UMCU Dag 2 – Start chemo

Op verzoek van Dolf zorg ik, Marjolein, voorlopig voor zijn blog.

Gelukkig was Dolf al opgenomen in het UMCU, toen het vannacht opeens toch nog slechter ging. Pijn in zijn milt, overgeven, diarree, naast hoge koorts. Besloten is antibiotica te gaan geven, naast zwaardere pijnstilling.

In de loop van de ochtend was de koorts, ondanks paracetamol tot 40 graden gestegen. De zaalarts van de afdeling hematologie, waar Dolf ligt, heeft uitgebreid overlegd met het team en met Dolf’s vaste hematoloog. Alle testen die infecties kunnen aantonen, zijn gedaan en hier is uit gebleken dat hij geen infectie heeft.
Het hb (rode bloedlichaampjes) is binnen 2 dagen 1 punt gedaald, nu dus 4,7…. Eerste vraag was: Zou de milt bloed lekken? Dit wordt echter uitgesloten. Wel was er vandaag dus weer een bloedtransfusie nodig, weer 2 zakjes bloed….

Ook de saturatie (hoeveelheid zuurstof in het bloed) is te laag, 90% . Er wordt besloten zuurstof bij te geven d.m.v. een slangetje in zijn neus.

In de middag hebben we een gesprek met de hematoloog en 2 verpleegkundigen. In overleg met Dolf’s eigen hematoloog is besloten, ondanks de koorts, met de chemo te starten.
Naast een infectie kan koorts namelijk ook door de acute leukemie worden veroorzaakt, de zogenaamde “tumor-koorts”. Omdat er geen infecties kunnen worden aangetoond, zal dat waarschijnlijk wel het geval zijn. De leukemie is zeer actief het lichaam aan het aanvallen.

Conclusie: er moet z.s.m. met de chemo-therapie gestart worden. 

Globaal is het behandelschema als volgt: vandaag starten met 2 soorten chemo.
De ene soort gedurende 3 dagen, de andere soort gedurende 7 dagen. Daarnaast antibiotica, en allerlei andere middelen die virussen, schimmels en andere bedreigingen moeten onderdrukken.
Ergens in deze week ontstaat de zogenaamde “dip”, dat betekent dat er geen witte bloedlichaampjes meer zijn. Allemaal uitgeschakeld. Er moet 3 weken gewacht worden, voordat de volgende chemo-kuur toegediend mag worden. In deze periode is de weerstand dus tot 0 teruggebracht. Dan volgt weer een week chemo. In deze 3 weken zullen er vele bloedtransfusies nodig zijn, om de rode bloedlichaampjes en bloedplaatjes aan te vullen. Een probleem is, dat witte bloedlichaampjes niet met een bloedtransfusie kunnen worden aangevuld. Strenge hygiëne-regels moeten gevolgd worden, strenge leefregels, streng dieet, en last but not least geen bezoek. Ook niet even of om een speciale reden, gewoon geen bezoek.

De zoektocht naar een donor is vorige week gestart. We hopen dat, aansluitend aan de behandeling van de acute leukemie, de stamceltransplantatie kan plaatsvinden, want dat zou het beste zijn…

Vandaag is een centrale lijn ingebracht. Dit is een infuus dat direct is aangesloten op een grote ader, 2 cm van zijn hart. Met een echo wordt de weg die het plastic buisje (45 cm lang) aflegt, gevolgd. Eigenlijk een soort mini-operatie. Na afloop van het inbrengen is een röntgenfoto gemaakt, om te controleren, of  het goed zit. Als je zo’n centrale lijn hebt, hoef je niet de hele tijd geprikt te worden. Er zitten 3 ingangen aan en alles kan erdoor: chemo, medicijnen, eventueel voeding, vocht. Bovendien kan er ook bloed door afgenomen worden. Hoe minder geprikt hoeft te worden, hoe beter, want dan is er ook minder risico op infecties.

20.00 uur ’s avonds
Het eerste zakje chemo is ingelopen…. Extra vocht wordt toegediend om schade door de chemo aan de nieren te voorkomen. Daarnaast is de hoeveelheid prednison verhoogd en is de inname van de chemo-tabletten die Dolf tot nu toe moest innemen, gestopt. Ook wordt er nog extra antibiotica toegediend, breed spectrum ter preventie van infecties.

En hoe gaat het nou met Dolf? Dolf is nuchter, optimistisch, houdt goede moed, blijft grapjes maken, maar hij is wel realistisch. Het gaat er om spannen en een lange weg te gaan…

379 gedachten over “UMCU Dag 2 – Start chemo

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  42. Sherry – So glad you are blogging again! Hope you are flenieg well and getting enough sleep. My pregnant belly is currently full of cheese mints I made for a baby shower. Hope baby likes cheese mints. We found out we are having a girl! We will name her Leila after Ken’s granny Lelia. Miss you! Love the pics. Your kids are darling!!!Love,Sherry

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