Sunday, April 17, 2016

It's the first Sunday after the Bone Marrow Transplant, aka Day +4 Update

Well, this is the "Papa," aka Robin Dugall.  Mark has added me to the contributors list for obvious reasons: sometimes the guy is beat!  He wants to do a blog post, but his fingers and brain are on a small but highly needed vacation!  Seriously, I'm blessed and honored to be able to share with our extended family of friends.  I simply pray that I can do the summaries justice.

Today is Day +4 - Abby is in the hospital continuing the fight.  The post-transplant days are filled with buzzers, beeps, nurses doing vitals, doctors performing tests and consults, and a whole host of medical realities.  I think the last number I heard was six - six different IV lines are heading into Abby's body carrying various drugs - for pain (four meds for pain, specifically), for nausea, for fluids, etc.  At this stage in Abby's journey post-transplant, the highest concerns have to do with Graft vs. Host disease and its physical implications.  As of today, Abby is dealing MORE with the continuing side effects of what happened with she received chemotherapy and radiation treatments PRIOR to the transplant.  Most problematic is the condition called, mucositis.  Here's a definition of the condition:

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer. Mucositis can occur anywhere along the gastrointestinal (GI) tract, but oral mucositis refers to the particular inflammation and ulceration that occurs in the mouth. Oral mucositis is a common and often debilitating complication of cancer treatment.

As you can imagine, the sores (that at this point are occurring in Abby's mouth and in her lower GI tract, are painful.  This "window" of potentiality in terms of this side effect will go on for at least the rest of this week.  The biggest issue is that she has no "fighters" within her blood.  After the transplant, her body is attempting to accept the new stem cells.  It is not yet at the point where it is producing the necessary white blood cells and antibodies that can do "battle" against mucositis or other "invasions."  She still needs to be in a very protective environment.  NOBODY can expose her in any way to something even as minor as a common cold.  So, essentially, she is on medical lockdown.

For me, I watch my wife (the Nana) Vicky and Mark and Tiffany making their way to Denver (a roughly 65 mile trip) daily in rotation.  Most days there is ONE person needed at the hospital to do mouth sore care, help Abby try to get a small walk in (if possible), bathe, and attempt to get her to eat and drink (if she can stomach anything at this point).  One of them spends the night at the hospital and then gets "relieved" after a two-day, one-night rotation.  As you can imagine, there is much to be aware of when having the on duty hospital care time.  I watch all three of them in the rotation and I'm amazed and blessed.  They can't sleep at the hospital amidst the beeping, buzzing and medical team vital checks.  Even so, there are small celebrations that we have daily.  For example, we cheered here in Ft. Collins last night when Tiffany (who was on duty) shared with us that Abby had a bite of BBQ pork rib.  Vicky was with her earlier and was celebrating her eating a small amount of mashed potatoes.  Another big concern at this stage is her calorie and fluid intake.  So we keep praying that she can eat and drink even small amounts so that the medical team does not have to resort to other means of keeping her nutrition "up" (primarily, feeding tubes).  At this point, remember, she has NO immune system.  The prayer is that by day +28 she will produce three consecutive days of ANC levels (white blood cell counts) over 500 (normally that number is in the 1000's).  But let me tell you what I hear, "Abby is such a trooper, she is strong, focused and incredibly brave to keep facing these days with confidence."  Not only that but Mark and I estimated that at any given moment 100's of people from around the globe are praying for her.  We have people praying in Japan, Romania, Poland, Hungary, the UK...Canada, Mexico, South Africa, New Zealand, all over the USA.  It is amazing and such an encouragement.  As I mentioned in (which is MY blog) we have as a family such HUGE THANKFILLED HEARTS for the outpouring of love, incredible gifts, and more support than we can dream of!

That's it for now...more to come as the days go by!


Unknown said...

Robin, You left out one other important team member. Your love and care for Anna and Lily on the homefront makes it possible for Mark, Tiffany and Vicky to focus on Abby. We send you many blessings for all you are doing. Thank you from Nonnie Pam and Grandpa Karl

VITA DVDs said...

Thank you, Robin, for all that you and Team Schreiber are doing with such GRACE and VALOUR on behalf of Abby, Anna, and Lily. We love you all and are praying each day that Abby will experience less pain as the days go by.

Kathi Carter (Pam's cousin) Jacobs in Randleman NC

Deanna Nowadnick said...

Yea, Team Schreiber. Go, Team Schreiber! Continuing to pray for those special moments of joy and healing!!