Tuesday, December 14, 2010

Stepping it up

It's hard to believe that the transplant is in less than 4 days.  Hopefully we can keep our spirits up, but it will be hard to ignore the impending transplant.  Mom will be admitted to the hospital on Wednesday and remain there until Saturday at the earliest.

We spent a bit more time in the clinic today, since mom was receiving an infusion of Busulfan as well as the usual Fludarabine.  As I said in an earlier post, she had to start taking anti-seizure medicine to pre-medicate against a Busulfan-induced seizure.  Last night was the first night in a few days where mom got in a good night's sleep.  I had to wake her up at 10pm so she could take the final Diflucan pill and so I could take her temperature.  In order to do these two things, I had to wake her up 3 different times.  Once to tell her I was going to take her temperature.  Once (five seconds later) when I was ready to take her temperature.  Once (15 seconds later) when the thermometer started beeping and she didn't move at all.  Very amusing.

Tomorrow marks the beginning of immuno-suppression.  She will start taking Gengraf (cyclosporine), which dampens the effectiveness of T-cells in her body to reduce graft-versus-host disease (GVHD).  GVHD is caused by the donor's stem cells producing T-cells that incorrectly identify mom's skin, gut, or liver cells as foreign, resulting in a buildup of white blood cells that attack her tissues.  By minimizing the effectiveness of the T-cells, the immune response to the 'foreign' tissues is dampened, leading to milder reactions.  Of course, this also means that her immune response is dampened for real infections, so the doctors have to balance the desire to minimize GVHD with the need for her to be able to fight off infections.

Tomorrow is also the last day of outpatient chemo.  On Wednesday, mom will be admitted into the hospital to receive infusions of either Atgam (from horses) or Thymoglobulin (from rabbits).  These Anti-thymocyte Globulins (you know, ATGs) are used to reduce the chances of rejection of the donor cells.  She will be in the hospital for this because they want to monitor her, since the side effects of these infusions include high blood pressure, high fever, chills, and other similar things.


  1. Rabbits and horses. Hmmm. I Googled that combination and got some interesting results, like:

    1.that's the name of some finance program titled 'Optimal Dynamic Capital Structure from Shareholder and Manager Perspectives'

    2.rabbits don't eat their poop and that horses can poop while they walk.

    Common denominator is . . .Go figure.

  2. And how do they decide beteen rabbits and horses? Do they just look at how hungry you are or what you eat? I like rabbits, but horses are healthier, I've heard.

  3. Go Wanda go!!! Keep on truckin'! Case, thanks for the detailed updates. Sounds like everyone is going to know more than they ever wanted to about GVHD and ATGs (woohoo acronyms!). Here's to bunnies and horses!