Monday, November 24, 2014

Day 3: updated

Day 3: Best friends reunited at last!
In Seattle, it even rains inside.

Ava seems to be doing pretty well by all accounts. One of the main things they're on the lookout for is mucositis. Mucositis from the chemo and TBI results in sores and inflammation of the stomach and esophageal lining. That's why transplant patients typically need TPN (IV nutrition) because their oral intake is grossly insufficient due to extreme pain from the mucositis. Most transplant patients are feeling the effects of the mucositis by now, unable to eat and screaming in pain. While Ava's appetite is definitely decreased, she is still managing to eat a little. In fact, she amazed the docs by eating three tangerines today, as citrus in particular can be painful to eat. On one hand, it's hard not to wonder how Ava is fairing so well: did she somehow not get the full radiation she was supposed to?? Unlikely. But our human flesh wants to find an explanation, even to entertain worry that something was overlooked. Then our hearts remember our loving God, who is able to do immeasurably more than we ask or think - surely this is His handiwork!...His answer to the many prayers you are lifting up on our behalf. Thank you. Praise be to God!

While we rejoice in these blessings, Mike and Esther are still trying to prepare for what's ahead, knowing how unbearable mucositis can be and how quickly any infection can change things. Today's labs showed that Ava's ANC has indeed gone to zero. Now we are waiting for her counts to go back up. For cord blood transplant, this can take 3-4 weeks, unlike the typical two weeks for bone marrow transplants. At that point, they will do more labs to determine whose cells are being produced: Ava's or her donor's. If it's her donor's cells, this would indicate that the donor cells are engrafting (hooray!) Until then, it's just more waiting...while maintaining good nutrition, minimizing pain and avoiding infection. Easy, right? Nothing is impossible with God! We pray for quick and successful engraftment.

Another prayer request is around transfusions. Apparently it's not uncommon for transplant patients to need almost daily transfusions for low counts. However, with Ava's allergies, this means she would need to be premedicated with steroids for each transfusion. We pray that this little body would receive as few drugs possible, with as little steroids as possible!

Thank you so much for your prayers. You are greatly appreciated.

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