still be developing into new healthy bone marrow . In addition some of the side effects of the infusion and the high dose chemotherapy may start to kick in.

Jodi has done better than anyone could have predicted both with her minimal side effects thus far and her body’s response to the therapy. Everyone on the team has been very pleased and surprised with the results. I have been able to look at all the imaging, laboratory and clinical data and can confirm that so far the results have been miraculous.

Jodi checked into "the bubble" (stem cell unit) at the hospital Today 06/20

Jodi successfully entered the hospital to start the autologous stem cell transplant (using one’s own stem cells to transplant one’s own bone marrow)

Thank You:

Jodi has expressed a great amount of gratitude with regards to all of the outpouring of love and support by her friends and family. Thank you, Thank you and Thank you for all of your support, emails, phone calls, good vibes, payers and thoughts! It has been felt and helped. I assured Ed and Jodi that I would express this on the blog but as you know, there are no words that can express the gratitude Ed and Jodi have for all you. So thank you!!

Updates:

Before I describe the process and what she will be going through over the next couple of weeks I should probably update everyone on how she has been doing / responding thus far. The bone marrow transplant process deserves a post all on its own. 

First things first, the update:

Jodi has had nothing short of a miracle thus far in her treatment. Her body's response to the medications has been beyond what anyone expected. Her cancerous cell have nearly halted in their progress and the correlating cancer marker cells have declined 10 fold.

Also the negative side effects have been way less than expected. The medications (chemotherapy) thus far have been Velcade (Bortezomib),  Revlimid (Lenalidomide), and Dexamethasone and all of these medications have a long, long list of side effects, many of which are very commonly seen in most  patients.

Now we are known for hyperbole at times but it is no exaggeration that thus far the only side effects that Jodi has experienced from her medications have been fatigue, weakness, and mild occasional delirium (short term memory loss and or confusion, that is temporary and reversible). Jodi feels that she has had hair loss but she definitely has not lost her hair. She has experienced some hair thinning but still has a full head of hair and no large clumps of hair falling out like often seen in patient’s on these medications.

She has had minimal pain and has continued to remain considerably active definitely tired.

I have seen patients on these same medications end up completely bed ridden and moaning in pain and plagued with complications that are quite serious. She has been blessed to avoid these issues.

Here bad numbers have improved and good numbers have gotten better as far as her lab work is concerned. Her kidney function is normal, her calcium levels are normal, her hemoglobin is normal. She is on a trajectory at this rate for a fast induction into remission and a positive outcome.

She successfully completed her pre- autologous stem cell transplant (using one’s own stem cells to transplant one’s own bone marrow) chemotherapy cycles and has entered the next phase of her treatment. This phase includes hospital admission to the stem cell bone marrow transplant unit where she will have her own healthy bone marrow transplanted back into her bones.

What is going on now and what is the next phase: 

I will add another post dedicated to the transplant process that Jodi started today. Stay tuned for more……..