Happy Juice

"Spectacular achievement is always preceded by unspectacular preparation." - Robert H. Schuller

Today was event filled.

The best news first: the donor was able to provide a stem cell donation and preliminary tests indicate that its a "good product". The donor is from Germany so their process was much earlier in the day so we had initial good news by about lunch time. Later I received more definitive information and also that "the product" had been received by NIH already. I guess FedEx delivery is really fast!

They'll be freezing the donated cells until Elise needs them in a couple weeks. I'm told they actually separate them into several individual packets and spread them across multiple freezers to minimize the risk (say if a freezer broke).

We also heard today that the donor has type O blood while Elise is B. She'll gradually change types over the next year after the transplant. Apparently there might normally be some complications from having different types, however one of the meds they are using for the conditioning (Campath) prevent these complications. In any case one of the folks said that if they took a spit swab (say from an envelope or drinking glass) and compared it to a blood sample from a crime scene that the CSI team would be confused because the DNA and other info would be different. I'll bet there's an episode like this.

Now for the "routine" news...

Elise had her vascular access device (VAD, aka "central line" or simply "line") placed this morning. She was sort of looking forward to it because they would give her "happy juice" to put her under (valium followed by some drug cocktail). They insert a catheter into an artery in her neck and then install a line under the skin from the artery to a dual access port that comes out her chest right of the centerline. They can use this to get blood samples, inject medications, do transfusions, etc without a million needle sticks. Elise will have this with her until just before we leave. She can shower with it, etc with a little care. But baths are out.

She seems OK with it. I guess she's known for a long enough time so she got comfortable with the idea before we got here. The only complaint she's had about it is the incision they made to access the artery. It's sore and feels weird (sort of tugs on her skin when she turns her head) because of the closure method they used: super glue. It forms a rigid scab-like covering that will eventually peel off. They say its faster to apply, faster to heal, and minimizes scaring.

While she was still unconscious from the VAD placement, another group went in and took a sample of her bone marrow and a core sample from her hip bone. They run some tests on this but also use it for later on down the road (about a year) when they'll do another one and compare the results.

The puncture for the bone marrow sample came from her posterior and she's a little sore from that. Tylenol seems to help a great deal, but I don't think she feels the trade off for getting "happy juice" was a good one.

We found out that they've decided to give Elise a Lupron injection that will interrupt her periods for a few months. Because her platelet counts will drop as a result of the chemo, they want to reduce any unnecessary bleeding. I don't think Elise was too upset to hear about this.

Tomorrow we get to visit with the ear, nose and throat specialists who are going to get a look at Elise for a baseline. One of Elise's Drs warned her that they'd likely want to spray some stuff up her nose that smells and tastes "like feet". I'm sure Elise is looking forward to that!

Sometime tomorrow we'll get training on how to handle the new line in emergency situations. They gave us a handout that includes the precaution "never use scissors near your catheter". I guess they've seen it all. In any case is all goes Elise will get a "pass" and be able to leave the hospital over night this weekend. Because the full catheter "care and feeding" class isn't available until Monday, we'll need to drop in once every 24 hours to have them flush and inspect the line. That's a good trade for a night in a comfortable bed (for me).

Becky broke down and visited urgent care today, so she's being medicated for a "respiratory infection" and hopefully she'll be allowed in the hospital starting next week. She was on her own and had to find a GEHA approved urgent care and pharmacy (the latter was not too hard because there's more CVS than Starbucks here).

So all is well and most of the groundwork is done.