Blood Transfusion #4

by Jena | Dec 22, 2015 | Radiation Therapy | 0 comments

Dad is actively being treated for pancytopenia, a condition that involves a drop in the number of erythrocytes (red blood cells), leukocytes (white blood cells) and platelets in the bloodstream, because his bone marrow took a heavy beating during his last cycle of Campath.  Mom, Dad, and I have been a bit frustrated in how the blood management has been going to address Dad’s pancytopenia.  By blood management, we mean…

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  Donor’s A+ blood hanging from Dad’s tree during Dad’s blood transfusion today.

  Who is responsible for tracking and managing Dad’s low blood counts? 

• Who is placing the blood orders?
• Have all the blood orders been placed?
• Which days (Monday/Thursday OR Tuesday/Friday)?
• Are they scheduled out far enough in the calendar?  
  

We are seeking to improve the logistics of the blood transfusion process as Dad experiences each blood transfusion.  We have learned…

• The blood draw order must be submitted in order to have Dad’s blood drawn so that the blood counts may be taken.
• The blood type cross match order must be submitted and scheduled to occur at the same time so that the blood drawn will be tested for compatibility between Dad’s blood and the donor’s blood.  The blood type cross match has to be done for each and every bag of blood Dad receives.
• Each bag of blood takes 2 hours to transfuse.  Dad requires two bags right now.
• Blood transfusion days are long days at the infusion center.  A minimum of 6 hours is needed to complete the blood draw, testing and transfusion.

Today, Dad received his fourth blood transfusion, two bags of A+.  Dad also met with Dr. Montejo, radiation oncology, to discuss how to address the new tumors that have appeared since Dad has stopped the Campath treatments.  Dad has several cutaneous tumors on his head, shoulder, neck, back and arms.  He also has two subcutaneous tumors on his arm and leg.

Over the next day, we hope to hear the results of Dad’s bone marrow biopsy and his skin biopsy.  These results are key for Dad to continue down the path to his scheduled stem cell transplant next month.

• Bone marrow biopsy.  It will indicate the health of the bone marrow.  Dad’s bone marrow has taken longer than desired to recover from the last cycle of Campath.  After prior cycles, Dad’s recovery was approximately one week each. There is a slight concern that the Campath treatments have permanently damaged Dad’s bone marrow to the point that Dad may now have myelodysplastic syndrome (MDS).
• Skin biopsy.  This will indicate exactly what type of tumors have appeared and is input for Dr. Sokol to determine which systemic treatment may be given to Dad.  Since Dad has not had subcutaneous tumors in the past, we are very eager to understand if anything has changed.