| March 7, 2004 Sunday Day +3 of transplant Day 11 in the hospital |
| Paige has had a few rough days. She is so tired she can barely hold herself up for more than a few seconds. The mouth sores, nausea, vomiting and diarrhea have really taken their toll. The high-dose chemotherapy given to Paige prior to the stem cell transplant (rescue) targets rapidly dividing cancer cells. Since normal cells such as the delicate ones that line the mouth, throat and stomach also divide rapidly, they can be temporarily damaged by the high-dose chemotherapy. The mouth sores (mucositis) and throat discomfort (stomatitis) typically appear four to eight days following the preparative regimen. While she hasn't required pain medication for the mouth sores as of yet, they say it will get painful enough that she will. She continues to receive kytril, zofran, benedryl/phenergen and ativan for the nausea. We feel the nausea and vomiting is mostly because of the sloughing of the mouth, throat and stomach cells. Of course her temperature has been a problem, running between 38.5 (101.3) to 39.7 (103.5) which responds minimally to tylenol. She remains of multiple antibiotics. Today she required a platelet transfusion (for clotting) for a count of 11,000. Our friends, Bill and Teresa, visited this weekend from Pennsylvania. Thank you Uncle Jay and Aunt Christina for watching Drew so they could visit. With much hesitation, the four of us went to dinner at a great little restaurant downtown Ann Arbor. We know we need to rest and take breaks in order to give our all to Paige, it's very hard to enjoy ourselves when we know Paige is laying here so sick. We're so thankful that Paige is comfortable with Grandma and Nana so we can have short breaks. Pop-pop returned Sunday to Pennsylvania with Bill and Teresa and will return soon. Thanks for checking on Paige. We'll update tomorrow. Love, Andy, Sandi & Paige ANC (Absolute Neutrophil Count) Neutrophils are the key component in the system of defense against infection. An absence or scarcity of neutrophils makes a person vulnerable to infection. After chemotherapy and stem cell transplant (rescue), the ANC usually depressed and then rises, reflecting the fact that the bone marrow is recovering and the new cells are beginning to grow and mature. An ANC below 1000 means a person is at risk for infection. The lower it goes the more at risk, so an ANC of zero means Paige has no defense from her immune system. |
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| Labwork: March 6 WBC (white Blood Cells) 0.1 or 100 Hgb (hemoglobin) 10.5 Platelets 60,000 ANC 0 |
| Labwork: March 7 WBC 0.2 or 200 Hgb 9.4 Platelets 11,000 ANC 0 |