Friday, November 21, 2008

2nd Transfusion

We scheduled an appointment for 0845 on Thursday at the cancer clinic. Really by the time we'd dropped our other kids off at friends homes and took our oldest daughter to school we didn't get there until 0900. But no one seemed too put out by it. Before they accessed Gracie's port they did a finger poke CBC, just in case she wasn't too low.

Hgb - 8.2
ANC - 830
Platelets - 6

 On Thursday (day 14) last round her platelets were 14 and it wasn't until day 15 (which would be today) that they dropped to 3 and she finally got her transfusion. So if on day 14 they were already at 6 this round and they were still dropping, they would have been nonexistent today. Not that there is really a difference between 3 and 0, or 6 even for that matter. Either way you simply won't clot. Needless to say she got her transfusion of platelets. It was an all day waiting thing, but we knew that going in to it. They actually had the platelets earlier, but because it was in too much volume they had to separate the plasma from the platelets. This takes a couple of hours. By the time they got to them there was hardly any volume at all to transfuse. They were just super concentrated. She did well with the transfusion. We briefly considered a red cell transfusion also as her hgb is kind of borderline, but as her energy level is so high we decided against it. She is pale though, but that's a constant thing now. Her ANC is going up again, so that's a good thing. We also drew blood for genetic karotyping to determine if she has chromosome 13 deletion. We think it's probably an under diagnosed condition so it was something worth looking into. 

I was able to talk to Dr. L. about Gracie not losing her hair. She's supposed to have lost it already and hasn't. Dr. L has been an oncologist for a long time and she's never seen a child keep hair like this. Sometimes they keep some of it, but there is always a severe thinning at the least.  My concern is that if the hair is resistant to the chemo, why wouldn't the cancer be too. I'd feel better if ALL of her fast dividing cells would show that the chemo is working, not just her blood. Dr. L didn't really have any good answers because this just doesn't happen. Etoposide simply makes you lose your hair, and Gracie still has a full head of it. It's a little thinner, but not much. Every time I brush her hair I hope it's just going to clump out, but it never does. It's a little unnerving. Sorry to all of you who have given us hats, we'd really like to have need of them. Maybe today will be the day. But they're really cute hats, even with hair. 

Claudia is the child life specialist at the cancer clinic and she's just amazing. Gracie is absolutely thrilled to see her whenever we go there. She loves the doll Sammie that she gets to do medical play with. Sammie has a port that Gracie can access and give medicine too. She has so much fun with it. Claudia also gave Grace her courage beads yesterday which were a HUGE hit. She gets a bead for every thing they do to her and different beads represent different procedures. A red bead is a blood transfusion. A white bead is for a day of chemo. A black bead with silver stripes is for a poke (she's got lots of those). A lime green one represents her fever. A yellow bead is for each day in the hospital. I could go on but you get the general idea. It's a wonderful idea that several cancer centers do. It's kind of like giving medals to soldiers. I guess that's why they're called courage beads. These kids do have courage and the beads represent all the tough stuff they had to do and I'm glad she has something to honour those accomplishments. She's very proud of her necklace. Not that she really gets what they're for, but she will someday and I'm sure she'll always treasure them. I do already. 

Stephanie

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