Transplant Day +10

Monday, February 3rd

Avery's ANC was 720 this morning! This is her first day of engraftment, although they won't technically considered her engrafted until Wednesday. Her fever curve continues to decline. She had a 102 temperature in the middle of the night, but it has stayed just below 101 the rest of the day. Unfortunately the rest of day was all downhill from the there.

Avery struggled through the night and all day with really bad stomach pains. No meds(Bendaryl, Ativan, or morphine) or position changes seemed to help. They did a chest x-ray and abdominal x-ray to rule out any major issues, and thankfully those were clear. If her pain continues, they plan to do a CT scan to get a better look at things. Her whole demeanor and behavior were different today due to the pain.

Her stomach pains seemed to overshadow her mouth pain for the better part of the day. I finally got a look in her mouth, and she has some very large ulcers. We are just holding our breath for the mucositis to start clearing now that her ANC is on the rise.

Later this evening, her nose started bleeding. It took 10 minutes to get it to stop, and even then, it still came and went for a while. We had to change her NG dressing because a ton of blood had pooled underneath it. Her platelet count was borderline, but they decided to give her a transfusion since there was active bleeding from her nose. Since we already had her riled up from the dressing change, I went ahead and gave her her nightly bath.

It was around then that we realized that her NG tube was officially shot, and we decided to remove it. With the state it was in, it was providing no benefit. It was leaking everywhere, and we couldn't be sure how much medicine was actually making it in. It was also in the nostril with the active nose bleed, so it wasn't making that much better either. It was a traumatic experience removing the tube, but they got it out quickly. Avery got upset and vomited a large(at least is seemed large to me and Shon) amount of blood clots that had been sitting in her stomach due to the mucositis. It looked a little like a scene from a horror movie. Of course, we weren't prepared with a vomit bag, so that resulted in bath #2 for the night.

We finally got her settled and back in bed, and she received her platelet transfusion. We will discuss tomorrow when they will replace her NG tube. They were wanting to wait a few more days to allow her to heal a little more, but there is one medicine that she has to take by mouth/tube, so it may be placed sooner since she will not take anything(including water) by mouth right now.

We are really hoping that tomorrow will be less eventful!

Please continue to pray for:

- Pain management

- Rest

- No more diarrhea and stomach pain

- No VOD