A new Day, A new dose of Cathi's donor

Day 22 in the Hospital, +38 since Chemo
The weekend is over, the boys have gone home, and a new plan. There was one plan Saturday, another Sunday, and yet another on Monday. Here is the approach moving forward.

Sunday morning Mcguirk came in to say that Cathi looked good and her lungs sounded the same. He did decide that he wanted a CAT scan of her lungs on Monday or Tuesday to confirm it clinically. This was to see things clearing up in order to prepare for another transplant, a mini-transplant like before.

He viewed the mini-transplant as a potential solution since her body is not ready to go through the rigors of a full-blown transplant & the chemotherapy preparation. But since the WBCs are stubbornly not regrowing, it’s an option he feels will give the desired results. As you look back in the September blog posts to see what the process was but essentially it’s a very quick ramp-up & preparation period followed by the transplant. The difference in a mini-transplant is the prep does not kill off the host marrow and blood the way it does on a full-blown process.

Prior to moving forward, Mcguirk wanted to seek the advice of some Seattle colleagues as they have the most experience with these mini-transplants. So the Dr's do have consultations. Cathi and a lot of us use discussion boards for troubleshooting IT issues. The medical community benefits from these and other collaboration relationships in ways many of us had not even thought of! He said based on what he finds for his answers, he’d decide when to schedule the min-transplant and what modifications to the previous procedures may be required.
That was Sunday

Monday he came in with an update on the pneumonia and a new plan. The infectious disease doctor finally has resolution on what type of pneumonia it is – fungal pneumonia. Mcguirk said, ‘Acts, looks, and talks like a duck. It’s a duck.’ This one of the primary causes of mortality in leukemia patients…hence another plan with quicker impact and results.

The plan is two-pronged in Dr Mcguirk's terminology. As opposed to Conor's ‘two-phased’ approach. So here are the details:
- Infuse the leftover cells from Walt on Tuesday, remember he gave an extra 130ml in Sept. These wbc's are put in to help Cathi with some WBCs to fight off the pneumonia, and improve her health and lap times at the hospital. Remember Dr Ganguly would say 'You have your brothers blood, you should feel 10 years younger. This may lead to Cathi getting out of the hospital in 7 – 10 days (Mar 3-6). But then Cathi's brother was always an unknown... so no way to know for sure, as history has shown us the two together only tend to last 90 days. Not doing the chemo treatment before opens the door for a greater risk of graft Vs. host disease.
- Then a full-blown transplant in about a month, when Cathi has fully recovered. That would include the total body irradiation, (Chemo + radiation) that would squash all marrow prior to a transplant. Cathi would also infuse fresh cells from the donor. Fresh cells increases success rates by about 10% & there will be no more of Walt on file at the hospital to use.

It is a good plan. It will strengthen her ability to ward off the pneumonia on her own, or with a little help from her brother so to speak. And with all we have done at the hospital, a plan that is sure to change as conditions change and improve. We shall see. There is even a chance, very slight, but a chance, that the infusion tomorrow would ‘take’, and that’d be it. But that is kind of like a lottery ticket, people do win them, but it is generally somebody else, with odds at seven digits.

So here is the 'marching orders' as Cathi would say, for the rest of us:
-Hope and pray the infusion tomorrow takes care of the pneumonia. Cards & posts
-Hope and pray the infusion ends up being the solution. There is always hope! If it is not the solution, then it is support for recovery and then on to the full transplant in about a month’s time, and for that transplant to work.