Transplant Day!

Friday, January 24th

Avery slept well again last night with no nausea or diarrhea overnight. She required a platelet transfusion , but her electrolytes are still being maintained through the TPN. Her ANC has dropped to 590. She also remained fever free all night.

She still battled with vomiting and diarrhea randomly throughout the day today. They changed her from taking Flagyl to Vancomycin 4 times a day through her NG tube. She is already on IV Vancomycin, but pushing through her NG tube as well with ensure it makes it to her gut to help clear the CDiff.

Her transplant occurred around 2:30pm today. Given the process it took to harvest the stem cells and all of the stress we endured waiting to figure out if we could even harvest them, the transplant itself was very anti-climatic. It took exactly 10 minutes to put BILLIONS of cells back in her body. Her heart rate fluctuated from high to low a little bit during the transplant, but otherwise she had no issues. The strangest part was the smell. They warned us that she would give off an odor that smelled like creamed corn(some think garlic). This is due to the preservative DMSO used to preserve the stem cells while they are frozen. They were absolutely right! As soon as they started the transplant, you could smell it, and we will continue to smell it until her body disposes of all of it.

Billions of Stem Cells

A little bit about stem cell transplant... Avery had an autologous transplant, meaning she was her own donor. They do not typically do allogenic(someone else donates) for cancers like Avery has. Your bone marrow is comprised of white blood cells(fight infection), red blood cells(energy), and platelets(to stop the bleeding). With her previous rounds of chemo, Avery was able to recover with time. The chemo she received this round is called marrow ablative chemo, meaning all of the cells in your bone marrow are wiped out. Your bone marrow can not recover on its own from that so you would never regain an immune system, and you would continuously require blood and platelet transfusions without a transplant. The transplant or "stem cell rescue" gives her back immature cells who over time become red blood cells, white blood cells, and platelets. This will allow her to have functioning marrow again.

The rest of our stay will focus solely on recovery and waiting for engraftment. Engraftment can take anywhere from 9 days to several weeks. While we are waiting, she will be at high risk for infection and be battling the worst of the side effects from chemo. They will begin IV Neupogen daily to try to help boost her counts. She will likely receive multiple blood and platelet transfusions.

We are extremely blessed to have made it this far in the journey and be one step closer to complete healing!

Please continue to pray for:

- No more vomiting or diarrhea

- Protection of her liver and kidneys

- Pain control