Slept very thoroughly last night after about an hour walk outside with mom. The sun, after 3 weeks of being here in Moscow, decided to pay us a visit. Glorious! Boy it felt good to get fresh air (like 8 degrees) with a crisp fall feel to it. Amazing what that does for the soul.
I was in the dead of sleep this morning at 7am, when the nurse came into take my daily blood draw. I think I managed 'Dobrayeeee' out of my mouth (not the full Dobraye ootra for good morning in Russian) and I was back asleep.
At 11, Dr. Fedorenko returned dawning a mask and full body aprons, and I knew the results were heading in the right direction. Overnight, my leukocyte levels had dropped from 3.2 down to 0.57. It is now time for Isolation to begin! These numbers should continue to drop over the next 2, maybe 3 days, until they bottom out. When it comes to the leukocytes, the lower the better. My hemoglobin and platelet levels appear to be holding well within the comfort zones.
I have mentioned many times how impressed I have been with the staff and protocol utilized here at this hospital. They do many, many transplants, some for autoimmune, more for cancer. As such, when the time comes...it's down to business.
I was given a half hour lesson on cleansing the body using various sanitary lotions. Now, you may think 'a half hour to learn body wash?'. Let's just say after the incident where the armpit thermometer went into the mouth last week, I paid extra attention. Thank goodness in all the pointing and gesturing about the thermometer, she didn't point to her bottom!
While you cleanse and change into new sterile clothiing, the nurses are garbed up and sterilizing your entire room. Walls, chairs, linens, you name it, it is disinfected. The hepa filters in both the inner chamber where I live and the outer chamber where the fridge and bathroom are located are now running 24/7. A UV light remains on in the bathroom at all times, while I am not in there. Don't need any burns on the top of my new lid...more on that in a bit! Again, I am duly impressed at how thorough the regime is, and your safety is always of utmost importance.
They have already started supplementing me with g-csf shots, which were the same shots utilized for four days prior to stem cell collection. It is now a single shot, and the dose is about half of that which they used back then, but it will help enable my stem cells to reboot this immune system a little quicker. I knew this was used, but other than for speeding recovery, I thought I would ask Dr. F more about the logic behind it. It purely comes down to the fact that it decreases the time the patient spend in a neutropenic state. Our immune system will definitely reconstitute. In fact, this would even happen in the absence of a transplant (just takes much more time). However, with that said, there appears to be a critical time where infection rates rise dramatically with fungus, bacteria, etc while in a neutroprenic state. This timeframe is usually in the 2-3 week range. Therefore, the cost associated with the prophylactic g-csf injections ultimately far outweighs fighting any untimely infections which may arise in a prolonged period of neutropenia. Enough of that...on to the new do....
We will wait and see what tomorrow's results come in at. Hopefully we will continue to see those auto reactive leukocytes disappear. As always, thank you all for following. Your feedback has been great and a very special shout out to Scott and Michelle at their wedding tonight. Sorry I can't be there with you guys. Hope it is a wonderful celebration!
Love from Moscow