Evolution of a PICC Arm Band

Today I share with you the evolution of a PICC Arm Band, and the innovative nature of my husband! When Joe had his PICC line placed last Thursday, they sent him home with this long folded up tube of "stuff." The idea was to snip off sections as needed and use those sections to cover his PICC. As you can see from the first photo, the material is cheap, kind of ugly, and it kept falling off. Plus, no matter how long we cut the material, once it was on Joe's arm it seemed to be too short.

Being the loving wife that I try to be and a joyful newbie knitter, I decided that it would be fun to knit Joe a PICC arm band. In fact, months ago, I remembered that I had come across a free pattern at KnitPicks.com. I even had the yarn that they recommended - one that they said "minimizes pilling and stretching." It really is a lovely yarn. And I knitted up the band in no time. It looked absolutely beautiful! (not that I'm bragging or anything) For the first five seconds that is, then it proceeded to prove that it in fact, maximizes pilling and stretching. At least when knitted up by a newbie like me. It looked perfectly snug when Joe put it on. Even a little bit tight. But once those first five seconds passed it proceeded to stretch enough it could have fit around his thigh. *sigh*

Being the innovative person that he is (and loving - Joe was really intent on making the arm band work!) Joe suggested using bicep bands to hold the arm band in place. PERFECT!

But then, my innovative husband came up with an even more perfect idea that will have PICC line wearers everywhere running to their nearest sports store. Joe was watching basketball, and noticed that a bunch of the players were wearing these sports sleeves (they are actually called shooting sleeves in case you are sports illiterate and curious.) They looked like they had just the right amount of stretch, and because they are made for athletes, we figured they had to be comfortable and breathable as well. Yes, yes, yes. Joe is a genius. Maybe Nike will hire him to create a line called "NikeChemo." (Are you listening Nike? huh, huh, huh? We LOVE YOU!) The sleeve works like a charm. It also has the added benefit of creating instant long sleeves, which is perfect for Joe since he has to cover up when going outside to protect his skin from the sun. The nurses at the BMT office were so impressed, they said that they were going to share the idea with all of their patients with PICC lines. Apparently, patients have come up with some pretty crazy excuses for arm bands. Joe's so smart. He's also a wannabe athlete. (shhh...don't tell him i said that!)

We received some hopeful news today! After a bit of a delay, we finally got Joe's CMV results from both this past Tuesday and this past Thursday. Both were NEGATIVE. We were so excited. Joe talked to one of the doctors on the phone today, and he could practically hear the doc jumping up and down with joy! This was a nice change from yesterday. Yesterday, Joe and I went to the hospital for his Cidofovir. Joe also ended up getting another platelet transfusion. When we met up with the doctor he sounded so serious and concerned about Joe's progress. We're still gunning for a miracle as far as Joe's next bone marrow biopsy. Another thing that gave us a little bit of hope today is that Joe's WBC has inched up a bit more. It is actually higher than it has been in weeks. Hopefully this is a good sign. Keep on praying!!!!!!! Second transplant - pshaw!

Don't forget. There are still a few more days to take advantage of the "Thanks Mom Marrow Donor Drive." You can register to be a donor for FREE if you sign up before May 21. Please, please, please, help us spread the word. It would mean so much to us. (Thanks Tina! We saw that you posted about it. :) )

Day +117

Thursday, Joe and I went back to the hospital for his third round of Cidofovir. If Joe is CMV negative on Monday, then we party! If he is still positive, then there is talk of giving him Ganciclovir and Cidofovir. There is a hope that the two together might effectively take care of the CMV.

Thursday, we knew would be a long day. The whole Cidofovir process takes 6 hours. (Joe also got platelets again, but that was relatively quick.)In the past, we usually went home around 2 or 3 in the afternoon. But last week was the Week of Waiting; we went home at 7pm. Still, we are blessed that Joe is able to go home. (Dear Baby Livi and her mom have been living at the hospital since her transplant two months ago.) Not only that, but we were blessed by a visit from our dear friend Sheena. You might remember that when Joe was admitted to the hospital shortly after being diagnosed, Sheena let me stay at her place many nights so that I wouldn't be as far from the hospital. Sheena started attending our church and fellowship the same time that Joe and I did. In the past four years she has become such a good friend. Unfortunately for us, she is finishing up dental school and leaving Pittsburgh this week. We're going to miss her so much!!!!!! Sheena has such a huge heart, and she is also just about as silly as I am. Actually, she may even be sillier. In any case, she made our long day at the hospital on Thursday feel much shorter. Thanks Sheena!!!!

Since Thursday, we have had a bit of a break from the hospital. Unfortunately, also since Thursday, Joe's rash has become increasingly worse. On Saturday, after a call to the doctor, Joe was put back on Cellcept - the immunosuppresant that was stopped when we first learned Joe's graft had dropped. This whole treatment process is so crazy. Lower the steroids and immunosuppresants and the GVHD starts to flare. Increase the meds and Joe's CMV becomes positive again. Then there is the chemo which initially lowers blood counts that are already low. Crazy.

When Joe starts to scratch he always gets a lecture from me...or a little slap on the wrist. This time around though, he is getting pretty smart. Joe will seemingly vanish into thin air, and the house will become very quiet. Then he will emerge again, looking a bit sheepish and with some patches of especially red skin. Very suspicious...

Our friend Sha invited me to go to the symphony with her on Saturday evening. I almost declined. I'm not with Joe all the time. But I am with him most of the time. Up until last night, all of my excursions were either during the day or they were only a very short distance from home. What can I say? I'm an overprotective wife. But Joe convinced me that he would be fine and that I should get out of the house - not only for my own sanity, but so that nice friends like Sha still love us once Joe is well enough to be out and about! Well, I had a wonderful time with Sha. It was a really fun night of music. Plus, I got to see my Uncle Kao. When I got home in the evening, I reenacted the whole experience for Joe. I'm not sure that the conductor or the musicians would appreciate my impressions, but Joe seemed to get a kick out of it. :)

We go back to the hospital in the morning. I'll keep everyone updated. Speaking of updates, check marrowtrek.org sometime this week. Jim & Jesse should be putting up an update on their progress soon!

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ANNOUNCEMENT

If you look at our links to the left, you will see that one of the girls in our prayers is named Kailee Wells. She is only ten years old and has already had two bone marrow transplants. Six years ago, her parents had an idea for a "Thanks Mom" bone marrow campaign. Since then they have been able to work with the NMDP to run a national bone marrow drive each year in honor of Mother's day. There are drives being held all over the country with a goal of 20,000 new registrants. You can also register online for free while funding lasts. The event runs from May 7-21. You can learn more here. Please, please, please SPREAD THE WORD!
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Thank you Sha for the lovely card that you sent!!!!

Thank you Indiana Mom & Dad and Monroeville Mom & Dad for visiting us this weekend and bringing food!

Again, I tell you that if two of you on earth agree about anything you ask for, it will be done for you by my Father in heaven. For where two or three come together in my name, there am I with them.
~Matthew 18:19-20

Keep up those prayers!!!!!!! (please)

Saturday...
Joe was started on Vidaza once again (a quarter dose like the last round). This was day two of round 2, post-transplant. On weekends the BMT office is closed, so Joe has to go to short stay. All of the nurses in short stay know us very well. It wasn't a very eventful day. For the last round of Vidaza, Joe had a line and thus he took advantage of the fact that Vidaza has been approved for IV administration. This time, since Joe doesn't have a line anymore, he has gone back to getting subcutaneous injections. With the quarter dose it is just one shot...not so bad, says the wife who isn't getting poked!

Sunday...
Joe had his blood drawn. Being a chemotherapy, Vidaza made Joe's counts even lower. Plans were made for a platelet transfusion to take place on Monday.

Monday...
The plan was to go to the BMT office. There we thought we might wait for 15, maybe 20 minutes for Joe to be called back to receive his Vidaza shot which would take a good 5 seconds. Then we would head up to short stay where we would wait about an hour for Joe's platelets. Platelets are fast, so the transfusion would take at most 15 minutes, and then we would be on our way home. We figured everything would take 2 hours...maybe 3 if things were really crazy. This is what we THOUGHT, because after months and months of going to the hospital and being given the opportunity to take full advantage of the WAITING rooms...we still haven't learned our lesson.

What really happened is that we went to the BMT office and waited for two hours before Joe was called back to receive his Vidaza shot which took all of 5 seconds. Then we headed up to short stay where we only had to wait about 15 minutes before Joe was taken to his room. At this point we were told that his platelets would arrive in an hour. Well, an hour came and went with no sign of platelets. Then a lovely nurse came and told us that they were informed that the platelets would arrive in 20 minutes. Apparently they were to arrive with the 2pm driver from the Central Blood Bank. Joe's platelets were not with the 2pm driver. We had to wait for the 3:10-3:15 driver. The 3:10-3:15 driver did not arrive until about 3:40, at which point the hospital people had to process it and such. Joe finally received his platelets at around 4pm. And yes, the transfusion took about 15 minutes. We waited over 5 hours for two procedures that took a total of 15 minutes and 5 seconds. The positive thing is that I was able to do plenty of reading and crocheting, and Joe was able to do plenty of reading and napping. The Benadryl that Joe was given before his transfusion did a great job of making him drowsy. The other positive thing is that Joe didn't have any reactions to his transfusion.

Today...
Today Joe had another blood draw. Everything was low again, which was expected. We also met with the doctor. Joe is going to be getting Vidaza each month again as a sort of maintenance. This sounds like a good idea right now. The not so great news is that after two negatives, Joe's Sunday blood draw showed that he is CMV is positive once again. That darn CMV loves to pop up and cause trouble all the time! Joe was already due for another dose of Cidofovir on Thursday. That will go as planned. Hopefully that will work to make that pesky CMV negative once again. If not then Joe might have to begin a combined therapy of Ganciclovir and Cidofovir.

The other thing is that Joe's rash started to flare up again. It is not too bad yet, but everyone would like it to stay "not too bad yet." So Joe's steroids were increased yet again. Not too high, but it already seems to be helping.

We are still smiling. In fact, on Monday one of the nurses said, "I think the two of you look happier every time I see you." Today, Joe's doctor said, "The two of you are always so positive." He thinks that all of this positivity has helped Joe to not look or feel as bad as many patients would during the "downs" of all the "ups and downs" Joe has been through. I think that it's true. One of the big things Joe and I have learned during this journey is that there is no point in worrying before you have to worry. And actually, with each "down" we experience, we are learning that there really is no sense in worrying then either. Worrying makes you feel miserable, it causes you to lose sleep, it gives you wrinkles, and in the end none of your problems are solved. Being positive makes you happy, allows for plenty of beauty rest, makes a better impact on others, and allows you to enjoy life despite all odds. :)

Thank you everyone for all of your prayers and all of the positive energy you've directed our way. Knowing we have so much love and support really helps us to continue to stay postiive.

Who of you by worrying can add a single hour to his life?
~Matthew 6:27

One Hundred Days!

Joe has officially hit Day +100. It has been 100 days since his PBSC transplant. It seems like just yesterday that our families were seated around a long table talking to Joe's doctor about the upcoming transplant. It was mentioned that Day +30 and Day +100 were big milestones. At the time, Day 100 seemed so very far away. And now we are here. Some days, when Joe was admitted to the hospital again, or while Joe was enduring the seemingly-never-ending-rash, each day seemed to pass SO VERY SLOWLY. Other days, we would look at each other and say, "wow! it's Friday already...again." The wonderful part about today is that the seemingly-never-ending-rash is barely visible now. Yes, there is a bit of redness here and there, but nothing even close to what it was. In fact, during the days of the seemingly-never-ending-rash, Joe would wake up in the morning and his face would look all hairy from the skin peeling on his head, eyelids, cheeks, chin...basically everywhere. Now, when Joe wakes up, he actually has some oil on his face. Remarkable. The doctors were really excited when they saw how much Joe's rash has faded. It feels as though we are rounding a corner and finally heading in the right direction. Hopefully we'll be encountering far fewer bumps along the way.

Joe had another dose of Cidofovir today. As of this past Monday he is still CMV positive, but that was expected. We're hoping next week, and each following one will be a CMV negative week! While Joe was hooked up to his IV pole, I decided to trek downstairs where there was a blood drive and get punctured with a giant needle. It was the least I could do after all Joe has been through. I felt really good afterwards, and then a couple hours later I felt like I had been run over by a truck. I gained even more respect than ever for Joe and all the other people we pray for each day. One pint of blood had me all woozy, and here Joe's counts have been low for months and months, and he has been poked with so many needles, big and small. Overall, I had a really positive experience and am really anxious to donate more regularly. Speaking of Joe's low counts, he did need another shot of filgrastim today. Fortunately, those needles are really tiny. Let's go counts, think UP!

Today is a monumental day for another reason. Jim and Jesse made their way down to the Mexican border today and will officially begin the Marrow Trek tomorrow. We are really excited about what they are doing, and so blessed by their energy and spirit. You can track their progress by clicking here. They will also be keeping a blog which they will update each time they encounter a computer! Please keep Jim and Jesse, and their beautiful dogs Whistler and Scooter in your prayers. Also a gigantic thank you to the people who have made pledges or donations to Marrow Trek so far. The support that has poured in for CLLF and Dana-Farber has been overwhelming. We are so amazed and encouraged by the generosity of both friends and strangers. Thank you.

Now for those curious minds who don't read Chinese, and saw my dad's comment the other day...Essentially, he was teasing me for writing such a lengthy blog and using a well known Chinese saying to equate my post to the cloths that were once used to bind the feet of women in China - long and smelly. Thanks dad, I love you too! :P

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Thank you Cousin Lilly, Ben, Kristin, Alex, Lauren, and 1st Auntie & Uncle for the postcard!!!!! (Bet you didn't know that I just started teaching myself how to play ukulele and learning a song that mentions the humuhumu-nukunuku-a-pua‘a. I laugh every time I get to that word. So the postcard was perfect!)

Thank you Gordon & Julie for the food. It was so sweet of you. We appreciate it so much!

Thank you Nancy for sending such great photos. I can't stop looking at them. They are great.

Wait for the Lord; be strong and take heart and wait for the Lord
~Psalm 27:14

99%

Three lovely photos have been posted for your entertainment. First, we have Joe smiling because his mind is far away from the Mepron he will soon be taking. The second is a photo of the Mepron. Didn't I tell you that it looks like bright yellow paint? The third photo needs little or no explanation - but it is Joe's reaction to taking Mepron. Apparently though, things could be worse. Poor Baby Livi has to take a medication that smells like skunk.

We went to see the doctor yesterday. Joe's rash is definitely looking better and better each day. He is not shedding as much skin, and his skin is not as red. Joe was given permission to taper his steroids slightly. Today was the first day of the taper; so far so good.

The results from the chimerism test earlier in the week show that Joe is 99% female. Yay! Those donor cells are doing just what they are supposed to be doing. The fact that they are doing what they are supposed to be doing largely contributes to why Joe's rash was so ugly. High price to pay, but in the end it should all prove to have been worth it.


Joe got another Neupogen shot on Friday because his WBC are still stubbornly low. The positive CMV result isn't helping either. Praise God though, because Joe is feeling well overall. Monday we return to the hospital. Mostly just a routine check. Thursday will be round two of the Cidofovir.
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I keep forgetting...thank you Susan H. for the lovely card! It was really fun to read.

Great is the Lord, and most worthy of praise, in city of our God, his holy mountain. ~Psalm 48:1

Day +93

Joe received his first dose of Cidofovir today. This means I can share more factual information on how it is administered, unlike yesterday. :) Joe was given fluid (Saline) over three hours, and some Probenecid. After that, the Cidofovir ran over one hour. Then Joe was given more fluid over two hours. Then some more Probenecid...and then he was to take one more dose of Probenecid six hours after the second dose. Such a complicated drug. And unlike what we thought yesterday, each Thursday will be the same routine. It wasn't so bad - says me, the girl who wasn't hooked up to an IV pole for six hours. The huge blessing of today was that Joe's rash looked even better than it did yesterday, and it was even less itchy. This made hanging out at the hospital less miserable. Coming out from the agony of constant itchy, dry, rashy skin makes everything seem more pleasant! Joe definitely is looking brighter and has renewed energy to fight this stupid MDS stuff.

Tomorrow we go back to the BMT office for another blood draw and rash assessment. We're hoping for a taper in the steroids soon. As mentioned before, a high dose of steroids makes it very difficult to treat CMV. A high dose of steroids can also mask infection by inhibiting the ability to get a fever. Infection is increased when WBC (and neutrophils and lymphocytes) are low as they have been with Joe. Surely Joe won't develop any infections, but we need to be prepared for the possibility so we know what to look for.

Thank you for continued prayers, good vibes, virtual germ-free hugs and kisses, and warm fuzzies!

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Happy happy birthday Rachel U. We love you!!!!!!

The Lord you God is with you, he is mighty to save. He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing.
~Zephaniah 3:15

The evil temptress is back...

Today we learned that the evil temptress Ms. CMV is back. We were prepared to see her again, but we were really hoping she would stay away. Oh well, as the doctor said, "don't be discouraged. This is treatable." Since Mr. Ganciclovir proved ineffective last time, and Mr. Foscarnet made Joe pay heftily to get rid of Ms. CMV, Mr. Cidofovir is intervening this time. I like to call him Mr. Sudokuvir...but anyway...

We will go to the hospital tomorrow. Joe will receive fluids for three hours. Cidofovir will be infused over 2 hours. Then there will be an additional two hours of something, but we're not so clear on what yet. :) I will have to report back! Cidofovir only needs to be given once a week, and apparently the very first treatment is much longer than the ones that follow. So tomorrow is a long day, but next Thursday should be a bit better. So far the plan is two Thursdays of Cidofovir, then a week off, and another Thursday of Cidofovir. Hopefully by then Joe will test negative for CMV. If not, he'll continue to get Cidofovir every other week.

Today Joe tried something new. It's called Mepron. It looks like bright yellow paint, or maybe French's classic yellow mustard. Apparently it tastes like fruity plastic. It is used to prevent pneumonia. Originally Joe was given Bactrim when his counts started to rise post-transplant. When Joe's counts started to drop, he was taken off the Bactrim and given a Pentamidine, which is inhaled. The Pentamidine is a monthly treatment. Unfortunately, it was discovered that those in the hospital responsible for administering Pentamidine weren't exactly doing it correctly. This understandably made Joe's doctor nervous. So Joe was given a prescription for Mepron. You have to take it once daily, and it is much worse than swallowing pills. Joe is convinced the doctors enjoy coming up with new ways to torture him! However, the upside is that the drug comes with these directions: TAKE THIS MEDICINE WITH MEALS. If possible, include foods with a high fat content (whole milk, cheese, ice cream, eggs, fried foods). Joe is especially happy to have a proper excuse to eat ice cream!

Some more good news. Joe's rash looks significantly better today, and he isn't shedding as much skin either. I'm praying he is able to get a good night sleep, since tomorrow will be along day. Joe's parents kindly brought over an oven-ready meal for us so that we don't have to worry about dinner tomorrow.

He will wipe away every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.
~Revelation 21:4