The First Transfusion of Many (BMT Day 4)

Esther's red blood count had dropped to 7.8 last night when they drew her labs (regular blood draws for labs are always done around 2am) so she had her first blood transfusion of her BMT stay early this morning. They don't wait around in transplant when administering high dose chemo, they act very quickly. Today was the 4th day of chemotherapy, not a time when she normally would need a transfusion. Even in the very first round back in July, when the chemo gave her system quite a shock, she still didn't need a blood transfusion until day 6.

She's doing well. I tried to keep her out of her bed for about half the morning and afternoon and we had fun playing with a new Strawberry Shortcake toy set that I had been keeping in the car and holding back a few days. Her preferred viewing today was The Backyardigans (and I just got that song stuck in my head as I wrote that...) and Timmy Time (a funny offshoot of the hilarious Shaun the Sheep). She still is very tired and took a long nap this afternoon and her appetite is the same. But she tried to eat a little bit throughout the day and her weight is only down about 0.2 kg since the first day. Her mouth and throat are still clear with no sores.

The doctors would like her to poop but that could shift quickly anyway as this much chemo tends to cause the reverse of constipation. We've given her a softener the past 3 days and miralax today but she hasn't had a bowel movement in a few days. Of course, she hasn't eaten much either and isn't complaining about any stomach pain.

The transfusion though is going to become a regular happening. Her red blood and platelet counts will take longer to recover than her ANC (immune/white blood cells) counts so they have to help her system hang on until her body recovers. Her platelets are still at 300 (normal is 150-500) and her ANC is still almost 3000 (normal) but that will change quickly.

Her chemo will finish up for good at around 10am tomorrow morning. God willing, that will be the last chemo she ever has to receive! We'll continue to manage her nausea and give her fluids but then it's all about getting to the stem cell infusion on Wednesday and then waiting for those cells to engraft and for her to rebound. The next two weeks from this point forward are likely when she will feel the worse and her system will be the most in flux.

At home, Zinnia has shown no other signs of being sick and no one else has had any nausea or signs of what Zinnia seemed to have yesterday morning. We're thinking that maybe she just ate some of a bad cutie and it was a bit of quick food poisoning. If all is well tomorrow, Sam and the kids will return to Brent's Place tomorrow night or Monday morning. I got out of the hospital for a little bit today to do laundry at Brent's Place while Esther watched a movie and showed some of the nurses the family picture book that Sam made for her. She continues to amaze me with how she pushes forward and does not complain nor get dejected. She's been plenty tired but she is in the routine and has not been sassy or prone to fits so far. I know it will harder but God has prepared her.

For who is God, but the LORD?

And who is a rock, except our God?

the God who equipped me with strength

and made my way blameless.

He made my feet like the feet of a deer

and set me secure on the heights.

He trains my hands for war,

so that my arms can bend a bow of bronze.

You have given me the shield of your salvation,

and your right hand supported me,

and your gentleness made me great.

You gave a wide place for my steps under me,

and my feet did not slip. (Psalm 18:31-36)

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