Bonnie, Mike, Isabel and Devon in MN
Kristen talked to Bonnie on Saturday morning. She, Mike, Isabel and Devon were all sitting in a master bed in a hotel across from Bonnie's hospital in Minneapolis. They were sharing a Starbuck's breakfast of bear-claws and croissants and various flavors of coffee and hot chocolate. Bonnie was looking forward to exploring Minneapolis through Tuesday as a family, at which point Mike and the kids will head back to Burlingame for a few days, then return as a family a few days later for the month of August.
All of Bonnie's tests have been successful, so she will be admitted to the hospital next Wednesday. This will be day "negative 7", seven days before her cord blood transplant on the following Wednesday. Beginning this Wednesday, Bonnie will begin total body irradiation, and a few days later, she will begin chemotherapy. This is all part of a pre-transplant regimen designed to irradicate Bonnie's leukemia cells (the cancer) and, as a side effect, will also destroy her immune system, which is the reason she will recieve a stem cell transplant in order to establish a "new" immune system.
On day "Zero" Bonnie will receive two cord blood units via an IV transfusion, and then we will wait four or five weeks to see if her neutrophil count returns to a normal level, at which point she will be discharged from the hospital. Over these first four or five weeks there will be a constant battle of opposing forces. Given that Bonnie will have no immune system, the physicians will monitor her for signs of infection very carefully, and if there is any infection, she will get escalating doses of various antibiotics. The chemotherapy and total body irradiation will also cause toxicity to cells beyond her leukemia cells; her liver and kidney will be challenged, among other organs, and many fast-growing cells beyond the leukemia cells will be damaged -- the cell wall of her intestine, for instance. The net effect is that she will be miserable. More miserable than past rounds of chemotherapy, as this is the "deepest" treatment, especially as this is the first time she has had total body irradiation.
With luck, somewhere between day 28 and day 35, Bonnie's "new" immune system will signal its presence through positive neutrophil counts -- a signal that the new stem cells have given birth to a "new" immune system, with white blood cells that are pumping out neutrophils to guard against basic bacteria and infections.
When her neutrophil count is 500, Bonnie will leave the hospital and go to a nearby apartment building where she will be until day 100, when she will be allowed to return to Burlingame.
All of Bonnie's tests have been successful, so she will be admitted to the hospital next Wednesday. This will be day "negative 7", seven days before her cord blood transplant on the following Wednesday. Beginning this Wednesday, Bonnie will begin total body irradiation, and a few days later, she will begin chemotherapy. This is all part of a pre-transplant regimen designed to irradicate Bonnie's leukemia cells (the cancer) and, as a side effect, will also destroy her immune system, which is the reason she will recieve a stem cell transplant in order to establish a "new" immune system.
On day "Zero" Bonnie will receive two cord blood units via an IV transfusion, and then we will wait four or five weeks to see if her neutrophil count returns to a normal level, at which point she will be discharged from the hospital. Over these first four or five weeks there will be a constant battle of opposing forces. Given that Bonnie will have no immune system, the physicians will monitor her for signs of infection very carefully, and if there is any infection, she will get escalating doses of various antibiotics. The chemotherapy and total body irradiation will also cause toxicity to cells beyond her leukemia cells; her liver and kidney will be challenged, among other organs, and many fast-growing cells beyond the leukemia cells will be damaged -- the cell wall of her intestine, for instance. The net effect is that she will be miserable. More miserable than past rounds of chemotherapy, as this is the "deepest" treatment, especially as this is the first time she has had total body irradiation.
With luck, somewhere between day 28 and day 35, Bonnie's "new" immune system will signal its presence through positive neutrophil counts -- a signal that the new stem cells have given birth to a "new" immune system, with white blood cells that are pumping out neutrophils to guard against basic bacteria and infections.
When her neutrophil count is 500, Bonnie will leave the hospital and go to a nearby apartment building where she will be until day 100, when she will be allowed to return to Burlingame.
posted by gbiddle616 at Sunday, July 24, 2005
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