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Posted 2017-12-21T04:46:00Z

Day +13 and Day +14: Problematic Platelets

Hi all, it’s Simone filling in for my mom again. This time she is not sleeping, but cleaning the shower in preparation for Linton’s return. We’re going to have to keep everything squeaky clean once he gets back.

Today's the first time any of Linton’s blood cell counts have returned to the normal range — his ANC has hit 2.3, surpassing the 2.24 threshold considered to be “low normal," so he's no longer neutropenic and the risk of infection is reduced.

His overall WBC counts are still steadily climbing. They reached 3.2 today, so he will probably get into the low normal range (starting at 3.8) tomorrow. His hemoglobin is pretty much stable, hovering around 9.

Padre would have been able to come home today had his platelets reached an acceptable level. However, they continue to underperform. On Day +13, they had dropped once again to 9 so he had his third platelet transfusion (from an O+ donor this time). Later that day, after coming back from a brisk walk around the unit, he had a brief nosebleed, but the nurse assured him it was just because of his low platelet levels. By Day +14 his platelets had risen to 19 thanks to the transfusion.

Yesterday (Day +13), a blood sample was taken to test for the presence of platelet antigens. This will allow the physicians to determine whether his poor response to the transfusions is due to immune incompatibility. Even though this test is supposedly “rapid,” the results won’t be available for two days. Unfortunately, the attending hem-onc physician said that Linton’s hemoglobin and platelet levels may never completely return to normal because of all the immunosuppressive chemotherapy he has undergone, and will continue to undergo as “maintenance” once he leaves the hospital.

Since we live so close to the hospital, the plan is to discharge Linton this Friday (December 22) and have him come in for any further transfusions as an outpatient. In preparation for this, he will receive two more transfusions on Thursday, probably with donor-matched platelets, in order to bring his platelet levels up to 50. If he successfully hits that threshold, his central line will be removed. Because this tri-fusion catheter has been inside one of his major veins for seven weeks (since Nov. 3), it might not come loose easily. Yanking it out could cause some bleeding, so it’s imperative that his platelet levels are higher when this happens. Then, Padre will probably have one more transfusion on Friday before leaving room 742 and coming home to his own bed (and me, mom, and Eartha, all of whom are eagerly awaiting his return).

Apart from the platelet troubles, Linton is getting stronger every day. His appetite is continuing to return; today he asked mom to get him a packet of Cheetos from the cafeteria. The Activities Director is trying to get the patients into the holiday spirit, encouraging them to either paint a tile or build their own gingerbread house. Padre, who has never personally encountered a fully-formed gingerbread house in his life, and who has no experience with their construction outside of watching Bake Off, opted for the tile. The tiles are going to be displayed in the entryway of the cancer wing of the hospital.

Holiday cheer at the central desk of the transplant unit.

More seasonal decorations.

Linton decided to paint a design reading “Beating Myeloma with Science” on his tile and worked diligently on it. The “Y” in “myeloma” is an antibody, the “o” is a plasma cell, and the “I” in “science” is a test tube.

Linton's progress on his tile. Tomorrow mom will bring him a paint pen so he can fill in finer details.

Today, Padre was doing his laps around the ward when he noticed a familiar face in one of the patient rooms. It turned out to be JB, a member of the local Multiple Myeloma support group who was admitted today. He was slogging through his six hours of post-Melphalan ice chewing and Padre was allowed in to cheer him on.

Finally, we must not neglect to report on our running tartan (plaid! It’s plaid!) theme. In today’s news: our neighbor kindly gifted us a jar of homemade jam wrapped up in tartan paper, and my aunt in South Africa had her hair cut by a stylist who happened to be wearing a tartan shirt.

The tartan wrapping paper, alongside a ceramic pot made by my late aunt Michelle, Linton's sister.

Auntie Louise's hairstylist showing off her tartan. "Hello Jill, look at my tartan!"

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Comments (5)

  • misty baker
    misty baker

    What great news! Continued wishes for a strong recovery so you can all be together at home soon.

    one year ago · Reply
  • deana chiusano
    deana chiusano

    What a wonderful Christmas present! Go Linton - make those platelets!

    one year ago · Reply
  • Muffy Koch
    Muffy Koch

    Roll on Friday - what a celebration that will be! I hope those new platelets set you up for the weeks ahead, Linto. Also, wishing JB success as he heads towards his SCT. The tile is a classic and I hope it will be on display for years to come. Thanks for great reporting Simone. Wish I could help Jill clean the house.....

    one year ago · Reply
  • Claudette Kulkarni
    Claudette Kulkarni

    Such great news!!! I can only imagine how much Linton must be looking forward to being at home! I join everyone in congratulating Jill and Simone on their fine and comprehensive reporting! Sorry I don't have anything to add to the growing Plaid (yes, plaid) collection--but I certainly appreciate the amazing variety you all have managed to assemble. Jill: I so look forward to meeting up with you when life permits. Warm regards to all of you. Madeleine sends her greetings to Eartha.

    one year ago · Reply
  • susan ryan
    susan ryan

    Dear Simone: Thanks for the encouraging news of your padre's homecoming. Hope it is a sunny day; we know you will all be happy to be sprung from the hospital. It sounds like you had a wonderful staff of nurses and doctors who will miss the charming Traub family but wishing you well. We are so nearby; call us if you need anything. Susan and Tom

    one year ago · Reply