A Week at Home { Day +29 }

Seven days after I was discharged from the hospital, exactly a week, I've been home with my family!!!

I had my appointment this morning, and it went well...no change on the dosage of all medication I am taking...but there's another value on my blood test that went up but nothing to worry about. I just have to drink more... I think this has something to do with my kidneys...

FACTS: Creatinine or Creat is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). (Check this site for more info)

About the Liver enzymes, AST and ALT went down a little bit...hopefully, it won't go up anymore...

Complete Blood Count
HGB – 112 (normal range = 120 to 160)
PLT – 158
WBC – 12.6
Neut - 10.5 (normal range = 2.0 to 8.0)
Mg - 0.77
Creat - 118 (normal range = less than or equal 100)

Liver Functions
ALB - Not Available
ALT - 271 (normal range = less than or equal 39)
ALP - 62
AST - 90 (normal range = less than or equal 35)
TBili - 6

Legend:
Green: Normal
Yellow: Abnormal
Red: Critical

"The LORD is like a father to his children, tender and compassionate to those who fear him...For he understands how weak we are; he knows we are only dust." Psalms 103:13-14, NLT

First Clinic Appointment after BMT { Day +26 }

Harold, the volunteer driver from Candian Cancer Society, picked me up from home early in the morning for my first clinic appointment. Tuesdays and Fridays Clinic are dedicated for Bone Marrow Transplant Patients. I managed to talk to few people who had their Bone Marrow Transplants 3 months ago, 18 months ago, 3 years ago and heard the other guy had his transplant 10 years ago?!...where I also learned that BMT are not only for patients with Leukemia. I met people with Multiple Myelomia, AML (Leukemia) and others. Some of them had their own marrow transplant, related transplant (full or partial match), unrelated transplant and identical transplant.

FACTS: Types of BMT

• In autologous transplants, patients receive their own stem cells.
• In syngeneic transplants, patients receive stem cells from their identical twin.
• In allogeneic transplants, patients receive stem cells from their brother, sister, or parent. A person who is not related to the patient (an unrelated donor) also may be used.

REFLECTIONS: Some of them could not believe I just had mine less than a month ago. They said I looked great for a transplant patients :) I even saw the nurses who took care of me while I was in the hospital and they were very happy to see me. But still, it's early to say, for other complications does not show until later time. Like my Liver Enzymes, they are still going up but I am already on medication for that.

"Worship the Lord your God, and his blessing will be on your food and water. I will take away sickness from among you."Exodus 23:25, NIV.

Complete Blood Count
HGB – 115 (normal range = 120 to 160)
PLT – 220
WBC – 10.2
Neut - 8.6 (normal range = 2.0 to 8.0)
Mg - 0.85

Liver Functions
ALB - 43
ALT - 296 (normal range = less than or equal 39)
ALP - 62
AST - 118 (normal range = less than or equal 35)
TBili - 8

Legend:
Green: Normal
Yellow: Abnormal
Red: Critical

Weekend at Home { Days +23 and +24 }

Oh, you probably can imagine how I felt these first 2 days at home...can't even describe!

Saturday, I just stayed home with my sister Irma, while Jerson and the rest of the family went to church. But before that, we realized that one of my medication is missing. So we have to call PMH doctor to get me a prescription to the nearest Pharmacy where I live. That's okay now, we managed to get it and I took it right away.

Sunday, same thing, just stayed home. At this time, it is better and safer for me to stay home. I am still in critical condition, especially the first 100 days after transplant.

I will have regular check ups every Tuesdays and Fridays. Only then, I can update you of my Complete Blood Counts and Liver Functions.

Weekend went well, although I felt abdominal pain Friday night, I reported it to my doctor, he said to watch if it will happen again...so far it didn't.

Most important was that my son, Jensine was very happy. He have a bit of runny nose and cough, but he knows that he can't stay close to me. He even ask first if he can smell me or touch me or my dress. You can tell how much he misses me. And hearing my own child again praying for me...incredible! He prayed that I will have my hair back soon to shoulder length :) He also prayed that I will get better soon and stay with him, his dad and the whole family. He also prayed for me to be healthy, strong and big :) (He even asked if big crosswise or lengthwise!)

REFLECTIONS: God is always good to His people. I believe that all your prayers are working...let's continue to pray for each other...

"And He healed every kind of sickness and disease." Matthew 4:23, TLB.

Home Sweet Home { Day +22 }

Speechless :)

My liver functions (AST and ALT) went up again today but the doctors think it's still okay to go home. They gave me additional prescriptions for that.

I am home with all of my medications and will have my regular appointments twice a week. If needed, I might still need to stay in the hospital if other signs of GVHD occur.

Thank God and thank you for all your prayers. Please continue to pray... for me and my family.

Busy Day! { Day +21 }

It was a busy day for a person like me, who is bound within the walls of PMH.

First, I had the IV nurse for blood test taken from my arm in the morning. This has been going on every Mondays and Thursdays after the transplant to test the level of my "anti-rejection" drugs in my blood. Yeah!, and that reminds me of the anti-rejection pills. Woooh! they stink like skunk. No kidding! Let me know if you want to try to smell it, to believe :) I am taking 2 in capsule form, one small and the other one is humongous! Over statement? I can always show you if you can handle the smell :)

Then, my nurse came for my usual morning vitals. After that, my lady doctor came to check up on me with all these news. Both of these are done in daily basis.

I was also visited by the dietitian to follow up on my eating habbits when I go home (*hint*) She wants to make sure if I know my food restrictions and the guide for safety eating for post-transplant patients. This has to be followed for 90 days.

Btw, since I experienced something weird with my vision this morning, they ordered for me to do an MRI test at 2 p.m.

FACTS: Magnetic resonance imaging (MRI) - also called magnetic resonance tomography (MRT) - is a method of creating images of the inside of opaque organs in living organisms as well as detecting the amount of bound water in geological structures.

I am not a claustrophobic person but I was pretty shaken up before I entered that tubular hole. Hey, that was my first time and not sure what will happen while inside that machine. But after couple of scans, I was fine. I didn't even use the "ativan" that I asked my doctor to give me before the test. It was about 3:30 when I got back to my room.

My AST and ALT went up again...but then nothing to worry about at this point, still under observation. But, a big but, if this went up really high tomorrow, I won't be able to go home on Friday...that's okay, if it's better for me to stay...I don't want to take a chance.

With my Magnesium less than normal, they gave me more to boost my Magnesium. They were given to me in tablet form and IV. Yes, I had my "bestfriend" pole to tag along with me this afternoon until before bedtime.

CBC
HGB – 113
PLT – 169
WBC – 3.6
Mg - 0.62

Liver Functions
ALB - was not able to get today's range
ALT - 89
ALP - 62
AST - 57
TBili - 8

Callers
Jerson
Tatay
Dete Amor
Ate Nenette
Auntie Josie Camato
Ate Judy Gamez
Catherine Herrera-De Leon
Ate Nancy
Kuya Manolo
Ina and Ama

Visitor
Ate Irma
Ate Emmie and Kuya Bong Buning
Jerson

Prrrt! Stop! { Day +20 }

This morning, some of my liver enzyme levels got off the wall...too excited to go home? :) The doctors does not have to do anything yet, but to monitor. Too early to say if I will or will not be able to go home.

FACTS: (taken from Wikipedia)

• Albumin (Alb) is a protein made specifically by the liver
• Alanine transaminase (ALT), also called Serum Glutamic Pyruvic Transaminase (SGPT) or Alanine aminotransferrase (ALAT) is an enzyme present in liver cells. When a cell is damaged, it leaks this enzyme into the blood, where it is measured. ALT rises dramatically in acute liver damage.
• Alkaline phosphatase (ALP) is an enzyme in the cells lining the biliary ducts of the liver.
• Aspartate transaminase (AST) also called Serum Glutamic Oxaloacetic Transaminase (SGOT) or aspartate aminotransferase (ASAT) is similar to ALT in that it is another enzyme associated with liver parenchymal cells. It is raised in acute liver damage.
• Total bilirubin (TBIL) is a breakdown product of heme (a part of hemoglobin in red blood cells). The liver is responsible for clearing this, excreting it out through bile into the instestine. Problems with the liver or blockage of the drainage of bile will cause increased levels of bilirubin, as will increased haemolysis of red cells.

Normal Range according to PMH
ALB - 38 to 50
ALT - less than or equal 39
ALP - less than or equal 109
AST - less than or equal 35
TBili - less than or equal 22

My range this morning
ALB - 39
ALT - 46
ALP - 66
AST - 41
TBili - 7

My ALT and AST went up. Two days ago, they were 28 and 27, respectively. Well, we just have to wait in the morning after my blood tests. I just hope and pray that they will go back to normal so that my liver won't be damaged.

Jesus beheld them, and said unto them, With men this is impossible; but with God all things are possible. Matt. 19:26

CBC
HGB – 105
PLT – 140
WBC – 3.0
Neut – 1.7

Callers
Jerson
Ate Irma
Tatay
Dete Amor
Ate Nenette
Tuni Idiculla
Karly Rodriguez-Lee
Ate Nancy
Ina and Ama

Visitor
Jerson

Edit:
FACTS: Liver function tests (LFTs or LFs), are groups of clinical biochemistry laboratory blood assays designed to give a doctor or other health professional information about the state of a patient's liver.

"You Might Be Able to Go Home on Thursday!" { Day +19 }

Again, my doctor said this morning, "You might be able to go home on Thursday". Because I could not believe it, I told him "No way!"...hahahhaha...funny...we just both laugh in the end. Well, yeah, that's my good news today. Although, it is not definite yet that I can go home on Thursday.

First, I have to learn to eat and drink again...As you know, my eating was not great, my stomach shrinked and I depended on the food they supplied intravenously. As well as my drinking, I have to learn or get used to drink 3L of water a day, actually, that includes soups, juices, and even ice cream.

Then they will monitor if I can take my "anti-rejection" pills and other medication by mouth and keep it in my stomach.

This morning they also took all the lines connected to my hickman line, no more IV poles, lines and cords. I am free to walk and run if I could :)

REFLECTIONS: Truly, God is good...all the time. The nurses have told me they were talking about my recovery for they were so happy about it. I know all those times, God is helping. With all your prayers, He made this one easy on me. Let's keep praying to Him, who hears our prayers.

"And because You answer prayer, all mankind will come to You with their requests." Psalm 65:2, TLB.

CBC
HGB – 103
PLT – 116
WBC – 5.0
Neut – 1.9

Callers
Jerson
Ina
Auntie Jean Dela Roca
Cathy Herrera-De Leon
Adi
Ate Nancy
Dete Amor
Ate Nenette

Visitor
Ate Irma
Jerson
Rob
Adi

Not off the hook yet! { Day +18 }

Other complications that I forgot to mention on my previous postings (Rejection and Complications) are the injuries to liver, lungs and heart. These organs are susceptible to be damaged because of high dosage of chemotherapy and radiation.

FACTS: VOD or Veno-occlusive disease is a disorder of the liver in which blood vessels become blocked and swollen.

FACTS: Interstitial Pneumonia is a form of pneumonia found within the lung tissues, caused by chemotherapy, radiation or infectious agents suc as viruses

They said there is no definite time frame in which one can expect certain side effects to occur. There are also other long-term side effects after transplant, this may include secondary malignancies, fatigue, recurrent infections, tight skin and stiff joints.

In my Day +5 posting, I mentioned an acquaintance named Susan who visited me. I also mentioned that her older sister has AML and had the Bone Marrow transplant last June. I just found out, she passed away last week, four months after transplant. My deepest condolences to her family. My prayers are with you at this difficult time.

REFLECTIONS: I was sad but not worried...my life is not in my hands anymore, I gave it up to Him, for He knows what is best for me and my family. Trust His Heart is a favorite song of mine and helps me to remember that...

God is too wise to be mistaken.

God is too good to be unkind.

So when you don't understand,

When you don't see His plan,

When you can't trace His hand,

Trust His heart.

"You will keep in perfect peace him whose mind is steadfast, because he trust in You." Isaiah 26:3, NIV.

CBC
HGB – 116
PLT – 102
WBC – 3.2
Neut – 1.9

Callers
Jerson
Ate Nenette
Ate Nancy
Ina
Dete Amor
Tatay

Visitor
Ate Irma
Jerson

Discharge Booklet! { Day +17 }

Yap, you read it right! Believe it…the nurse went to see me to talk about the Discharge Booklet…not that I can go home tomorrow, maybe soon... Another thing happened this morning, they released me from “Isolation”…I could get out of my room. Yeheey! But I can’t go far, just within the walls of 14B floor. That’s still good news. If you notice, my counts are getting better, too. They will just have to wait until they become stable, since they might still fluctuate anytime.

CBC
HGB – 107
PLT – 121
WBC – 2.6
Neut – 1.5

Callers
Jerson
Kuya Manolo
Ate Nenette
Ate Nancy
Ina

Visitor
Jerson

Neutropenic, not anymore! { Day +16 }

Because my counts are still going up! and my Neutrophils is not 0.0 anymore...

FACTS: Neutropenia is a condition that is caused by one having a low white blood cell count. A patient who is neutropenic (i.e. those having organ transplants, high dose chemotherapy, or have suppressed immune systems) are more likely to develop an infection. (JHBMC)

CBC
HGB – 110
PLT – 82
WBC – 1.8
Neut – 1.3

Callers
Jerson
Kuya Manolo
Dete Amor
Ate Nenette
Ate Nancy
Jensine

{ Day +15 }

Today, I was in the mood to eat. Jerson brought me home meal that my sister Irma cooked, "Adobo" (Adobo is considered the national dish of the Philippines. This dish consists of chunks of chicken cooked in soy sauce, vinegar, bay leaf, lots of garlic and whole peppercorns.) Too excited, I guess, I ate more than enough...sadly, the next thing I know, I was so nauseous and you know what happened next...

CBC
HGB – 109
PLT – 75
WBC – 1.0

Callers
Jerson
Kuya Manolo
Ate Irma
Ate Nenette
Ate Nancy

Visitor
Jerson

Working { Day +14 }

No, not me…but the transplanted bone marrows are! Did you notice my counts, especially, the Platelets, White Blood Cells and Nuetrophils are starting to go up or say increase in number? Doctors said this is a sign that the bone marrows are starting to engraft, even though, my Hemoglobin is low that I needed 2 bags of blood. Anyways, it seems that HGB is the last blood to go up base on my observation frim my past chemotherapy. I guess my sister is healthy after all :) Thanks, sis…

CBC
HGB – 78
PLT – 47
WBC – 0.5
Neut – 0.2

Callers
Jerson
Kuya Manolo
Ate Nenette
Ate Nancy
Dete Amor
Ate Tina Ninalga


Visitors
Ate Irma
Kuya Manolo

Milestones { Day +13 }

My doctor visit me this morning, well, they actually visit me everyday. But this morning, I had the chance to chat with her. I asked if the worst is over…yet…she said I have to look at things as milestones…

• Day +11 (hey…I am on Day +13, I passed my first milestone)
• First 100 days after transplant
• Six months
• 1 Year
• 2 Years
• 3 Years
• 4 Years
• 5 Years

One day, I might be in very good shape, I don't know ,only God knows...I Know Who Holds Tomorrow (Please click on the link to hear and view the lyrics)

CBC
HGB – 85
PLT – 24
WBC – 0.3
Neut – 0.1

Callers
Jerson
Kuya Manolo
Ate Nenette
Ate Nancy
Dete Amor
Josephine dela Rosa

Visitors
Ate Irma
Dete Amor
Adi
Rob

Amaze { Day +12 }

My nurses and doctors are amaze about the result of my post transplant, so far. If you remember the chemotherapy I took for Days +1, +3, +6 and +11, they told me not everyone are able to take all the dosage. Some can only tolerate up to third dose, some only took two doses and some even only take 1 dose. Not only that, the side effects of these chemotherapy are expected to be worse, but then I felt nothing, not that I did not feel anything at all. But I had very minor side effects. Who knows how toxic those chemotherapy but they are very necessary to fight the Graft Versus Host Disease in the future. Since I took all of them, they, my doctors, are hoping other complications will be easy on me…Didn’t I tell you we have an AMAZING GOD?

Callers
Jerson
Kuya Manolo
Ate Nenette
Ate Nancy
Dete Amor
Karly

Visitors
Adi
Rob

Happy Thanksgiving { Day +11 }

Every 2nd Monday of October, Thanksgiving is celebrated here in Canada…As you know I have so much to thank for to many…as in…many…I better start, now.

• I thank my sister Amor for giving me her bone marrow, to add more happy days in my life…and
• all my family for being supportive, all of them.
• My friends who visit me in the hospital, in the house, for giving the time and making sure I am always in happy moods.
• Friends and families who send me email, notes, cards and messages.
• Friends and families who take care of me when I was in the hospital.
• Friends and families who bring gifts, books, flowers, food and etc.
• Friends and families who never forget to give me a call, doesn't matter where they were in the world.
• Friends and families who started and contributed and still contributing in the fund raising opened for me by group of friends.
• Friends and families who day and night hope and prays for me to get well.
• My son and husband for their love and the strength they showed me to fight this disease.
• Our Almighty God for everything...I once said...this trial will not be complete, this hardship will not be easy and this life will not be sweet without you and you and You...

I hope I did not forget anyone on this posting, but I thank you all everyday not just today...

CBC
HGB – 86
PLT – 16
WBC – 0.3
Neut – 0.0

Callers
Jerson
Kuya Manolo
Ate Nenette
Tatay
Ate Nancy

Hair Loss { Day +10 }

Did I mention I am starting to loose my hair again?…well, yeah…not that I have a shoulder-length hair now…but yap their shredding again. I told Jensine about it and he said “Why the doctors have to cut them again?” What an innocent reaction? Here’s more, “Don’t worry, mommy, you have your hair here at home, what is it called again?” And I replied “wig”. We talked on the phone while looking at the webcam. We could have used the Call from Yahoo Messenger but since my internet connection here is dial-up, the quality is not that good. I’ll settle with what we have as long as I see my child and he sees me.

CBC
HGB – 94
PLT – 31
WBC – 0.1
Neut – 0.0

Visitors
Jerson

New Neighbor { Day +9 }

My sleep was still not good…even with the talking that me and Ate Nenette did the whole day, hoping it would make me very tired, so I can sleep at night…I had to ask for sleeping pills. In that way I could rest for a while and not be bothered by this tummy pain again.

I got a new neighbor too…well; I hope I don’t sound happy to have a Filipino neighbor in this place. This means she’s sick like I am. This means a lot…pain, family, love, kids…It reminds me when I was first diagnosed. And I never even wished or think, it would happen to any of my friends or family again or simply anyone I know… Ate Nenette tried to visit the new neighbor. Her room is always busy with friends and family. I wanted to visit her too…obviously, I am still bound in this room for I think another 10 days…I’ve been thinking too, what to tell or give her. But I honestly have nothing to give her, but I can tell her that God is in control and He knows what the best is for everyone. And in this time of need, we need our friend, our families, and our love ones to be there for us and pray for us, believing God’s will…

CBC
HGB – 99
PLT – 40
WBC – 0.2
Neut – 0.0

Visitors
Ate Nenette

Platelets Transfusion { Day +8 }

The Morphine dripped was stopped. It is not for my tummy ache. They could give me something else…not as harsh as morphine. My platelets are very low, 7. I got a bag of platelet from one donor, of course, with my pre-med Benadryl, which make me drowsy and make me fall asleep…

CBC
HGB – 99
PLT – 7
WBC – 0.2
Neut – 0.0

Visitors
Jerson

Blood Transfusion { Day +7 }

My HGB is now at 80, I usually get blood transfusion if my count is at this low. Two bags of Type O positive with my usual pre-medication, Benadryl.

CBC
HGB - 80
WBC - 0.1
Neut - 0.0
PLT - 13

Tomorrow, I might need another bag of platelets...they usually give me when my platelets are below 10.

Visitors
Jerson

Callers
Kuya Manolo
Ate Nancy
Dete Amor
Ate Nenette

{ Day +6 }

On days +1, +3, +6 and +11, I will get an amount of chemotherapy drugs to minimize the side effects of graft versus host disease.

CBC
HGB - 82
WBC - 0.1
Neut - 0.0
PLT - 28

Visitors
Ina
Jerson

Callers
Dete Amor
Ate Nancy
Kuya Manolo
Ate Nenette
Karly

{ Day +5 }

I started Morphine drip today because of the almost unbearable pain in my stomach. This pain is normal because of the chemotherapy drugs. The dosage is very minimal and not addictive...that I can stop it if I don't need it anymore.

CBC
HGB - 89
WBC - 0.2
Neut - 0.0
PLT - 43
Mg - 0.79

Visitors
Ina
Jerson
Adi
Rob
Nida
Susan (her older sister has AML and had the Bone Marrow transplant last June)

Cramps { Day +4 }

I felt nauseated, no appetite, and cramps, altogether...what to do? I only had 6 crackers in total for the whole day. Aside from the food they are supplying me from my intravenous line. When I eat I threw it up. If I don't eat, I have cramps. Theys said it's normal, the chemotherapy drugs are doing this to me. They gave me anti-nausea and pain killers. That's good enough, they'll make me feel asleep and that's what I just need...rest...

I did not get my counts today, I'll add it up later...

Visitors
Ina
Jerson

Callers
Ate Nenette
Ate Irma
Ate Nancy
Dete Amor
Adi

Droopy { Day +3 }

It started yesterday, now I had to ask for a sleeping pills, in the beginning it didn't work...it was already daytime when I felt very sleepy. My nose was bleeding too, I needed platelet transfusion for my platelets is low and to stop the bleeding. With the pre-meds of transfusion, I think I was sleeping the whole day.

CBC
HGB - 95
WBC - .9
Neut - .6
PLT - 14,000

Visitors
Jerson

Callers
Ate Nancy
Ate Irma
Dete Amor
Kuya Manolo

{ Day +2 }

No signs of any complications yet, as I mentioned before, some of the complications are desired to make sure the bone marrow is working. Aside from tummy ache and headache, my sleeping habbit is not as good as before. This morning I don't have appetite too. I felt nauseated but they were all controlled of medicines. Imagine how many drugs I've been taking ;)

CBC
HGB - 100
WBC - 2,800
PLT - 28,000

Visitors
Ate Irma
Tatay
Jerson
Ina
Ama
Pastor Edwin Martin
Ate Esther Rosal
Kuya Ross Cuizon

Callers
Ate Nancy
Kuya Manolo

Post Transplant { Day +1 }

Day +1, or first day of post-transplant...it was a quiet day for me. Just a little tummy ache, and headache. I started my food through my intravenous line...but I am still eating solid food well.

CBC
HBC - 100
WBC - 3,700
Neut - 3,500
PLT - 54,000
Mg - 0.96

The doctor said that my Complete Blood Count will be up for a bit after the transplant but then will start to go down in couple of days...

Visitors
Jerson

Callers
Kuya Manolo
Dete Amor
Ate Nenette
Ate Nancy
Karly
Ate Josie Camato