My mom was discharged from City of Hope on February 25th, 2014 after 26 days since the transplant. Many people stay longer but the team of doctors decided she is a rockstar and ready to go home. She still has pneumonia in both lungs, liquid around the lungs, swollen feet (the tissues retain too much water), pain in the abdomen and several other issues, but her white blood cell counts are up and she has been able to eat oatmeal instead of just live off of TPN so she is going home and will coming back 2-3 times a week for out-patient visits. I initially felt quite apprehensive about her release since she seemed so evidently sick, but she has more comforts at home and has already been able to hold down more solid foods like chao!
We had our first outpatient visit back at City of Hope yesterday. She had some blood work and saw the Nurse Practitioner since her oncologist was out of town. WBC up to 7, Red Blood cells at 11 (wooo!), and Platelets down a little to 86. When platelets are down, she bleeds really easily. Platelets are part of the blood that help the blood clot and thus helps with healing wounds. The other numbers look great! Most of the white blood cells are neutrophils, which is great news!
In the near future, we still need to try to get rid of the stubborn pneumonia, get the stent taken out, blast out the kidney stones (probably caused from chemo) and figure out treatments for her swollen feet so she doesn’t trip so easily when she walks. A long road ahead, but the road is looking a little more paved at this point.
WBC: 5.0 – Pretty good for day 26!
Hgb: 8.3 – Close to needing a transfusion
Platelets: 42 – Needs a transfusion
Tonight, my mom’s nurse has 42 years of experience across 5 different cancer hospitals. She had some very informative “tips of the trade” as well as tips for medication and home care that I had not heard or read elsewhere. Experience is really a wonderful thing.
Much has happened in the last 16 days! As you may recall from a previous post, the stem cell transplant day is Day Zero. We are now on Day 16. The first two weeks are the hardest part of any stem cell transplant. The patient feels all the side effects of the radiation and chemotherapy from the previous week and the body has to deal with having 8.7 million new cells from another person’s body. Here’s now I like to compare it to a wartime scenario: The original fort (the body) is almost completely annihilated with different types of poison (radiation and chemo in this case) leaving just enough infrastructure so that the fort can be rebuilt. Once it is deemed that enough of the enemy has been eradicated, a completely new army (enemy/cancer free) is sent in to rebuild. The fort is still reeling from all the damage, and the army still has not adjusted so the first two weeks is quite rough. Hopefully, soon, all the damage slowly starts to heel, the army gets acclimated and everything works in full force to rebuilt the fort again. During that time, we just hope that no other enemy comes in to attack since neither the fort nor the army are ready for battle!
During the past two weeks, unfortunately, my mom’s defenseless body has had to fight some infections. She has had bronchitis in both lungs, swollen intestines and many mouth and throat sores from the radiation and chemotherapy. The hospital has kept those infections under control by varying different anti-fungal and antibacterial medications. She has been put on oxygen several times to help her breathing. She was also put on Total Parenteral Nutrition (TPN), which is food through the IV since she has been unable to eat. She has been hanging in there.
Yesterday, we heard great news. Her peripheral blood is completely cancer free and her WBC is up to 3.0! We still need to wait on bone marrow biopsy to see if my uncle’s stem cells have grafted and if the bone marrow is cancer free. She has always had disease in the bone marrow and not just the peripheral blood. But this news is great news so far. There is still much ahead, but this is fantastic news at this point. Next week, we will have more scans to figure out the source of some of her infections, have a bone marrow biopsy done at one point and hopefully get her eating real food again. 🙂
Here are some references from medical resources that have some nice summaries about stem cell transplants and the donation process:
My uncle donated 8.7 million stem cells. They said the minimum that they needed was 3 million. They need at least 3 million to increase chances of the cells grafting, which means that the body accepts the cells and the cells start producing blood for the body – white blood cells, red blood cells and platelets. They have a cap at 8 million because beyond that, there are increased changes for Graft vs. Host disease, which is a condition where the body attacks the cells because they are foreign. Since I mom got over 8.0 million cells, I naturally had questions. The best response I got was (paraphrased): Well, studies show that 8 million is max, but 8.7 million isn’t that much more (that’s almost 10% more!) and we think it will be ok. We want to increase her chances.
So here’s to the cells grafting, the body accepting all that is done to it, the bone marrow making new cancer free blood cells, and my mom never suffering Graft vs. Host Disease!