It all comes down to a balancing act. Trying to find the right mix of meds to counter the side effects of the other meds. For now, it's still a daily adjustment.
Vfend (voricomazole) is an antifungal and must be taken on an empty stomach.
Valtrex (valacyclovir) is an antiviral that replaced the Valcyte I was taking prior to transplant. The Valcyte also fought against the dreaded CMV virus, but it interferes with my GVHD meds.
Bactrim DS, an antibacterial that I took pre-transplant, is also on hold because of the same reasons.
Prograf (tacrolimus) fights against GVHD. My levels are checked through my bloodwork three times per week and the dose is adjusted accordingly. There's no just taking the amount printed on the bottle. It changes every other day...at least for now.
Ultram (tramadol) helps with my bone pain caused by busily reproducing cells and the occasional Neupogen shot.
One of the side effects of all these meds is headaches. Since I already had a propensity toward migraines, this has been a daily battle.
Maxalt (rizatriptan) keeps the migraines in check and is taken every eight hours at 6am, 2pm, and 10pm.
Oxycodone plays backup to the Maxalt for when the headaches come back before the eight hours are up.
Flexeril plays backup to that.
The other side effect is intestinal distress. GVHD can also cause it, so it is important to know which it is.
The very common Pepcid (famotidine) is taken daily to try to ward off some of the stomach upset.
Reglan (metoclopramide) is my daily friend to overcome the nausea. Most cancer patients take Zofran, but it severely aggravates my headaches.
If the Reglan isn't enough, Ativan (lorazepam) comes to the rescue but at the cost of being awake.
If all else fails on all fronts, Dilaudid (hydromorphone), a pain med 10x stronger than morphine, comes to the rescue and knocks me out until all is better.
All of these meds cause me to have constipation. So we are continuing to look for the right balance of Senna-S, Miralax, and Benefiber. When these are not enough, Lactulose does the trick...but at a great cost! There's no leaving the house after that one.
Monday, Day 19, my labs showed that I had a urinary tract infection. I asked if I had done something to cause it, but she said that it is simply the state of my weakened immune system. I will tend to catch any stray bug floating by. Thus the importance of my mask, lack of crowds, and all the other precautions. So back to the MDA Pharmacy I went for Ampicillin, an antibiotic, to add to my regime four times a day for a week and must be taken with food. Please pray that the infection would heal quickly as these are the types of things that can cause set backs.
Tuesday, Day 20, the doctor and APN (advanced practice nurse) decided to start me on the pill form of Magnesium Oxide, which also has to be taken with food. I have been receiving it daily as part of my IV fluids. They will slowly build up the number of pills while reducing the amount of IV until it too has found its balance. This is also a step in weaning me off daily visits.
They will begin the weaning process by giving me Thursday off. I will bring home a portable pump so I can administer my IV fluids at home. :) If that goes well, I may get the weekend off too!
Other than dealing with the headache and intesinal issues, I have not had any more significant events since the weekend. For that, I am very thankful. Please know that your prayers are playing a vital part. I am daily overwhelmed by the oupouring of love and care by my drivers, meal providers, grocery shoppers, note writers, and prayer partners. We are truly blessed!
Today, my dad has been gone 15 years. I know that he is up there manning the heavenly prayer warriors. While I look forward to the day of seeing him again, I am so glad that this miraculous transplant will postpone that reunion for a while longer.
Here's to this crazy bunch of meds that plays its part in this journey of ours.
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