Allo Day +2 thru today Allo Day +12

Since the transplant, Shannon has been very sleepy. She sleeps more than she’s awake on some days. Her appetite remained good until about a week ago when her throat began to hurt a lot and she also developed some nausea. The intense sore throat is from stomatitis, which is irritation of the lining of the mouth or throat. Her’s is mostly in her throat making it very difficult to swallow. It’s an expected side effect from the transplant. They said that after her White Blood Cells start going back up, it should clear up quickly. For now, they have had to put her on a PCA pump, so that she can deliver her own small doses of narcotic IV pain medication. Once her throat clears up and the pain subsides, she won’t need the PCA pump anymore.

She’s been trying her best to shower daily and do at least 2 laps around the unit for some mild exercise. Some days have been worse than others and she can’t bathe nor walk. When she does go for a walk, she has to wear a 3M mask with special filters to protect her from airborne germs in the hallways. She’s also had limited intake of food and water for the past 5 days or so. Her throat just hurts too much. They’re supplementing her with IV hydration and she drinks small amounts of protein shakes. Her weight has been fairly stable so they’re not too concerned.

We watch her blood counts daily, and she’s needed several transfusions of red blood cells and platelets. Her white count got down to 0.2 but we were expecting it to go down to near zero around 0.1. The doctors said some people don’t drop as low and also because we’re only checking once per day, sometimes we don’t capture the lowest point. It could have dropped below 0.2 in between lab draws. So she hung around 0.2 to 0.27 for several days, then yesterday she was 0.58 and this morning she was 0.98. So that means she’s “engrafting” already. The new cells from the donor bone marrow are already taking hold and starting to produce cells. This is good news and they said she’s a little bit ahead of schedule, maybe by a few days. They said it’s probably because the donor cells are very strong since they were donated by a 25 year old who was healthy.

We expect that her white count will continue to rise daily and once her ANC is above 500 (absolute neutrophil count), she’s off of the IV pain meds, and she’s eating normally…she’ll be able to go home. She was able to shower today and go for a walk around the unit. Today has been better than yesterday so far. Hopefully she will continue to meet her goals and progress towards going home. Merry Christmas.