Day +1 and Brianna Feeling Better

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The doctors always have rounds about 9:15 am every Monday through Friday and today was no different. However, this morning we learned we'd be getting a new calendar with a new treatment course.

(Here is Brianna this morning a little while after she threw up, which always seems to make her feel better. I guess that's just the way kids are!)

The doctors told us they didn't get as much marrow from the donor as they would have liked, so they're changing Brianna's treatment slightly for the next few weeks. Ordinarily, she'd get several small doses of Methetrexate - a chemotherapy type drug to kill the donors T-cells that came with the marrow. T-cells are programmed by our bodies to fight invading infections, viruses and other foreign cells. So those donor T-cells will try to fight Brianna's body. Methetrexate will kill them, but in the process some of the new marrow stem cells will also be killed. The doctors don't want to waste any of those precious stem cells. So instead of the chemotherapy drug, she'll get a steriod for the next month and rabbit-ATG - both of which specifically kill the T-cells and leave the stem cells intact.

There are pros and cons to all this, but the pros far outweigh them. (And thankfully the cons are not that bad. The good news is she won't get as many of the terrible mouth sores that some people get with the Methetrexate and she may even get out of the hospital sooner. "May" is the optimal word, as with any medical care.

The cons are she'll have to temporarily go on blood pressure medicine (they say 80-90% of the kids have to anyway), she will have to have her glucose checked and she may get flu-like symptoms during the infusion of the ATG. She'll have five 8-hour infusions of it over the next four weeks.

All in all, we're happy to hear this!! If they continued with the regular protocol, she would have had to stay in the hospital longer, which meant a greater risk of infection. So we're all for getting out early and saving all those wonderful new stem cells!!!

Last night, they also put her on TPN (total parental nutrition). It provides all the nutrients her body needs in IV form. All BMT patients go on this, because of everything their bodies are being put through and the inability to eat. Basically, it looks like she's getting a huge bag of Gatorade pumped into her. She can still eat whatever she wants though! It did keep her up all night going to the bathroom every two hours. (They also want to be sure her body is well nourished for the new stems cells.)

Also, they hooked her up to a PCA (patient controlled analgesic) system. She's now on a super low dose of a pain killer, and so now if she's feeling any pain, she can push a button and get a little bump in the pain killer. She's only pushed it twice and it knocked her out both times and enabled her to rest, thankfully, especially the way our nights have been going lately.

So we wait and continue to pray that her new marrow begins to form and start producing those much-needed cells!