Ready for Discharge? Blood Counts are Climbing!

Todd was unhooked from his IV pole today, October 5, 2014. He gets hooked up for some medications and transfusions,but they are switching him over to pill-form of most of his medications, getting him ready for discharge this week.

On October 4, 2014, Day +18, Todd's blood counts were not only climbing, but his white blood counts and ANCs (neutrophils) more than doubled!

 On Friday, October 3, his white count was 360.  On Saturday they jumped to 970.  The goal for discharge from the hospital is 1,000.

His ANCs on Friday were pretty much non-existence and on Saturday they jumped to 890!  The goal here for discharge from the hospital is 500.  So you can see he has already cleared this hurdle! 

While his Platelets were still only between 6,000-7,000 the past three days, there was already talk of him being discharged as early as Monday!  Neither of us was prepared for this.  I started gathering unnecessary items to take out of his room and made plans to prepare the hotel room for his arrival.
 
By today, Sunday, October 5, 2014, Todd's CBC blood counts were: Hemoglobin 8.2, Whites 1,630, ANCs 1490, and Platelets at 7,000. Unfortunately, this meant once again that he had to receive platelets.  Since the transplant Todd has had a total of 11 platelet transfusions.  We were under the impression that since there was no restriction for being discharged with low platelets, that Todd could just get platelet transfusions through outpatient visits.  However, the doctor stated today during her rounds that Todd would NOT be able to get platelets daily on an outpatient basis, so he may have to stay in the Hospital longer until his body can start maintaining his platelets after infusion (or are creating them) for at least a couple of days at a time.  Now that his white counts are multiplying they can start doing their job to allow his body to start cranking up the bone marrow to make platelets.

I'm planning on talking to the doctor tomorrow about this situation.   How many more days does she estimate this is going to take?  Can she push again for the HLA matched platelets again?  (The latest on this saga: not planning on giving any HLA matched platelets at all). Can she request platelets from a single donor instead of a bag of platelets combined from multiple donors? Would this work better?

I'm a little frustrated that they got us all excited that he could be discharged tomorrow, when he may have to stay several days longer.  Why didn't she say anything about the platelets before telling us he could leave Monday afternoon? 

Well for now we are content to stay if he has to.  We are still excited that he is doing so well and that the time to leave the hospital is drawing near.  Meanwhile, I will continue my nursing training on taking care of his Hickman Central Venous Catheter and preparing for him to come to the hotel with me.  He is looking forward to good food and sleeping in a big bed.  I'm looking forward to doing things together like eating meals together and going out. 

This is "Chester" the bust caregivers can use to practice Hickman Catheter care like changing dressings, caps, and flushing the lines.