At 8:00 a.m., Dad had his blood counts checked to determine whether or not he needed another platelet transfusion to get his platelet count above 50 (50,000/mcL of blood).  50 is required for the medical procedure to place Dad’s new central line catheter.  Dad’s platelet count came back at 64.  Thus, no need for a platelet transfusion this morning.  It was important for Dad to have enough platelets in order to clot, as needed for the procedure.

Dad getting ready for his central line catheter procedure.

At 10:00 a.m., Dad was prepped for his central line catheter procedure in the outpatient surgery department.  Two small incisions were made in Dad’s upper right chest.  One incision was made near his neck, and the second was made a little lower to insert the catheter into the proper place.  The catheter was “tunneled” under his skin.  He received some stitches in his chest close to the catheter exit.  These stitches will be removed in 21 days when his skin has healed around the catheter.  The procedure took about 45 minutes with an additional 30 minutes for recovery.

When Mom and I went to see Dad in recovery, he was happily drinking an orange Gatorade.  He hadn’t been able to eat nor drink since midnight the day before.  We discussed plans to eat lunch.  We were determined not to eat in the Moffitt cafeteria since Dad, along with Mom and I, would be eating this food for the next month.  Dad was craving pizza.  Mom was adamant that Dad not dine in a restaurant for fear of picking up an illness.  Thus, we agreed upon take-out.  Dad seems to enjoy Little Caesar’s HOT-N-READY DEEP! DEEP! Dish pepperoni pizza.  I am not a pizza fan, but I want Dad to enjoy his last few meals “outside” of Moffitt.  It should be all about what he wants to eat.

At 12:30 p.m., we returned to the Blood & Marrow Treatment (BMT) Center to learn about post-insertion care.  Dad may have some discomfort in his shoulder and chest area over the next few days.  The physician’s assistant (PA) recommended 1,000 mg of Tylenol to relieve any discomfort.  They provided ice packs for Dad to apply to the catheter site 20 minutes at a time, every hour, as needed for the first 24 – 48 hours.  Dad is to expect a small amount of blood and bruising around the exit site.  He cannot shower for 48 hours.

We did find it odd that the BMT nurse had to remove Dad’s PICC line since the surgery team did not remove it during Dad’s central line catheter procedure.  We had been under the impression that it would occur during the surgery.  This was even discussed with the doctor 20 minutes prior to the procedure.

Nurse removing Dad’s PICC line.

The nurse indicated that removing a PICC line was rather commonplace in the BMT treatment center.  The nurse removed the dressing on and around the PICC and pulled the line right out of Dad’s left arm.  The amount of line that came out of Dad’s arm was incredible.  How could all that line be inside of him?  The nurse felt bad since a couple drops of blood fell onto his shirt.  She worked hard to remove the blood stain.

As we were getting our final questions answered, Dad happened to mention to the nurse that he has had a slight sore throat the past three days.  Mom and I were unaware of this slight sore throat.  Well, that sounded the alarms!  The nurse went to speak to the PA.  Dad had his nose and throat swabbed to check for infection.  The PA looked at Dad’s throat and said it looked like strep throat.  The PA consulted with two other PAs, who also examined Dad’s throat, and agreed that it looked like strep.  The PAs were puzzled since Dad’s throat was only slightly sore.  They ran a rapid-strep test, which came back negative.  For now, the initial diagnosis is rhino-virus (the common cold) and potentially something fungal.  Dad was prescribed two medications.  The swab results won’t be back from the lab for a few days to provide a more definitive diagnosis.

The PA consulted with Dr. Ayala.  The bad news is that Dr. Ayala has postponed Dad’s stem cell transplant.  He won’t be admitted on Sunday.  This is very upsetting for Mom. Dad is now scheduled to see Dr. Ayala on Wednesday, February 24th.

We are on the stem cell transplant roller coaster.