Day +10: Exciting News!

We have a new attending for the weekend who is very personable and engaging so the words he chooses are simply more exciting to hear than had they come from any of the attending doctors we have had on the BMT Unit thus far.

Even with that in mind, I cannot help but be excited by the conversation we just had:

• "If you were to ask what we would hope for Day 10 to look like, this is exactly it."
• "Yes, it is possible that this is engrafment."
• Her White Blood Cell Count is 0.4 (It could easily be "high" today and go back down to 0.1 tomorrow).
• She is holding on to her platelets and does not need a transfusion like she has the past ~4 days.
• She is a baby and got 8x the normal stem cell donation which truly can result in engraftment sooner than Day 18.
• She is feeling better (can't see mucositis in her mouth anymore although it doesn't mean it isn't in her throat and the rest of her GI tract).

We also discussed that there are still some things to work out: particularly the allergies causing her to rash and her fluid levels.  Rash can be one of the signs of graft vs host disease - so I am particularly glad to have confirmed (in my mind) what was causing her to rash over night (Dilaudid) and to find that Atarex (which is a non-drowsy anti-histimine) does better than Benadryl for Clara when she reacts to a drug.  She is almost rash free and itching much less.  I am going to continue giving her Atarex over the course of the day to help her get past the left overs of all her reactions and hope that we will see a marked improvement today.  If we can get the allergic rashes to stay away, we will be better able to detect potential graft vs. host disease rashes. 

She also doesn't seem to need the pain meds much at all.  I think most of her discomfort lately has been due to reacting to so many things and, if she really is recovering her white counts, then that means any pain she is/was having due to mucositis may actually be gone or gone soon.

Alan is on his way to the hospital for the day and night.  The whole family gets to be together for the weekend which is HUGELY exciting to me.  My baby is sleeping soundly.  It is the beginnings of what I hope will be a very very good day and weekend...and dare I say many days more?