Chia Pet Tongue

Lucky 13

Chia Pet Tongue
(Pam cooperated because she is on drugs)

Today is day 13 since the transplant.  Pam called me early this morning because she was feeling terrible: blowing chunks, having the poopy-scoots, and her mouth and throat pain are much worse.  Her tongue looks like a Gross Chia Pet because of opportunistic fungus.  (This is an expected part of immunosuppression... not a big deal, just gross looking.)


A Rash Thought

But... we think we may have GREAT news... she is also getting a rash.

Let me explain: A distinctive rash is one of the expected symptoms of Graft vs. Host Disease, or GVHD, and GVHD is an expected side effect of an Allogeneic Stem Cell Transplant, like Pam's.


Day +13

It occurs because the immature stem cells are "doing their thing"... they are looking for a fight, and they recognize the patient as being a foreign invader so they attack everything in sight, including skin, which causes the rash.

Dr. Holtan has emphasized to us repeatedly that "there will always be GVHD, it is expected, and some GVHD is actually a good thing". So, she was pleased and excited when she saw Pam's rash this morning. Weird, huh? Some tests are being done on the rash to see whether or not it is a side effect of GVHD and not a drug allergy. We should get the results in 2 days. Keep your fingers crossed!

Bag Countdown

Lots of bags hanging on her IV stand now, in addition to her pain pump.  She will be getting nutrition through another bag this evening, as I expected.  She is also continuing to get blood or platelet transfusions every 2-3 days. 

The number of bags hanging here are a good indicator of how close she is to getting out of here and going home... as you can see, we have about 7 or 8 bags to go.

Obviously, she is taking a LOT O' DRUGS right now, among them Dilaudid for pain, Benadryl for itchiness, and Tacrolimus, which is an anti-fungal agent.  Her nurse, Amy explained to me that the combination of the Dilaudid, Benadryl, and Tacrolimus can cause auditory and visual hallucinations.  "So she could wake up thinking she was just talking to a vampire or something."  I told Amy that she does that normally without the help of any drugs.  She is a little disoriented already and has lost track of days and time.  When she wakes up she can't hazard a guess whether it is day or night, morning or afternoon right now.

How about a blanket?

I asked her about 30 minutes ago if she wanted a blanket.  She said "OK" about a minute ago. I said "OK what?". She said "OK, I'll take a blanket, please."  I said "You are on drugs. Here is a blanket."