TRANSPLANT DAY!!! Wednesday, the 19th of October, 2011 - T- 0

It's Transplant Day!!! Miya's donor cells should be in the building, and the volume being reduced at the lab. The volume is reduced to allow for the fact that our donor weighs 60kg and Miya is now hovering around 11kg.

On Sunday night (T-3). Miya awoke during obs (or "observations"-temperature, blood pressure, pulse rate, etc.) and was difficult to settle. She ended up having codeine and I slept in her hobbit-sized bed with her.

Miya was experiencing some peripheral coldness and blood samples were taken to check for infection. So far, Miya's results have been good and there is no sign of infections.  We did, however, start to bundle her up and her umbilical hernia subsided. Her belly is back to normal size.  We feel that because she was tensing in the cold, it caused her umbilicus to emerge from the split in her immature abdominal muscles.

Miya's appetite and weight have decreased since Sunday.  She began to refuse food on Monday (T-2) and she had a nutrient-rich milk feed through her NG tube.

On Monday, (T-2) we began wearing plastic aprons when in the room with Miya and having to wash and gel our hands in a manic ritual to prevent infection.

On Monday night, Miya's NG tube came out while she was having an uncontrollable fit of rage, and the nurses had to put another one in.  At the time, she was having a milk feed through the tube and it slowly leaked all over her pyjamas. 

When an NG tube is inserted, a small sample of stomach contents are extracted into a syringe to test the PH. A PH level that is unlike the acidic stomach acid can indicate that the tube is not in place correctly.  Each time Miya receives something through her NG tube, a sample is taken and tested to insure Miya will be receiving the medication/milk into her stomach.  Because Miya had not been eating, a sample could not be  retrieved and tested and the milk feed was scraped.  She continued to receive IV fluids and I slept with her again as she was diffucult to settle and didn't want to be alone.

On Tuesday (T-1), the NG tube was tested in the morning after I got Miya to drink some water after having her teeth brushed. It was indeed successfully placed.

Miya started Aciclovir, an antiviral drug on Tuesday and started Ciclosporin on Sunday. Ciclosporin is an immunosupprescent given so that Miya's own body will not reject the donor's cells.  The doctors will control the dose of Ciclosporin so that the stem cells will be introduced to Miya's system gradually. 

Last night, (Tuesday night) Miya slept well and I got to sleep in my bed (which is not Hobbit-sized).

An interesting point: Miya has not vomited or had diarrhea yet. She has not had a fever since the first dose of Campath.

Miya continues to take a variety of medicines via her Hickman line and through her NG tube. She takes an antifungal, antisickness, some antibiotics, some pain medication when required, some antihistamine to reduce any reactions she might have.

***A NOTE ON TRANSPLANT***

A bone marrow tranplant, as some believe, is not an operation. Bones are not opened up, marrow placed, and then bones screwed shut. How painful!!

Remember when I explained the chemo drugs and their purpose? If you remember, the purpose of some of those drugs is to tunnel holes in Miya's own marrow. This is so when the donor's cells are infused via IV line into her Hickman line, they will migrate from Miya's bloodstream into the holes in her own marrow.

Bone marrow produces new cells, and contain stem cells. Stem cells (found in umbilical cord blood) can differentiate into a variety of cells. In a transplant, the donor's bone marrow is harvested and the stem cells are extracted. These stem cells are placed into an IV bag and infused over a period of time (4-8 hours) into the recipient. Sometimes, recipients can have a reaction, so the infusion is slow. 

Our nurse has just gone to phone the lab and we have found out that Miya's cells are here and being worked on right now!! They should be on the ward arounf 1400hrs-1500hrs!!