Day + 21 - Going Home!

Michelle is going home tomorrow – Thursday February 23^rd!  The good news doesn’t stop there either.  Shelly’s white blood count is almost to the low end of normal.  Her counts are coming up and they look fantastic!  She still has a lot of healing that needs to take place and must be really careful until mid-May to not be around any sick people.  There is nothing like returning home after a vacation, I’m sure there will be nothing like returning home after a months stay in the hospital.

Here are her counts for the last several days.

	Monday 2/20	Tuesday 2/21
WBC	1.33	1.81
HGB	33.8	33.1
PLT	227	264
ANC	.7	.9

The throat is beginning to show signs of improvement.  She has been off of the nutrition supplement for several days and she is eating ok for everything she has been through.  Shelly continues to exercise everyday by riding the stationary bike and going for walks in the corridor.  She’ll miss the stationary bike, but it will feel good to go for walks in her yard. 

You have accomplished hard things Shelly.  There will still be hard things to come, but the road is definitely getting smoother!

Day +16 - Encouraged!

Shelly's numbers are looking almost normal, normal for a healthy person!  This is so encouraging! 

WBC: 1.01
Hemoglobin: 10.1
Platelets: 165
ANC - .6

All the doctors can't speak highly enough about her progress.  The morning was a bit shaky.  Literally.  Shelly's blood sugar was a little whacky.  No doubt this is due to the intravenous nourishment and now the added real food.  The intravenous nourishment is going to be dropped to half tonight, allowing her body to rely a little more on real food.  Another encouraging achievement is not only that she is eating but she is keeping it down too.

Today she had orange juice, 1/2 a bagel, lots of m&m's, a popsicle, 1/2 an ensure drink, and she also took a small pill by mouth.  Shelly sat up in a chair for over an hour and went for a long walk.  Her naps are decreasing which I also look at as a good sign of recovery.  I'm sure as she moves back home and is taking on more activity, her naps will increase too until she regains all her strength again.

Michelle's goal is to move home next week.  Something she is working very hard to achieve and looking forward to with much anticipation!

Keep going Shell!  You ARE doing great things!

Day + 14 and +15 - The Road That Leads Home

Shelly’s blood levels are changing.  Here are the counts for the last few days.

	2/13/12	2/14/12	2/15/12	2/16/12
White Blood Count	.11	.29	.47	.74
Hemoglobin	10.1	9.5	9.7	9.5
Platelets	47	42	72	116
ANC	0	.2	.3	.4

ANC stands for Absolute Neutrophile Count.  This number needs to be at .50 for 2 days to be considered total engraftment.  Her platelets definitely have engrafted and all the other numbers are looking good.

Yesterday Shelly was feeling a bit improved with energy.  She pedaled on her bicycle for a few minutes and she went for a walk down the hall and back all on her own.  The intake of food has been a bit more of a challenge.  Yesterday she had a half a popsicle.  The goal is to increase the food intake.

Goals for today are a bit more exercise.  I don’t foresee that being a problem.  Eating food.  Hmm…nurse Camille suggested to Shelly today that she order one of everything, try a bite, if she absolutely couldn’t eat it, then throw it away.  She needs to try a bite of something every time she received anti-nausea medicine.  That would be four bites more than yesterday.  At breakfast this morning Shelly ordered an English muffin and scrambled eggs.  I was so proud of her!  Before I left the hospital for work she had eaten ALL of her English muffin and had taken about five bites of the scrambled eggs.  I’m anxious to check in to see how the rest of the day has gone.  Nevertheless, she has accomplished great things today. 

Release from the hospital is on the horizon.  There are just a few things that need to take place before she can move back home.  1)  No fever, so far she has not had one, and probably won’t get one so this is not to much of a concern.  2) Swallow pills on her own, she’s working on that.  3) Eat about 500 calories.  You and I may think that seems like not a big deal, but this is probably her biggest obstacle.  4) Her ANC level needs to come up to .5 and remain there for 2 days.  Dr. Wei is sure she’ll hit that tomorrow, so again, this is not a problem.  There are also things that need to be taken care of at home to ready the house for her.  It needs to be completely dusted from top to bottom and sanitized.  We’re working on this one as well.  I can’t believe Shelly is getting to the point of looking towards home.  She has done hard things and is on her way to recovery.  The road ahead will still be slow, but it is possible!



Dr. Wei and Michelle



Shelly eating breakfast this morning!



Day + 13 - ENGRAFTMENT!

It's official.  She's engrafting!  This means the bone marrow transplant worked!  This is the best Valentine's Day EVER!  Dr. Wei said her numbers are definitely coming up.  Tomorrow they will double, by Thursday they should reach 500 and continue to double every day on out.

Michelle has been a miraculous patient to the doctors.  She is only their second patient to never have a fever and get some sort of infection.  Even though she had the CDIFF, she never had an infection.  Most patients retain 30-40 lbs. of water because of diminished kidney and liver function.  Shelly hasn't retained any water at all, meaning her kidneys and liver have continued to function properly.  She is still throwing up, but that is due to the mucous in her throat and the sores.  It is still very difficult for her to talk.  However, with the numbers coming up, each day she will improve and be able to fight off infection and all these things will begin to heal.

Tonight she has a Valentine's Date not only with Steve, but Dr. Wei said he'll be joining them since he has no date and she is his favorite patient.  Thank you for your prayers.  I know this is why Michelle has had miracle upon miracle bless her life these past few months.  The final destination has not been reached yet, but it is in sight.  I believe in miracles.  I believe in angels, and I believe in the power of the priesthood.  All these things have been evident in Michelle's life over the past several weeks!  Happy Valentine's Day Shelly!  This is one I know you will not soon forget!

Day +11 and +12 - How Low Can We Go?

Just when you think you cannot go any lower, guess again?  Shelly received her last dose of immunosuppressant last night.  She has now had four of them to help prevent graph versus host.  This would be so much worse than what she is experiencing now.  We were so hoping that she would not have it because we knew it would give her more sores and that it did, but I guess it is still better than the alternative.  Today she has no voice left because her throat is covered in sores.  For the first time Michelle asked for pain medication last night.  Unfortunately it made her sick, causing her to throw up, making the pain worse.  This is definitely among the top hardest five things I’ve watched someone go through.  If you know anything about me, then you know this is very difficult.

Dr. Wei has already been in today.  He is still hopeful that tomorrow will be the engraphtment day.  Her WBC came up from .07 to .14 today.  We’re just waiting for the neutrophils to begin showing up.  WAITING!  The Deters are not known for patience.  This is truly teaching us patience and that all things are in the Lord’s time.  He reiterated that even though Michelle feels “her” very worst, she is still ten times better off than the other patients on the floor.  Steve and I talked about that this morning, if this is what Michelle is going through, we can’t imagine watching the suffering of the other patients.  It tears my heart up to watch my beautiful sister suffer so much. 

Usually when I arrive early in the morning she is at her best, feeling somewhat rested from the previous night.  This morning she sleeps.  Hopefully she will rest well today and tomorrow will come quickly.  I love you Shelly Dawn.  Tomorrow, the sun WILL come out tomorrow!  Gotta hang on til’ tomorrow…

Day +10 - Things to Pray For

Spending the morning with my sister is always such a sweet time.  It breaks my heart to watch her suffer so much.  Both doctors today complimented her on how well she's doing.  Michelle and I both though, "if this is good, what do the other patients look like?"  Grateful that she isn't categorized as doing bad.  However, she is suffering and I wish that we could take away some of that for her.  So I plead with the readers of this blog to pray for a few specific things and if you would like to join her family in fasting, it would be appreciated.  Specifically that her complications and suffering with the CDIFF would heal, the sores in her mouth and throat would subide, but most importantly that engraphtment will take place very soon.  Dr. Wei is hoping for engraphtment by Tuesday.  Cross your fingers...we are hoping for that to.

Engraphtment really is the answer to cure all the suffering.  Once Michelle engraphs the sores in her throat and mouth will heal, the diarrhea will subside, her energy will return along with her appetite.  She is one tough lady.  Shelly has been offered pain medication to help ease her suffering, but she isn't taking it.  I commend her for her decision.  Watching her, I know that what she is experiencing is extremely painful and must seem like the tunnel is never ending.  I see the tiny pin hole at the end of this tunnel.  I know that if Shelly can have the strength to endure just a couple more days, she too will see the light.

Her blood count today remains similar to that of yesterday.  WBC: .07, HGB: 7.7, and Platelets: 30.  Normally Michelle would not receive a blood transfusion until her HGB reaches 7.5, but late this afternoon her doctor ordered the transfusion for today instead of tomorrow.  A platelet transfusion usually isn't given until it is below 30 so she will probably receive platelets tomorrow.  Both of these transfusions will help the time pass for Michelle because the accompanying Benydril will help her sleep.

As I left the hospital today I reminded Shelly of our favorite pig and spider.  She is "terrific" and to keep her "chin up."  I love you Shell.  You can do it, I believe in you!

Day 9 – CDIFF and HATS

I think the WBC have finally reached bottom today.  Michelle’s WBC is .07, HMT 7.9 (probably a blood transfusion tomorrow) and Platelet 44 (she received platelets twice yesterday).  Her doctor is hopeful that Tuesday we will begin to see engraphtment take place!  WOOT WOOT!

The sores have really started to be a big inconvenience for Shelly.  She began with just a couple under her tongue, unfortunately she has several in her mouth and her throat is covered.  This makes it very difficult to eat, so she’s back on the popsicle diet and ice chips diet.  There is time for eating later when the sores begin to heal.  Go white blood cells!

Another complication arose today.  Shelly has CDiff.  She has likely ingested spores from her stay in the hospital.  The bacteria were introduced into her colon where the normal gut flora was destroyed from the chemo and now her gut has become over run with clostridium difficile or CDIFF.  CDIFF causes bloating, diarrhea, and abdominal pain.  Just more of what she was already experiencing.  The hospital staff is monitoring it closely and is staying on top of it.

Mom is going crazy making hats to keep Shelly’s head warm and stylish.  Cameron wanted in on the action so when he went for a visit this morning he took his hunting cap.  When she wears it no one can see her (ha ha).  Mom has found a great pattern to make soft knit hats.  If anyone is looking for a service project we would be happy to share the pattern.  The soft knit hats are more comfortable than the crocheted hats.  The crocheted hats tend to be a little scratchy.  The pattern is quick and only costs approximately $5 a hat.