Dillon continues to improve. Overnight his temp was below 101 all night. The nausea and diarrhea are in full swing, presumably from the total body irradiation. This is uncomfortable, almost uncontrollable, and will possibly last for several weeks....UGGHHH!! Dillon has now not eaten for a month (aside from a few bites of watermelon a couple of times). He is not wasting away....he has the IV nutrition that includes completely balanced nutrition. Today I asked when we might expect Dillon to begin eating again and the doctor's response was that a lot of kids go home on TPN (IV nutrition) and they get it for 12 hours every night to maintain their weight and they slowly wean off of it as their intake increases and they begin to be able to maintain their weight and hydration through oral intake.
Speaking of weight.....Dillon is back down to his baseline weight, which means that his fluid overload and retention has been corrected. It is still a delicate balance but he looks much much better; he is not so puffy anymore and he is just barely yellow. His bilirubin is still 5 today but they say it takes a while for the body to clear that out.
Okay, so about the counts that we are holding our breath for.....I found this article about BMT and felt that the explanation of the engraftment was perfect for sharing with all of you...so here it is.
Measuring Engraftment
After you receive a bone marrow or cord blood transplant (also called a BMT), your transplant team will watch for signs of engraftment. Engraftment is when the donated cells you received for your transplant start to grow and make new blood cells.You will have daily blood samples taken while you are waiting for your donated cells to engraft. The blood samples will be given a complete blood count (CBC) test. A CBC test can give your doctors information about the kinds and numbers of healthy cells in the blood. The types of blood cells that are counted to measure engraftment are neutrophils, which are a type of white blood cell that are important for fighting infections, and platelets, which help control bleeding.
Neutrophil engraftment
A CBC test counts the number of neutrophils in your bloodstream. An absolute neutrophil count (ANC) of 500 or more for 3 days in a row is a sign of engraftment. This means that the blood test shows 500 or more neutrophils in a cubic millimeter of blood. Neutrophil engraftment can occur as early as 10 days after transplant. About 20 days is more common for patients who receive marrow or peripheral (circulating) blood cells. For patients who receive cord blood, the average time to neutrophil engraftment is between 21 and 35 days.Platelet engraftment
A CBC test will also show the number of platelets in your bloodstream. A platelet count of 20,000 to 50,000 is a mark of platelet engraftment. This means your blood test shows 20,000 - 50,000 platelets per microliter of blood. For patients who receive marrow or peripheral blood cells, platelet engraftment often happens at the same time or a little bit after neutrophil engraftment. For patients who receive cord blood, it may be 8 weeks or longer after transplant before platelet engraftment occurs.Okay, so as you read the magic number is 500 for 3 days.....two days ago Dillon's ANC was 192, yesterday it was 97, and today it is 277!!! So this is a bit of a roller coaster and tomorrow it could be lower again, but we are definitely trending in the right direction. Now my posts will include the ANC...so you can watch and wait with me!!
Okay, now a photo. You know Dillon has been on over 40 medications on any given day....check out this IV pole and the best part, of course, is the new T-shirt!!
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| There are 9 pumps on this IV pole!!!! |
To review...Dillon received Core Blood? Or marrow?
ReplyDeleteCord blood from a baby girl whose blood type is A positive. Dillon's DNA test in the future will show him as female and his blood type will change from his O positive to the A positive in the next year.....CRAZY STUFF. I wish I could explain it...but the science is still a mystery to me so you will have to google to get a clear explanation of why/how this happens.
ReplyDeleteOur cousin Ken received O positive and had been A positive. In discussions with Ken he mentioned that he never like beef much when he was A+ and as an O+ he couldn't get enough beef. I had him read a book by Dr. Peter D'Adamo 4 blood types and 4 diets for the Blood types. As an O you are a meat eater and as an A you aren't. Interesting book as it explains why one type should eat certain food. Type O is the oldest type of blood on earth and they ate mainly meat. So Dillon will not be a meat eater any longer and will lean toward other foods. An interesting read for sure.
DeleteThat is mind blowing!!! And, great news!
ReplyDeleteSending love and healing energy from California. We keep praying for you Dillon. Other people praying here, too, that you don't even know, but they care about you! We got your back. We're fighting along side you in spirit. Emma is working on another card.
ReplyDeleteTroy, Lisa, Luke & Emma