Engraftment Starts!

I have now been in the hospital for 4 weeks. One week after my transplantion, on Christmas Day, my baby stem cells started growing. My white cell count had gone from nothing to 500 and then two days later, the white cells were at 1000. For the next 10 days, my white count has been hovering around 600 to 700.

The doctor thinks the two baby cord stem cells are fighting each other to see who will win the overall fight. I have had rashes on my arms, neck and chest which shows that something is going on inside of me. Supposedly, this is all normal and it takes longer for the baby stem cells to figure out what they are supposed to do. I have been in room isolation for 1 week until my white count gets above 1000. I need to get the stem cells to over 2000 to be able to leave the hospital. Normal levels for white cells are 4000 to 11,000.

My body is currently not making the correct amount blood products (red cells and platelets) until the baby stem cells get to work and make bone marrow which makes blood products. Todate, I have received 5 units of blood and 5 units of platelets. When my hemoglobin blood level falls below 8.5, I receive a unit of blood (normal levels are 13 to 18). When my platelet levels fall below 20, I receive a unit of platelets (normal levels are 150 to 350). When your platelet level is less than 20 there is a serious concern about internal bleeding since you do not have any platelets (glue) in your blood stream. I have to be careful about bumping into things and possibly having internal bleeding.

On December 30, I had a scare when I tossed my gown into the garbage receptical and the steel cover of the receptical fell hard onto my wrist and immediately caused blood to swell up in my wrist. I thought, oh no, I have survived being a cancer patient for 3 1/2 years and I am going to end it here now, death by steel lid! Luckily, the nurse grabbed an ice pack and ordered another unit of platelets. Luckily, I had just received a unit of platelets the prior day when I was at 17 but today, I was at 38 (above the dangerous below 20 level). The charge nurse had to come to my room to document the accident and my doctor came flying in saying, "What the hell are trying to do? Do I need to tie you down to the bed to keep you from killing yourself?" So far, my blood puddle on my wrist has healed and I am left with just a nice looking black and blue bruise.

Two weeks ago, when my white cells were down to zero, I started to get a fever which is the body's only way to fight infection when the immune system is down. Since I had a fever, they had to give me a slew of antibiotics to help the body fight since I had no immune system. The antibiotics are very strong and they are not very friendly to my digestive system. I could not keep even a sip of water down before I was tossing my cookies. Since I was not eating, they hooked me up to 24 hour TPN which is a huge IV bag of solution with all the vitamins and mineral, fat, sugar and so on that you need to live. I did not eat for about 4 days and then I started a clear liquid diet (popsicles, broth and gelatin) and then a soft food diet. I had major bloating in my stomach (3 to 4 months pregnant) and they did an abdominal ultrasound to see what was going on inside. They found out that my intestines were so swelled up from the chemo and radiation that I had a blocked intestine. I was put on 70 mg of prednisone (steroid) to help with the inflammation and my two anti-rejection drugs that allow the baby stem cells to grow in my body were changed since they may have been contributing to the intestinal swelling.

On top of all this, I was shivering at times constantly due to the fevers so they gave me a shot of demoral to calm the constant shivers. The demoral instantly stopped the shivers but it also started to drop my blood pressure which is normally 110 over 70 to 70 over 35 (dangerous levels). Then they had to give me other medications to help bring the blood pressure up. The low blood pressure problem lasted for 2 days. My wife stayed in the hospital with me overnight to help keep on eye on me.

Today, I am doing good. The fevers, inflammation, low blood pressure are gone. I am only getting TPN (nutrition bag at night for a few hours) and I am back on the normal, low bacteria diet (no fresh veggies or fruit, all has to be cooked).

Tomorrow, the doctor is going to run a DNA tissue typing blood test to see what's up with the new stem cells. The tissue typing test should show my original 10 tissue typing numbers plus a percentage of each of the two cord blood units. They say after 100 days, one of the cords will take over the body and my DNA tissue typing numbers will change to the numbers of the winning cord. Will I be Belgium or will I be Australian? We will have to wait and see.

I would like to thank all of my blood and platelet donors who have come to the City of Hope at a moments notice to give life to me. As I said, I have received 5 bags of blood and platelets and they have all been directed donations which means I have been receiving all of these donations. Thank you again for those who have donated and are keeping me alive.

I will blog as more news comes up!