Day Plus 18: Engraftment

by Jana

Oliver has officially engrafted. He has now started growing stem cells and building a brand new immune system from his donor's bone marrow.

Oliver has made it to Day Plus 18. Last Tuesday we were still expecting things to either stay the same or get progressively worse. However, after his second post-BMT sinus surgery on Wednesday, things started trending in a better direction and then stayed stable the next few days. He continued to fever and deal with severe mucositus, rashes and GI track issues related to BMT, but was able to cope with those things better than expected and without supplemental oxygen. He was even able to finally finish Dr. Verma's scarf and come up with an unique method for managing the yarn for two color yarn projects.

During that time, a little girl who had her BMT a week after Oliver's was transferred to the PICU for kidney and liver failure and has not returned to the cancer unit. Oliver's friend, a boy his age who had a BMT over the summer, has been in the PICU for over a month. We have been praying for their return to our unit, which has helped put this past week into perspective.

Now that Oliver has engrafted, the next big milestone will be making it to Day Plus 100. The goal is do that without developing acute Graft vs. Host Disease ("GVHD") or other life threatening issues that are common among recent post-BMT kids during this period of adjustment and heightened immune suppression.

At the moment, we are not sure what exactly is going on with Oliver. Since he now has engrafted and has some capacity to fight infection, the mucositus has started to heal. While he definitely needs continuous morphine, yesterday for the first time, he was able to swallow a pill without first pushing his pain pump for a boost. However, his fevers have escalated and are now routinely above 104 every four hours. There is ongoing concern for GVHD. He is also being aggressively treated for invasive fungal sinus and lungs infections. However, unlike the case with the aspergilliosis invasive fungal infection this summer, which was confirmed by the fungus actually growing out on cultures, nothing has grown from either his bronchial fluids or the dead and diseased tissue removed from his sinus last Monday. The nodules in his lungs (which appear on the CT scans with the "halo sign" usually indicative of invasive fungal infection) are still there. The doctors were surprised to find that when they tested Oliver's bronchial fluid using a cutting edge DNA test, they were able to identify the subset of his cold/rhino virus while picking up zero trace of fungal infection or anything else infectious that could cause the nodules in his lungs. Several people have commented lately that Oliver is not just a medical miracle, he is also a medical mystery. We liked it better when he was just considered a medical miracle.

We are definitely still on the BMT rollercoaster, suspended, upside down, with no end in sight. That said, we are grateful Oliver has made it this far and hopeful things will get a little less frightening from here on out.

We continue to be amazed at and grateful for the love, prayers and support our relatives, neighbors and complete strangers keep sending our way. Thank you!

Oliver stepped up his crochet game last week by repurposing a cheese ball
container and straws to help keep the yarn for his multi-yarn projects easy
to access and tangle-free.

Samantha, Oliver's little sister, at Primary Children's last week--
two days before we distressingly found out she had SHINGLES!
Needless to say, the days of being able to wave to Oliver
through the glass of  his door are gone until she is healthy
and no longer contagious. 

Popular Posts