Day +22

Today we had a conference with the current attending doctor, Dr. Bleakley, one of the PA's and a fellow.It was a good check-in time for us to ask questions and hear their current thinking and approach with Zoe.

She is doing well, she's on her way to engraftment, and the platelet situation has them moderately concerned. They have some courses of action they plan to explore in terms of lining up additional matched donors (even going out of state to find more) and giving her IVIG to encourage her immune system not to attack the platelets so determinedly.

If that doesn't work they will then explore using steroids and a drug regimen to suppress her B cells that are responsible for attacking the platelets. It would have the effect of further compromising her immune system, but it could help her hold onto platelets.

Bleakley told us that we would be in the hospital with her for at least 4 more weeks easily. We've been here almost 5 weeks already. Platelet production is the last thing to kick in after a transplant, and with Zoe's body taking its time to engraft, who knows when the platelets will come online.

An interesting thing to hear Bleakley say today was that, given all the challenges with the platelet situation, it's probably for the best that Zoe's donor opted to give stem cells instead of marrow. Stem cells do engraft more quickly, therefore bringing in platelets more quickly. With engraftment taking this long for stem cells, marrow would have taken even longer, and platelets longer than that.

As some one had posted back when I was frustrated with the donor for not willing to give marrow: who are we to say that stem cells aren't what Zoe most needs?

Indeed.