End of Day 2

Trish is doing pretty good this afternoon. She had a good visit with everybody. Her speech is still slurred, but that should pass in a few days. If the infection in her central line doesn't clear, they will likely replace it with a PICC -- I think if they give Trish a choice she would choose the Hickman again.

I know I have said this a lot in the last few days, but thank you. I hope to get back to folks over the weekend who have written and called this week, but I can't promise. Please know that your well wishes and prayers are read, felt and appreciated.

Tomorrow they will start a round of cytoxan around noon-ish and the next two days will likely really stink for Trish. If you want to talk to her ry her before noon tomorrow.

Day 2

Good morning and welcome to day 2. Yesterday was a busy day for me. I had to pick the boys up from camp and had a lot of work related things to accomplish. The boys had a great time at camp and enjoyed a short visit with Mom late last night after getting their friend Eli to the airport.

Today Trish's Sister, Mom and our niece Kristie come into town. If I can wake the boys up we will meetthem for lunch in Baltimore.

Trish was kept fairly sedated overnight last night to help control her nausea. She is worried that her speech is slurred and that it might not be a by product of the sedation. I am pretty sure it is a by product of the sedation. While I was talking to her on the phone this morning, she slipped and fell, but didn't hurt or hit anything. In fact her nurse checked her out while I was on the phone and she was ok.

Her blood work from last night revealed an infection in her central line. They debated removing the line and placing a new one or treating with antibiotics. They settled on antibiotics and will start those today.

Today is a day of rest for Trish and tomorrow she will be given more chemo (Cytoxan) -- she'll get that tomorrow and Saturday.

I keep mentioning that I will tell you about the process and keep not having the time to write about it. I'll take a few minutes now to try and explain.

So, on Tuesday, Trish received an infusion of bone marrow/stem cells from a fully matched unrelated donor. Friday and Saturday she will receive more chemo (Cytoxan) designed to control and limit graft versus host disease. Graft versus host disease is the effect of the new marrow and Trish's own cells fighting each other. You want some of this (mildly) to fight the leukemia (graft vs. disease), but full blown GvH can be fatal.

What we want to happen now is engraftment. You probably know about grafting trees, you take two cut plants and tie them together and take good care of them and hope that they grow together and become one -- sorry Marianna, I am sure you could have explained that better.

The concept is similar with a bone marrow transplant. You take marrow and sttem cells from a donor, transfuse into the patient and hope that they setup shop and begin to grow and work in the new host. Stem cells are pretty smart. While they are transfused into the blood stream, they make their way fairly quickly to their natural home -- inside the bones. Where they set up shop and start making more new stem cells, which grow up to hopefully be new healhy white cells, red cells, platlets and all other wonderful cells in our blood. So we will once again at some point, about 30 days out, start watching very closely her blood counts (see the counts link in the left column). Engraftment will be confirmed and we will watch the counts. Trish will have a bone marrow biopsy sometime around Day 30 to confirm all is going according to plan.

Saturday Night Late Report

I have never seen Trish sleep so much, not even during her first bout with chemo drugs. To be fair they are sedating her more now, than they did last time. That's a double edged sword, both good -- controls her nausea, she sleeps through many of the side effects, but if you know anything about Trish -- she doesn't stop, doesn't rest and she handles pain fairly well. It is very frustrating to her to be in bed all day. She can eat a regular diet, but hasn't eaten anything. They will start TPN tonight -- the nutrition bag. I have missed rounds every day so far -- they seem to be earlier on this ward than they were on 5a, so I emailed Dr. Griffiths about finding a balance between sedation for the effects and letting her feel like she's awake at some point when it makes sense to lighten up on the sedation. For those who have called her in the last 24-48 hours she is trying to talk to you but her quality on consciousness varies greatly. To make matters worse she has had a lot of wrong number calls today too. I'll keep you posted on how she's feeling so you'll know when it is good to call.

Today was the last day of chemo till the end of next week. So I am hoping she will start to feel better this week before they make her feel worse again.

Don't forget to send those cards to help decorate her room. Linda L from her work wins the award for getting a card here first! She's also gotten some pretty good email jokes from the Alabama crew. Keep the good cheer coming and sore knees and folded hands aren't a bad way to spend your time either. Thanks for all your support, we really do appreciate it.

Saturday Mid-day

Welcome to Day 2. Trish received red blood last night, guess her crit was low. She's sleeping like a baby today. Every once in a while I'll ge up and just stare at her to make sure her chest is going up and down, and it is. It's the simple pleasures. They probably have her well sedated to avoid the nausea. She is still vomitting whenever she moves. I expect to her sleep today away. She should have a fairly good week though, because she won't get chemo again till next Friday (Day 8). Her Mom will be with her then and I will go home the night before. I'll return in about two weeks which should bethe time her counts start coming back and she would be eligible to be discharged. A discharge really isn't a discharge though as it means IPOP every day for a week or two.

The boys are playing Lacrosse today in deep south Dade county. When I tried to get an update at what should have been 30 minutes into the game, my Mom told me that they were still waiting for the referees. She'll call me at half time with an update if they ever get started.

In the Chip is really human department -- Trish and the boys like to think that I think I am perfect. Trish has gotten her fair share of traffic tickets, but I am at a lifetime of 1 and holding. On the way to the hospital today I was pulled over for going 83 in a 65 mile an hour zone. The trooper had empathy for me with all the Hopkins stuff strewn about the front seat of the rental car and let me off with a warning....But see guys I really am human....