A Good Night and Looking Forward to a Better Day!

Sabine did NOT want to go back and get admitted to the hospital yesterday! So, Dr Longo let her come home after a real big dose of broad-spectrum antibiotics. THE FEVER BROKE LAST NIGHT!

We have an appointment this morning back at the hospital for more blood tests and a re-checkup. Dialysis this afternoon at home and that's our day!

Sister Barbara and husband, Ken, are still here helping us get settled in our cottage. The main thing now for Sabine is hydration and nutrition (in that order). She is still pretty weak but as we all know -- a real fighter!

Danger Zone

Well... we almost made it a full day at home until Sabine's temperature started to spike late in the afternoon. A run to UW Hospital, blood tests, and antibiotics... almost a re-admission, but I convinced Dr Longo that after they administered the antibiotics I could take care of Sabine just as well at home... so, we will watch her temperature and the possibility of an infection this evening.

We are scheduled to return to UW Hospital in the morning for more blood tests and an investigation into the infection. I sure hope it is not the tunnel catheter... but with all this chemo and repressed immune system, infections are part of the package.

Not out of the tunnel yet!

At Home

Today is going to be our first full day at home!

I have not forgotten how to be a dialysis nurse again.

Here are some thoughts on our 15 days at UW Hospital (and with thankful and grateful hearts we congratulate the nursing staff at 6 East and Dr Walter Longo!

A Poem

you descended
into a sealed
plexiglass pipe
i ran
alongside
anxious
are you okay?
what can i do?

we
try
to listen
try to read
lips
but in your pain
and isolation
i am outside
running
waiting
i cannot stand
it

but now
we are home
still weak
still hurting
yet home
and
slowly as
we settle down
into
our and
familiar
routines
the
plexiglass tube
slowly
dissolves
and i can
touch
you
again

T Day +12 -- COMING HOME!

TODAY IS THE DAY! NUMBERS ARE WAY UP!

SO...

SABINE IS COMING HOME TODAY!

During this ordeal I cited the 4th verse. Today the entire psalm fills my heart!

Twenty-third Psalm: A psalm of David

1 The LORD is my shepherd, I shall not be in want.

2 He makes me lie down in green pastures,
he leads me beside quiet waters,

3 he restores my soul.
He guides me in paths of righteousness
for his name's sake.

4 Even though I walk
through the valley of the shadow of death,
I will fear no evil,
for you are with me;
your rod and your staff,
they comfort me.

5 You prepare a table before me
in the presence of my enemies.
You anoint my head with oil;
my cup overflows.

6 Surely goodness and love will follow me
all the days of my life,
and I will dwell in the house of the LORD
forever

T Day +11 -- Eureka!

GOOD NEWS!

Yesterday we noticed a slight increase in Sabine's white blood cell count (from zero to .7).

It was a sign of things to come: This morning she had an increase in her white blood cells to 4.7 (normal range from 3.8 to 10.5)! Her neutrophils are at 2914 up from zero (normal range 1700-7500). There is also good activity in other blood marrow cells.



So, those stem cells are starting to KICK IN! (For you medical types out there, her platelets are still low at 37 (normal range 160-370), her hemoglobin rose slightly (but without a transfusion!) from 8.3 to 8.8 (normal range 11.6-15.6).

The throat swelling (mucousitis) has gone down permitting Sabine to eat after three days without solid food.

Dr Longo, and Nurse Practitioner Blythe (see picture), has set some goals for Sabine in order for her to be able to be released home. We hoping it's this week! (Maybe Wednesday?)

As I write this Sabine is getting an ultrasound on her arm -- the one that had a vein blockage a while back after she had a vein and artery hooked up for an eventual fistula for dialysis. The fistula would then replace the tunnel catheter we now use for dialysis. We are hoping this is not something connect with the transplant.

Continuing prayers are needed to keep those stem cells multiplying in the right way, for no infections to occur, and for Sabine to have a successful transplant.

To celebrate this day (Transplant Day +11) I bought Sabine this metalwork character I found in a gift shop. When I saw it I knew immediately that this was MR. STEM CELL. This little bug looks exactly how I would imagine someone animating a stem cell. He will be with us during Sabine's 110 day recovery at home (or he might end up in the yard looking in the window!

This is a joyful day.

P.S. In case you haven't been following all this closely, I have enclosed this primer on stem cell transplants. A successful stem cell transplant in Sabine's case would most likely give her a year or more without having chemotherapy. With multiple myeloma there is no cure at this time. So we talk about managing the disease.

Bone Marrow Stem Cell Harvest

A bone marrow stem cell transplant uses stem cells derived from bone marrow to provide a fresh and healthy source of new blood cells which in turn, allows for a patient to receive higher doses of chemotherapy to treat certain types of cancer such as leukaemia. This ultimately means that a person has a better chance of surviving cancer. The bone marrow stem cells may be allogeneic and therefore donated by a family member of stranger, or they may be autologous, which utilizes a patient's own stem cells. (Sabine is using her own stem cells – autologous.)


Importance of Bone Marrow

Bone marrow is the soft tissue found in the centre of bones. It is here that new blood cells are formed; stem cells are considered the parent cells of these blood cells. Stem cells in the marrow have the vital task of creating a person's three blood cell types. These are:


* Red blood cells: transport oxygen

* White blood cells: fight disease

* Platelets: aid in clotting after injury


Bone marrow stem cells are found in bone marrow and in a person's blood. After stem cells multiply, they form immature blood cells, which are then subject to a collection of changes that allow them to develop into mature blood cells. Once mature, the blood cells migrate from the marrow and are introduced into the bloodstream, where they provide important functions in keeping the body alive and healthy.


Effects Of Chemotherapy On Bone Marrow

Because chemotherapy operates by destroying the fast growing cancer cells, higher levels are generally more effective for killing cancer cells. Similar to cancer cells, however, bone marrow cells grow quickly and are also very sensitive to chemotherapy treatment. The chemotherapy can eventually destroy the marrow completely, which then prevents new and healthy blood cells from developing.


Autologous Bone Marrow Stem Cell Harvest

In an autologous transplant, a patient's own stem cells are used. The problem here is that the patient’s bone marrow and peripheral blood usually have a lot of cancer cells, so isolating stem cells can't generally occur until the patient is in remission.

A patient will usually receive some chemotherapy to reduce cancer cells before stem cells are collected. The harvested stem cells are also treated to ensure that no cancer cells remain. Higher doses of chemotherapy are then given, sometimes alongside complete body radiation, to confirm that no cancer remains. Stem cells are then transplanted back into the body via a rapid injection. Stem cells will eventually migrate to the bone marrow, where they latch onto other cells there and develop into the different blood cells.

T Day +10 -- More Pics

Some photos that did not make the last blog. In spite of the weather this week which ranged from 75 degrees to 45 and rainy, Sabine got out for a walk (no matter how terrible she felt!) and then a snooze (both of us here).

The bus stop photo was made by sister Barbara who said that she caught Sabine trying to hail a westbound bus! (Yes, she is very anxious to get home and into some familiar surroundings!).

Barbara administers her wonderful foot massages which makes Sabine's hospital life so much easier!

T Day +10 (Mothers Day)

A special Mother's Day gift for Sabine: her WBC (white blood cell count) went from less than 1 to .7 -- that means something positive is happening in the bone marrow. We are excitedly waiting for tomorrow's labs!

Still nothing to eat for Sabine (3 days now) but she is getting her hydration by an IV. Oxygen use is back to normal so no more O2 hookups!

Mother's Day contacts (cards, phone calls and pictures) from the kids (and granddaughter, Taylor) made her day and perked her up when I got back from leading worship this morning at Trinity Episcopal in Mineral Point.