Day +20

Today's numbers were down--neutrophils at 317, and WBC's at .7. Fortunately, we were warned that this could happen.

Natalie the PA said that the labs show a snapshot in time of flow. She said it's as if you were to take a picture of a section of freeway: maybe in that second there might not be very many cars in the photo, but the next picture in the next moment might show MANY cars. Zoe's counts are similar, as we hear. Her neutrophils and WBC's course through the blood river; the labs scoop up a sampling and project numbers based on what shows up in that small cross section.

The important thing they consider is whether everything is trending up, not whether the numbers briefly dip. The team still feels, by the looks of everything, that Zoe is trending towards engraftment.
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Strangely, Zoe swallowed two doses of oral medicine this morning--all of the sudden she remembered how to do it on her own. Not an entirely reclaimed skill; tonight's oral dose of medicine pooled in her mouth and led to a little emesis. But, at least she swallowed today!

(Someone mentioned the swallow to be the next bird to watch for--let's hope for a flight of them!)

Her liver numbers--bilirubin levels--were up today, quite considerably. Two things could be the probable cause for that: either sludge from back-up, or liver GVHD. They did an ultrasound today to look for sludge (results to come tomorrow), if no sludge appears, they will assume GVHD is the culprit and administer steroids accordingly.

Of course, my little mind started to chew on the GVHD possibility, but the attending doc said that since her skin rash was treated with a 3 day course of steroids, it was a good likelihood that a short course of steroids would take care of liver GVHD.

I'm pulling for sludge though. Treatment for that would be dietary changes to her IV nutrition, and getting her back on the oral liver support medicine.
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Today was my first day back in the massage studio after 4.5 weeks. Felt good! It's a good thing, though, that we are working slowly back up to a full schedule. Three massages today and I was whooped! (whuped?)
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Check the YouTube link for a vid of Zoe feeling mightly chipper in her bumbo seat and rocking out to Lady Smith Black Mambazo!