It’s just about “game day”, the magic “100th day”, the day that we see what is behind the door we picked. But first, to prepare Wayne for the big day, he had to go through a post-transplant work-up. He has had his heart and lung function tests, the results will be compared to his pre-transplant results to make sure there are no significant changes. He had a dental exam, making sure his teeth don’t have damage as a result of the transplant treatment, these findings were also compared to his pre-transplant dental exam. He had extensive lab testing, and last but not least, he needed to have another bone marrow biopsy. Wayne has had experience with bone marrow biopsies, in fact, enough experience that we scheduled with the person he thinks does the best bone biopsy. There truly is a big difference and because we are having this done at teaching hospital, this time he wanted the teacher not the student. In order to see how the transplant has grafted, you must go to the source, the bone marrow, the soft spongy tissue inside the bone where the 3 types of blood cell production (red blood cells, lymphocytes/WBC, and platelets) takes place. Bone marrow is generally taken out of the bigger bones, this time around they obtained the sample by going into Wayne’s posterior superior iliac crest, the left pelvis, buttock area. The area is numbed and then with a rather large needle, that is really a nail (see below) they push and push until the needle punches a hole into the bone. Yes, you do hear a “pop” noise when the needle punches through. Several samples of the liquid marrow are withdrawn, this is the part that bothers Wayne the most, he can feel it all the way to his toes, and then they take a piece of the spongy part of the bone. Once done, they put a bandage on it and for the next 2 days he has a real pain in his ….behind. Of course, we have to wait for 8 days to get the results, OF COURSE!!
A time to celebrate A time to appreciate All of you who mean so much Thanks a bunch!!!!!
A feeble attempt to wish you all BOUNTIFUL BLESSINGS. We are truly thankful to have you all in our lives. The prayers, good wishes and love have been the very best food for healing Wayne. We have feasted like kings on your support. THANK YOU, THANK YOU, a MILLION TIMES THANK YOU
- Erythroid cells are the oxygen carrying red blood cells and is referred to as erythropoiesis. This is the cell line that people think of when they are “anemic”.
- Lymphocytes are the cornerstone of the adaptive immune system. The lymphoid lineage is primarily composed of T-cells and B-cells (types of white blood cells). This is lymphopoiesis.
- Myelocytes, which include granulocytes, megakaryocytes and macrophages are involved in such diverse roles as innate immunity, adaptive immunity, and blood clotting. This is myelopoiesis. We really watch the platelets from this group.
I have come up with a plan to whip Wayne’s skinny, actually no butt, into shape. I am not certain that this will bring a happy response from him, but I have put the plan in motion. I, of course, will nag,nag, nag until he has walked, walked walked. And then 2 days a week I will let someone else do it. I have enrolled him into the physical exercise program Huntsman offers to their patients. Because Wayne had an allo transplant (this is a transplant that came from an unrelated donor) and has not reached the magic 100 days, he will be only patient in the room, one-on-one with the trainer. How lucky is that! Whew, for a minute I thought I would have to work out with him, why that could ruin the “muffin top” look I have going. I need to just sit, it takes a lot of energy to do all this planning and nagging.
Remember when we had our science fair projects next to each other in junior high. Remember then you weighted twice as much as me. Remember when your mom told you to stay away from that older girl she was nothing but trouble. Well, guess what buddy I am going to be trouble and it won’t be long now until we have restored order around here. I am supposed to be the skinny one and you are supposed to be my “chubby little 7th grader” REMEMBER!
He has been released and is on home confinement. I (the parole officer) will be checking in with Wayne. He will have random testing; getting on scale to check his weight, and the ankle bracelet will tell me he is on the move. Now, he must get to work, eating and exercising to prove he can stay out of the system (the hospital). I (the parole officer) will be sweating, REALLY sweating, we keep the heat at 80 degrees. I don’t want him make the accusation that he was mistreated during his confinement.
Yes, I am feeding him! Yes, you are right, he has gotten skinny!!! One big factor contributing to his thinness is the long-term use of steroids he has been taking. High doses and long-term use of steroids can cause damage to the muscle fibers. The muscles in the arms, legs and pelvis- Wayne’s butt, are most commonly affected, and then spreads to the neck and down the back. The muscles begin to atrophy (shrink). The muscle weakness starts in the upper part of the muscle and spreads to the lower part of the muscle. This condition is called steroid myopathy. Believe me, he will be working like crazy to get back muscle; can you just imagine if it got out that I beat him in an arm wrestling match!
Wayne’s adrenal gland seems to be sleeping on the job. At the time Wayne started having issues with his gallbladder, he also started having more fatigue. Oh, I hear you out there, “Really! He did just have gallbladder troubles and a BMT, most people would be tired!!” And of course, you would be right, but this is more fatigue than you would expect even under his current circumstances. So what’s up? As you may recall, Wayne had engraftment syndrome (ES) treated with high doses of steroids. The ES resolved and he started to taper (wean) off the steroids. Coincidently, the steroid taper ended the same time he started having issues with the gallbladder. So, why do they taper the steroid dose? Steroids are really hard on the system, so why not just take him off as soon as you can? One of the reasons you taper is to give the adrenal glands a chance to start to work. All the time Wayne has been on synthetic steroids, the adrenal glands have been snoozing, taking a break. We have to convince them to come back to work. The reason a person is weaned off steroids slowly is to give the adrenal glands a chance to “get fired up” so it can build up, to work full-time, on it’s own power. In Wayne’s case, his adrenal glands just do not want to get to work, so we will have to put him back on steroids. I am pretty sure no one ever thought of Wayne as a “Speedy Gonzales.”
Don’t know if you heard- the latest journey to space has been fueled. In other words, the bowels are working, and working,