Day -1: Rest Day: They call this day the “rest” day because it is a day of rest after five consecutive days of chemotherapy to destroy all the stem cells in Idan’s bone marrow to make room for the donor cells. His counts have been dropping. His lymphocytes (mostly T & B cells) have been at zero for a few days and his red blood cells and platelets are getting pretty low, so he will need a transfusion in the next day or so. This is all to be expected as we have knocked out the factory in his bone marrow that produces all his blood (white and red cells alike).”rest” is a bit of a misnomer as it really just means rest from the chemo. As far as Idan is concerned, it was just like all other days, tethered to an IV pole and nurses attaching different meds throughout the day. Today we started a new immunosuppressant, Tacrolimus, that will help reduce the risk of severe GVHD post transplant. We are very familiar with Tacro, as Idan was on it for over a year last transplant. It is tough on the kidneys so he has to get a lot more fluids. His target fluid intake is 50 oz. Think about yourself or your children and then imagine how many cups of water one usually drinks a day. That is over 6 cups of water. This will most likely mean that when we are outpatient we will have to continue Idan’s IV fluids for a while longer unless we can get him up to that Intake number. Not so fun.
He spent the day playing a lot with his grandmother and grandfather who are here until tomorrow. This gave Amanda and I some time to pop out of the hospital and take a break and enjoy some of the nice weather we had today in Seattle.
Overall Idan has felt ok today and no major incidents. His mood has seen better days and we had a few melt downs, mostly about not wanting to take his oral meds. On the bright side, Dr. Idan had a lot of appointments today and as you can see from the photo below, he performed a transplant on Amanda today. Notice the professional touch on taping that syringe onto her leg. Not bad for a soon to be four year old.