BMT Day 38 and 100% chimerism

BMT Day 38: The last several days have been the most calm in Ashtyn’s room since the beginning of her bone marrow transplant process that started on July 31st. Her nurses stay busy but tasks are scheduled and there haven’t been any recent outlandish complications. Ashtyn obviously really really really needs neutrophils (a type of white blood cell) which solidifies engraftment and provides a beginning immune system. Despite her delayed engraftment and ongoing lack of neutrophils, everyone in the hospital is very pleased with how well she is doing. A lot of credit for her staying alive during this waiting period is given to the BMT and infectious disease teams who discuss Ashtyn’s circumstance all. the. time. Her plan of care is ever changing as they balance infection prevention and  management, being mindful to not push her kidneys into failure, and at the same time provide precise nutrition and hydration while keeping all her electrolytes at safe levels. She also requires blood products regularly because her marrow is not currently making red blood cells or platelets. Our bodies are mind blowing intricate and, as of this moment, Ashtyn is in a good place because of the efforts of many people. Most recent, she had a sleep study from 8:00 p.m. until 5:00 a.m., where she was attached to I don’t know how many wires and probes. Results haven’t come back yet but her sleep apnea is improving and using 2 liters of oxygen while she sleeps seems to do the trick. She had a recent heart echo and EKG, showing a good heart. She had a recent chest X-ray that showed good lungs. She took an actual bath, which was paradise for her, and had the strength in her legs and arms to get in and out of the tub. Most results from her bone marrow aspirate and biopsy have not come back yet to determine if there are viruses, or cell mutations, in the marrow. So far results have come back showing no leukemia! The scarce cells that are in the marrow have also been determined to be 99% new donor cells and 1% old donor cells. Her peripheral blood also showed 100% genetics (chimerism) from the donor and 0% from Ashtyn, her brother (1st donor), and Dad (2nd donor). It’s complicated but simply put, we want the blood cells that are produced in her body to be 100% donor cells, so all of that info is very good news. On top of being physically well, Ashtyn is doing emotionally great. We both feel patient, calm, and certain that engraftment will occur. We are happy and hopeful.

Sleep study set up. What you don't see are all the probes on her head, chest, arms, and legs. 

Check out the wires on her right. This girl endures it all. 

Occupational therapy.

Blood products save lives.