singapore general hospital

Medical Update

21 May

(For anyone following the rest of the blog, I have a backlog of posts I will catch up on! Just wanted to update people on the current situation for now. Also, as a medical novice, I'll add more details as I become more certain of facts/terms etc)

The last 36 hours have been a reminder of how rough this treatment is. It was expected this would be the hard part for Becks, but it’s still a fight to stay calm when it becomes a reality. The staff and nurses at the hospital however are pretty amazing, and we are confident with Becks in their care.

To recap and expand on where we are in the treatment: Becks is currently in isolation for the second part of the process (the actual transplant), followed by a recovery period. With transplant day labelled as ‘Day 0’, here’s the outline of this stay:

Day -6: Admission, line inserted ready for chemotherapy
Day -5: to Day -2: Four days of chemo to wipe out the immune system
Day -1: Rest Day
Day 0: Transplant day to insert new stem cells (and Dad arrived, woo!)
Day 0-10/12: High risk period due to having a low blood count and no immune system, all precautions taken to avoid risk of infection. Expected that side effects hit from day 3 or 4. Body expected to strengthen from second week
Day 7-14: One in ten chance of an MS flare up for a week
Day 14-21: Discharge expected within this time depending on recovery

We have just started Day 7.
Becks has had the expected side effects - intermittent fever, nausea, vomiting, diarrhea, and mouth sores. This has meant a lot of lying with a few ice packs on her body and a paper bag always by her side. She has been given lots of medication to help subside the effects, and sedatives also. For a couple of days she couldn’t hold any food or liquid down, so would suck ice cubes when she could. She has started back on soft, bland foods since though.

The unexpected bumps - two nights ago she was running a fever and as part of this experienced convulsions. Then yesterday she was given a platelet transfusion (because her bloods were too low), but unfortunately had a reaction and experienced shortness of breath. From what we understand Becks had also contracted an infection of some sort (we’re still waiting for clarification around this), but they caught it early and put her on antibiotics and oxygen straight away. As I mentioned before, she’s being well looked after and closely monitored.

So, all in all, a predicted storm. However, we know that we’re supported by so many family and friends back home and around the world, as well as friends and the church we are connected to here in Singapore. Most of all we know we are in the hands of an almighty God, and he will not fail us.

Thank you for your continued love and support, it means so much to us!

Air con cold

24 April
Going in and out of air con screws with you. I've had a head cold for the past three days. So minor but a tiny taste of how being sick makes you just want to be at home in your own country in your own bed. Respect, Becks. Because keeping sister germ free is of utmost importance, hospital visits are accompanied by a thug life surgical mask. Sichuan spicy chili wontons also working miracles.

Eyes wide what

I often have trouble sleeping and over here is no different, though at the moment it's largely because of the heat. This means that when I walk into Becks' cool hospital room the first thing I want to do is sleep haha. I have become an expert at napping on the floor. Clearly great emotional support for my sister. Sorry sis. G'night.

New homes

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10 April

Becks' home for a couple of weeks: Ward 72 at Singapore General Hospital. Staff here are lovely and sister being sister is quick to make friends with the nurses. Some have even made the Facebook cut. Lots of adjusting for Becks with glam hospital life but overall coping really well. Core duties for me include making sure all her technology is charged and her mobile wifi working so she can be in touch with everyone back home.  I'm also twice the size of half the nurses here (lolz) so I help with lifting when I can, and I've been sitting in physio sessions so I can help Becks with stretches and exercises when she's up to it.

For the first part of the trip I'm staying with one of my besties Vera, who happens to live in one of the closest apartment complexes to the hospital. You can even see it from Becks' room (it's the building in the sun in the photo). God looking out - the chances of that were crazy.  It's just a 15-20 min walk to the hospital, but don't be fooled. The heat is no joke. Everyday I turn up to the hospital a hot mess (only in the literal sense, nothing attractive about it). I thought you love heat Phoebe, they say. Yes - I do, when I'm tanning next to a pool. There's a big difference.

Logistics and timings

Because I am no medical expert, here is my ABC version of how a stem cell transplant works at Singapore General Hospital. The rationale is to reboot the immune system, with the hope that the new immune system will not attack the way it has with MS. There are two parts to the process:

  1. Harvest (Inpatient, 2-3 weeks)
    During this time, there is one day of chemo to injure the bone marrow. My sister is then given injections to release the stem cells from the bone marrow into the blood stream. After this, there is a stem cell collection (3 million) taken from the blood. The stem cells are then conditioned, and the good stem cells are separated from the bad ones.

    In between: Rest (Outpatient, 2-4 weeks)
  2. Transplant (Inpatient, 3-4 weeks)
    This part of the process all happens in isolation. It starts with four days of chemo to wipe out the immune system, then one day of rest before the new stem cells are injected. The time after the transplant is apparently the hardest physically and emotionally (Superman dad is coming to the rescue around then for extra support, yay Papa!).

    After: Rehab, neutropenic diet (diet for low-immune system) for 6 months 

The particular stem cell transplant Becks is having at Singapore General Hospital is nonmyleoablative, so of lower risk than other stem cell transplants available. The biggest risk during the process is contracting any infection, particularly while the blood count is low after chemo, but obviously we'll be doing everything we can to avoid that. A healthy sister with a healthy new immune system is the expected outcome yes yes.