Day 50 - Tuesday June 26, 2012

WooHoo - we're up to 1% neutrophils with WBCs still at 500!!  Platelets dropped to 10,000 - the lowest yet.  Low enough that spontaneous internal hemorrhage is a risk - and severe hemorrhage with a car accident, etc.  We went in for platelets at 1 pm, but there is a critical blood shortage right now, and they didn't have Ryan's blod type - A negative. 

Platelets are separated out from whole blood by a phoresis technique - similar to the centrifuge technique they used to reduce Ryan's cancer cells in the ER the first night.  But the resultant product is not 100% pure platelets.  Some Red Blood Cells (the ones that carry the blood type and Rh factor antigens) are still in the solution, albeit in very small numbers.  It's these errant RBCs that can cause problems by invoking an immune response or transfusion reaction.  Rh positive cells have a protein (antigen) on their surface that Rh negative cells don't have.  So the body of an Rh negative person recognizes the Rh positive cells as invaders and tries to destroy them.  In pregnant Rh negative women, these antibodies can cross the placenta and destroy the RBCs with the baby if a baby inherits Rh positive blood from the dad.  We are able to prevent this by giving the moms RhoGam - which locks onto the Rh positive antigens of Rh positive RBCs and essentially camoflages them from the immune system.

So guess what Ryan got today - RhoGam!  And a unit of A positive donor platelets.  Not his usual flavor, but we'll take them!

The siblings who are in the US got their HLA packets today.  Sean (working for the US State Department in Albania) is really stressing since they are short-handed at the embassy for much of the summer, and he simply can't take time off or leave Albania.  And last minute tickets are outragiously expensive.  So we're hoping someone else will be the match.

For those of you who were concerned that I posted in the wee hours last night, I've got to reassure you that it wasn't from insomnia.  Since Albania is 6 hours ahead of us, I got up a 1 am to talk to Sean before he went to work today.  He had an appointment with the embassy physician to discuss the HLA testing (by blood per the order from Albany Med).  He was told the testing couldn't be done there.  His swabs kit is on its way, and he should be able to do that easily and FedEx it back.

So I'm praying not only for minimal side effects of the chemo, and a close HLA match from a sibling, but also that it will be someone other than Sean.  Am I asking too much?

Thanks to Anjanette Yeager and Denise Stevenson for bailing me out in transporting the girls today.  I really appreciate you steipping up at the last minute for me.

Maybe I should let Ryan just go to these things by himself - he is, after all, an adult.  But there's still a voice in me that say that I need to be there in case Mama Bear needs to make an appearance.....

Another CBC tomorrow, to Boston for consultation with the transplant team on Thursday.  How do people who are working do this?  One more evidence of tender mercies, even though I never planned to not be working at this stage of my life, God knew I was needed at home, first by Kaia and now by Ryan.
---Barb