Today’s complications have all surrounded around Idan’s pain when he tries to take care of his “business.” He is in a lot of pain still and went the whole first part of the day refusing to go because of the pain involved. The doctors felt there is a chance a virus might be causing his pain and fluid retention. He was able to go more comfortably when they gave him an extra dose of pain meds. They sent out his urine to be tested for viruses and it will take a few days to get back. If it is a virus, there is little we can do besides give him more fluids (he is already getting 60 ounces daily) and hope it helps to flush it out of his system until his white blood cells come in to take care of the virus.
That said, today was the first day we saw a small amount of ANC and lymphocytes. As you might recall from our posts from his last transplant, when the donor cells start setting up the cells factory inside the bone marrow, they start producing the white & red blood cells and the platelets. The first cell line we watch for is the ANC, or absolute neutrophil count. After 9 days of “zero data,” today he showed an ANC of 26. This is very very low, but is the first sign of some activity in his marrow. He then received another dose of methotrexate (a chemo drug he gets to reduce risk of GVHD), which will likely knock this ANC back down to zero for a few more days. Once the ANC really comes in and starts to go up, we will watch it closely. They like the ANC to go up above 500 for at least three days before we can be discharged (probably a couple weeks away still). At that point, we would be able to discontinue the around-the-clock antibiotics IV he has been getting since his ANC dropped around Day -1.
Lastly, Idan continues to shed his hair, and at this point it looks like he has shed almost all his old hair and has a thin layer of blond peach fuzz that is pretty cute.
We are hoping for better days ahead. Days will less pain, discomfort and grumpiness. We hope he stays virus-free and infection-free while his new immune system comes online. We are very pleased that he has continued to eat and drink, and the BMT team is also quite amazed with his appetite and eating skills. We are hoping that this continues as well.