We’re fully engrafted and movin’ on up!
As a reminder, engraftment is when the stem cells you received on transplant day start to grow and make healthy blood cells. It’s a very important milestone in your transplant recovery, and really when you start to feel better and feel like all of this was worth it.
The real transitional period of your transplant begins with the atomic bomb of chemo, which runs through your body essentially killing everything in sight. 48 hours after this chemo infusion, the cells they collected, cleaned and stored are returned to your body (the actual “transplant”) and you get a bit of a bump in how you feel because they pump you full of steroids during the cell infusion/transplant. That bump lasts a few days and then you begin to bottom out and the side effects of that big chemo bomb really take hold. Your numbers start ticking down, down, down, eventually bottoming out at zero. That happened for Corey on “Day +9”, which is right about average. Once your counts zero out/bottom out, they stay there for a few days while the transplanted stem cells take root and begin to grow and repopulate (or engraft). This is the period when you feel the worst and the side effects are pretty ugly, severe and constant (and when most patients end up being admitted). The fever that landed Corey in the hospital last week is totally normal because your body, with its very limited resources to fight any kind of infection, treats those transplanted cells as foreign agents and tries to fight them off. Luckily your body can’t fight very hard and those good cells override the fighting cells to take root and begin rebuilding healthy blood and bone marrow. Once you’re engrafted, your numbers start ticking up, up, up and the transitional period of the transplant is complete, moving you into post-transplant recovery.
That’s where we are now, we’re post-transplant “Day +15.” Corey is engrafted and beginning to feel better and like all this really was worth it.
When you’re admitted with a neutropenic fever (meaning your white blood cell count is below 500), they won’t release you until your neutrophils are back above 500. Neutrophils are a type of white blood cell. There are 5 different types of white blood cells in our bodies, and neutrophils account for about 60% of the makeup of your white blood cells. Corey was admitted last Wednesday with ZERO neutrophils and ZERO white blood cells. He started to register a white blood cell count on Saturday (from the other types of cells that make up your white blood cells) but no neutrophils. Then on Sunday he registered .06 neutrophils and .47 white blood cells, meaning he was engrafted and things were taking hold.
That’s one. small. step. for. man…
And. one. giant. leap… for a post-transplant patient!
When he was first admitted last week, Corey was at the lowest part of this process and was feeling pretty terrible. Now that his neutrophils and white blood cells are coming in, he’s beginning to feel a lot better. Once your counts start going up, they go up pretty quickly so we’re hoping for discharge from the hospital in the next day or two. As of this morning his neutrophils are at .26 and his white blood cell count is at 1.44 (for you number lovers or medical types). We’re praying they double today and that he’s at .50 neutrophils when they draw his labs tonight at midnight because he’s going stir crazy and is ready to bust outta there. We know he’s right where he needs to be and that his being admitted this past week was the right move, but now that his numbers are trending up, I’m afraid that when I arrive tomorrow morning, I might arrive to him running out the door, IV lines flapping behind him, yelling “Go! GO! GOOO!” when I slow down at the curb…
What’s the penalty for breaking a patient out of the hospital?!?!
Anyway, because Corey was admitted and receiving ’round-the-clock care, I took advantage of the break and came home to spend a few days with the kids. We visited Corey over the weekend and you could see the visible lift in his spirits from the time we arrived to the time we left. Kid cuddles can, for sure, cure what ails you. His numbers doubled within the next 24 hours.
We’re praying this hospitalization won’t set us back and that his numbers keep going up, up, up, and we’re back home by Dec. 1 (the original timeframe if there were no setbacks). We know Corey is exactly where he needs to be and that he is receiving world-class care, but we’re anxious to be together again, walking through our own neighborhood and surrounded by the people we love.
I’m reading through the book of Joshua right now and I read something with fresh eyes yesterday. This is the story of the children of Israel finally crossing over the Jordan River and out of a 40-year trek through the desert. It’s the story of God leading His people into the “Promised Land” after a pretty rough patch (to put it mildly). Once the children of Israel crossed over the Jordan, their first battle was at the city of Jericho (where they marched around it and the walls came down). From there, they had a lot of fighting and ground-taking to do before there was rest and victory. There were years of hard-fought battles, but eventually victory came.
For whatever reason(s) I had at the time, every reference to the Lord fighting on behalf of His people had been underlined in my bible from previous readings. Phrases like:
“I have given them into your hand…”
“the Lord gave…”
“because the Lord, the God of Israel, fought for them…”
account for a lot of this story. But there are also a lot of phrases that say that Joshua:
“did just as the Lord commanded…”
“left nothing undone of all that the Lord had commanded…”
There’s nothing we can do to speed up this process. There’s nothing we can do to make Corey’s neutrophils populate faster. We can, however, control how we handle each and every battle we face along the way. We can control whether we’re being obedient to the what and the who and the where the Lord is leading us and whether we are “leaving nothing undone” of all the Lord is asking of us during this time. We have a lot of ground to take in this process yet. Our lives will forever be changed by this diagnosis and this journey. But what an incredible opportunity to cross over a metaphorical Jordan River in our lives and take hold of all the Lord has promised for our family. Maybe Israel and the Jordan River should be the first stop on that post-transplant world tour I wrote about a while back…
Whether we ever get there in real life or only symbolically, I pray this post-transplant life is full of all the promise our little family can possibly contain. So here’s to “movin’ on up” to the post-transplant life and whatever this phase of our journey holds!