At 6:30 a.m. Chandler arrived at the hospital with Jason. I met them in pre-op while he was getting ready for surgery. Chandler was calm and completely fearless. I became a little nervous when I found out that Chandler had woken up feeling sick. He had a sore throat, body aches, and a slight fever of 100.4. I wondered if it would affect him during surgery or the stem cells he was giving to Ashtyn. Before checking in, Chandler prayed that he would start feeling better. He didn’t want them to say he couldn’t do the surgery. Chandler was not at risk so the doctors weren’t concerned. The surgery took a little over an hour. They poked both sides of his lower back with a large needle and obtained 550 ml of fluid from his bone marrow. Chandler woke up with back pain but it was soon controlled with Oxycodone and Tylenol. He also woke up not feeling sick anymore. “I feel perfectly fine.” I checked his temperature and indeed it was normal. Chandler truly enjoyed recovering in the post op clinic because “they take care of you really well.”
This isn’t the first or last time Chandler will change the world for good.
Chandler’s surgery was at 8 am. By 9:30 a.m. he was relaxing in the post-op unit. At 12:30 p.m. his bone marrow blood had been processed with the plasma filtered out and was in a bag ready to be infused into Ashtyn. I pushed Chandler in a wheel chair upstairs to Ashtyn’s room. The room quickly became full with staff members to express congratulations and to sing “Happy bone morrow transplant birthday to you.” The staff then presented a few gifts. One of the things given to Ashtyn was a t-shirt that said, “Bone Marrow Transplant Recipient.” Chandler got a t-shirt that said, “Bone Marrow Transplant Donor.” On the front of each t-shirt was written, “A Gift Of Love.”
The marrow transfusion went into Ashtyn’s central line fairly quickly and without a problem. A few family members came to celebrate with us including Ethan and Morgan, my two younger children. There was a happy and light spirit in the room. By 3 p.m. everyone left. Chandler went home to rest and play XBOX. Ashtyn stayed in the hospital and took a nap.
Today was a big day. The next big day we are waiting for is Engraftment Day. We will all be watching for signs of engraftment which usually takes 14 to 21 days after the transplant. Once engraftment occurs, Ashtyn will begin to feel better and will be on the road to going home. Engraftment is when Chandler’s stem cells start to grow and make healthy blood cells in Ashtyn’s body. Each day Ashtyn will have blood tests while waiting for the donated cells to engraft. A complete blood count (CBC) test will show the kinds and numbers of healthy cells in her body. 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. An absolute neutrophil count (ANC) of 500 or more for three days in a row is a sign of engraftment. A platelet count of 20 to 50, without a platelet transfusion, is a mark of platelet engraftment.
The staff and bone marrow team use a number system to keep track of days after the transplant. Transplant day was Day 0. The day of engraftment will be a day of great celebration and gratitude. Each day we will pray for a quick and smooth engraftment. The transplant team gave Ashtyn a calendar to tape on her wall so we can keep track of what day post transplant we are on. It is a tradition that people place bets on what day they think Ashtyn will engraft. The name of those who guess is written on the predicted day. Whoever wants to can bet one dollar and place it in an envelope below the calendar. The winner gets recognition, Ashtyn gets the money. Four days ago, when Ashtyn and I were driving to the hospital to be admitted for the transplant, she said, “I think I am going to come home on July 14th. Actually, I think it will be the Sunday that is closest to July 14th.” I looked at my calendar. “July 14th is a Sunday.” She said, “Well then that’s the day I think I will be going home.” Ashtyn guesses she will engraft July 10th and will go home on July 14th. What’s your guess?
Ashtyn felt fairly well today. The night before her transplant she threw up her NG tube. She no longer has a tube and is no longer getting tube feedings in her stomach. Though her nausea has decreased from yesterday, she doesn’t have an appetite to eat much so IV nutrition (TPN and lipids) will be started. Her ANC is currently zero and will remain that way until engraftment. To help prevent infection, she was started on an antibiotic called Cefepime for bacterial infections and Amphotericin B for fungal infections. It is just a matter of days before mucositis will start affecting her. In February Ashtyn had severe and extreme mucositis. Every day we pray that her mucositis will be less than it once was. Every day we pray that she will be safe.
We are grateful for where we are today. We are grateful that Chandler was a match and that Ashtyn had the chance to have a bone marrow transplant. We are grateful for past cancer children pioneers who have paved the way for Ashtyn. We are grateful for the inspired research that has been done and the knowledge health care providers have. We are grateful for a merciful God who blesses the details of our lives and sends earthly and heavenly angels to assist us. We are grateful for trials and struggles that stretch and refine us so we can progress and become who we need to become.
D&C 122:7 “Know thou, my son, that all these things shall give thee experience, and shall be for thy good.”