BMT Day 32: I’ve used the word “engraftment” a lot lately. A bone marrow transplant is a process that obliterates the old bone marrow with chemotherapy and radiation because it was insufficient at providing an immune system that kept leukemia in remission. Donor cells then are transfused into the blood, make their way to the empty marrow space, and over time build a new bone marrow that provides an immune system which ideally prevents cancer from coming back. A successful transplant depends on engraftment: when the donor stem cells establish themselves in the bone marrow space where they grow and develop into new blood cells. Engraftment allows the bone marrow and immune system to begin recovery. The indicator that engraftment occurred is when a complete blood count lab shows white blood cells, specifically neutrophils. If engraftment does not occurred by Day 42 it is said to be a graft failure which is a serious complication. To further put things into perspective, Ashtyn engrafted on Day 21 with her first transplant and Day 17 with her second. How do we feel about being well past the average day for engraftment? It is completely out of our control. The only thing we can do is keep praying and hand it over to God, who is Ashtyn’s ultimate parent, with trust in His plan.
Story: Ashtyn dreams big and always has. Tonight she asked, “Would you let me do an experiment and see if my stomach can handle milk?” Without a doubt I said, “Of course! By the way, room service closes in 10 minutes so if you want something you better order.” Looking at the menu for the first time in a month, she told me to order “one chocolate shake, one chocolate milk, one regular milk, one peach smoothie, and a orange ICE.” The girl hadn’t had anything in her stomach besides water in weeks but why not dream big? She took one sip of the smoothie, drank the entire container of chocolate milk, drank the entire container of regular milk, and then laid in bed with a barf bag waiting to see what her stomach would do. 10 minutes later she threw up the 16 ounces of milk plus 10 ounces of whatever else was in her stomach. After everything was out of her stomach, the first thing she said was, “I think I’ll try milk again in a week. I’m thirsty, can I have some water?”
Please continue to pray 1. Adenovirus will be killed 2. The skin/line infection will get better. 3. Sleep apnea will improve. 4. Kidneys will heal and less potassium will be needed. 5. Her heart won’t go into ventricular tachycardia. 6. Engraftment will occur.
