New Roomies

Engraftment.  No one said this was going to be easy, yet so far, Jim has skipped most of the notorious side effects.  Looks like that's changing.

Engraftment.  That is what you call it when those nifty new stem cells start to settle in and get to work. With engraftment may come issues; call it engraftment syndrome. It happens around 10 days after transplant (now), is commonly seen after the initial appearance of new white blood cells (now again, remember yesterday's good news?) and may eliminate those first new babies (yep, they've gone AWOL), and is not unusual with the kind of transplant Jim has received.

Engraftment.  Let's say that when the transplanted stem cells start to do what we hope they will do it's like a new bunch of roommates moving in. As they settle, there are going to be adjustments, engraftment syndrome. It looks like fever, rashes, and soggy lungs.  It may also include funky numbers regarding the liver and kidneys, puffy tootsies and a soggy brain. Jim tells me it feels pretty uncomfortable.

Yes, the same sort of symptoms could belong to an infection. We tested for that, none present. Jim's nifty antibiotic cocktail has kept such buggers out of his system. Since there isn't an infection and we do have a fever, rash, and the disappearance of those pretty new white blood cells, the logical culprit is engraftment syndrome.  New roomies settling in.

The program for today, is support, watch and see. Support may include steroids (they are very good at treating engraftment issues), skin cream on the rash and Tylenol.  Watching includes a chest x-ray to see if the lungs are soggy (done), measuring his temperature and analyzing his blood (in progress). See means wait for time to pass - this condition may take a few days to pass on by.

For now, Jim is sleeping; didn't get much of that last night.  He's already sucked down more tasty platelets, liquid nutrition (one bag o' yellow fluid feeds a man for a full day!) and headache meds. He is working his way through a bag o' red (blood).  When that's complete, he'll shower and I'll anoint his body as he likes to term it when I smear cream on his skin.  We'll keep that headache at bay (it comes from a different source, not the engraftment).  He is far less cranky than he was last night after I returned to the hospital from a lovely Christmas dinner at the Fisher home (thank you, Tia, Greg, Mark, Ricky, Rose, Clark and Lindsey) with my family: Alisa, Robert and Spencer (hope you enjoyed your port wine and chocolates on the train ride back to San Diego!).  Frankly, my guess is that if we can keep the headache at bay, the boy will be reasonably cheerful.  The doctors and nurses (bless them one and all) are doing their job.  Ours is to cope and so we shall.