Everything went fairly well until Friday night of the first week. During the night Richard started becoming a little delirious. He woke up every hour or so and seemed very unsteady on his feet. When we walked to the hospital for the daily routine blood work, he tripped on a tree root and fell. He didn't get hurt but because his platelets were about 20,000, he got a huge black eye and bruises on his legs and shoulder.
Today, Richard says he doesn't remember the disorientation, but I'll never forget it. He reminded me of some one with DTs, talking to people who were not really there. I also felt really guilty because I was supposed to be taking care of him when he fell.
Also, he started talking in his sleep, something he had never done in all of our 35 years together. He would also gesture with his hands while he was sleeping. If I woke him while he was doing this, he would tell me what he was doing, like eating or cutting something with scissors. He also had lots of muscle jerking and twitching during sleep. We were told that this was likely a medication side effect.
On Monday, we got a call from the BMT nurses. Richard's cyclosporine level was 465. The theraputic range for cyclosporine is 100 - 300. The goal for bone marrow/stem cell transplant patients is 200-300. Likely this was the cause of the deirium. His dose was reduced and the confusion and unsteadiness was gone.