Transplant + 63

Barb and I drove to London this morning with a level of apprehension.  If we temper our expectations it is harder to be disappointed.  Bottom line is that we don't have a lot of history to back a significant jump in my blood counts, so we hope for a modest improvement with the full expectation of needing red blood cells.  We are indeed a cancer family.  Our lives scheduled around clinic appointments, treatments, results and the like.  It is predictable that our lives become that way to a degree.  Our prayer is that as I improve it may become less so of a schedule maker but a reminder of God's good gift of healing.  In the meantime we pray that we can rest in God's promises of His tender care for us each day.

Cancer clinic is not much different from your doctor's office - hurry up and wait.  We go early to get blood work done and then wait a long time in exam rooms for lab results before we see the head doctor.  As expected I needed RBC because of low hemoglobin.  My platelets slipped to 22 from 26.  My WBC to 1.9 from 2.1 and my neutrophils 1.3 from 1.7   Disappointing it is but it has not hit us as hard as last week which followed a week of a nice lift in numbers.  Overall now my blood counts are completely flat since I came   home on Day + 24.  The doctor has no convenient explanation for it, still the uncommonly slow line.  The isolation unit head stopped by the exam room earlier and asked how I was today.  I responded with the lower numbers and that patience is a virtue, and she reminded me to be like Job.  That was neat.

With the blood transfusion my doctor is confident that I am fine for a 2 week appointment, and of course I can call if there are issues.  In the meantime I will be running an IV at home for those 2 weeks.  A regular saline bolus to help flush my kidneys as creatinine is still creeping up.  Not less by mouth of course, but a boost on overall fluid consumption.  I have been having some more issues with nausea and vomiting so a anti nausea has been ordered.  Vomiting with low platelets can be dangerous so this is a precaution against some internal bleeding. Overall kidney function is good as is the liver.  Bilirubin stays up a bit with some yellowing of the eyes but enzymes marking liver function are in a good range.

No signs of GVHD for which we are very thankful.  Heart and lungs look great, spleen is much smaller, skin is healthy although doesn't grow any hair yet to speak of :) Fatigue is what it is.  Doctors reminded us of how well I am doing physically apart from blood numbers, indeed a very good blessing.

Text from evening devotions are very appropriate for us today:  II Corinthians 4:16-18  ESV
"So we do not lose heart.  Though our outer self is wasting away,
our inner self is being renewed day by day. For this light momentary affliction
is preparing for us an eternal weight of glory beyond all comparison, 
as we look not to the things that are seen but to the things that are unseen.
For the things that are seen are transient, 
but the things that are unseen are eternal.

Prayer Requests
1.  We give thanks for overall physical well being including no GVHD.
2.  For the good care of doctors and nurses.
3.  For engraftment taking place even though it is slow. To learn how to give thanks for that.
4.  Patience for all of us as we long to see a speedier recovery.
5.  For resting in God's good promises for us.