Brand New Day

Day +1 (D 139)

Ann's first new day began with a nice start. Her blood work came back with the predictable results. Her blood counts are still in the basement (WBC 0.1 K/uL, Plts 17 K/uL, RBC 3.2 K/uL). The RBC count had moved upwards, but that had more to do with the lasix infusion from the previous day which had dehydrated her a bit, but no transfusions were needed.

Yesterday her blood pressure and heart rate had gone up and down respectively after a drip of Prograf was started. Prograf is an immune suppressant that is supposed to limit the ability of any of her original marrow, whatever of it is left, to react. Thats so the new stem cells don't get attacked before they can find their new home in the newly hollowed spaces in her bones. Her blood pressure and heart rate had returned to normal today after the dose and rate of infusion of Prograf had been adjusted.

Eating is a frustrating enterprise at best for Ann and at worst it is a trip on the vomit comet. For the last 5 days Ann has had very little of any substance to eat. She has sampled just about everything on MDA's menu. Which by the way is getting really, really old considering we have been looking at the same one for six months now. Anyway, about the only thing that she has found which will not instantly trigger her stomach to turn is plain white rice. However, you can only eat so much of that. Over the last week has lost 3 Kg, which the Doctors and staff here consider "normal". I have taken to eating cold sandwiches or out of her room all together because just the smell of food can sometimes set her stomach off.

In addition to walking the floor and staying out of bed as much as possible, MDA has a physical fitness class that meets Tuesdays and Thursdays for transplant patients. I had tried to get Ann to go to the class last week, but her stomach vetoed the idea pretty effectively. This week she didn't have an excuse and got to meet some of her neighbors.

The exercises are pretty basic and focus on small basic movements of arms and legs. A lot of them use rubber bands to provide mechanical resistance to arms and legs. Others involve using the legs to either move through their range of motion or help lift your body. Ann had the most trouble with these as she still has not regained the muscle mass that she lost during the first month of treatment here.

The physical fitness staff is still pretty impressed with Ann, as are the transplant nursing staff. They have commented that they expected her to be feeling much worse than she is and to have much less strength than she does for being just transplanted. On the other hand Ann is by far the youngest patient here on the floor. Most seem to be in there late fifties or early sixties with one or two minor exceptions.

I ran into a man whose wife is on day +9 of her allogeneic transplant for mantle cell lymphoma. He told me that a day or two after the transplant his wife's experience was absolutely terrible. So bad in fact that he was not convinced that she was going to make it until yesterday night. He went on to caution me that Ann's experience would most likely be the same. After thinking it over for some time I have determined that he might be right, the current high we are on might evaporate into the lowest of lows. That being said, I think we can both live with it because today marks the very first positive step we have taken towards living normal lives together again.

Today was a great brand new day.