Wednesday +7 (10:30AM)

Jackie has been asleep most of the morning. They give her Benadryl to premedicate her before some of the antibiotics. They also gave her Demerol throughout the night. From what I can gather her night wasn't good. Her highest temperature was 104.4. This morning it is running about 100-101 so it is much better. She is retaining fluids and they are hoping she will begin to stop retention.

Her counts continue to drop. He RBC count was 8.8. They begin infusing red blood cells at 8.0. However they may withhold these due to her fluid retention. Her WBC count is .2. I was surprised it wasn't .1 (the lowest they usually record). Her platelets are 20 which is good. A fever tends to deplete platelets. I'm sure they will continue to infuse platelets. They like to do so when her temperature is on the decline.

She was able to eat a small breakfast of milk, Cheerios, and half a banana.

When she is awake she is in good spirits. In fact, you wouldn't realize she has a fever.

I spoke with the nurse this morning and, again, she says this is very normal. The nurse last night told me they don't really know why many people develop fevers. They think it is a result of the struggle inside the body of the new cells replacing old cells and beginning the engraftment process. It is important to remember that the new donor stem cells are in the process of killing off any remaining cells Jackie might have which includes the CLL cells. The process goes on for most of the 100 day process. By the end of 100 days most patients have 100% of their cells converted to donor cells. By day 55-60 the process is 60-80% change. So there is almost a 1-to-1 correlation. With each day that passes 1-1.5% of her cells are converted to donor cells. You can only imagine the process that must go on within the body!

I'll update again later today.

Bruce and Jackie
From Rochester, MN