Today is T - 5 days and counting. In preparation for stem cell transplant, they count down just like a rocket launch, but instead of hours and minutes, they use days. Each day has specific things that must be done and medications that must be given in order to be ready. It has been a grueling three weeks to get to this point.
We found out today that Derek's stem cell donor is
international. There were no good matches in the U.S. Interesting. Because the stem cells are coming from so far away, Derek may not actually get them until the 10th.
This afternoon he completed the sixth and last of his total body irradiation (TBI) treatments. Overall he handled the treatments well. He did have some nausea Tuesday after the second treatment, and he is tired. The first treatment lasted three and a half hours because they had to make sure everything was placed exactly right. Because the tissues in lungs are the most fragile in the body, they made lung blocks to shield his lungs from some of the radiation. For most of that time and during the actual treatment, Derek had to stand. The actual treatments lasted about 30-45 minutes. I took audiobooks on CD for him to listen to. About two and a half hours into the first treatment, the doctor came out and remarked how mature Derek was and how great he was doing. She said most kids get fussy after standing for so long, but Derek was still cheerful and standing still and doing just as instructed. Thank you God for giving him the stamina he needs to persevere through this ordeal.
With TBI, the worst effects don't show up immediately. It can take days, weeks, months or even years for some effects to manifest themselves. He has a dark tan now, and they say that over the next several days his skin will become dry and will peal. We have to cover his body from head to foot with special creams three times a day. Some areas that received more radiation than others will become inflamed and very painful. It is so painful to watch him go through this.
On Monday, Derek also had a PICC line placed in his
right arm. The plan was to give him a second central line so they
wouldn't have to keep sticking him with peripheral IVs for all the meds
he will soon need to receive. Also, because of skin changes, they
sometimes have to abandon use of the port for a while to allow the port
access site to heal. However, they did not succeed in getting to a
central vein. An x-ray showed the line was kinked. On Tuesday he was
given anesthesia again so interventional radiology could try to fix the
problem. When they did the procedure however, they found it had shifted
on its own and had penetrated just barely into a central vein. So they
did nothing more to it, fearing they would lose it completely. Derek's
doctor doesn't feel it is stable enough to use as a central line because
it could shift out of that vein just as easily as it shifted in, so we
are praying that he will maintain use of his port throughout transplant
because some meds cannot go through a peripheral line.
Tomorrow the high-dose chemotherapy starts. The doctor calls the chemo he has gotten before this a sprinkling of salt compared to what he will get now. This is hard for me to comprehend, knowing what he has already been through.
Thank you for your prayers on his behalf.
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