Dispatches from TransplantLand: Day +11 (An UPward Trend--Mostly)

Beth's white count more than tripled between yesterday and today (note--I'm posting this a day late, so when you read this pretend it's Sunday) from .3 to 1.3. This is a sizable jump, and we're very happy about it, but we have to keep in mind that one requirement for being discharged is to have the total neutrophil count be at least 1000 without having had any Neupogen shots for at least two days. So far the increases in the white count have been helped along by this growth factor. Once the count gets up to the point where she can stop having the shots, then the clock has to tick two days without it and without any transfusion of blood products. We're crossing our fingers.

While we waited for one thing or another in the clinic, I kept looking at the clock and thinking I should go swim my laps, but I was just so tired and I really hate swimming in the morning. Beth needed an IV of potassium, which would be almost another hour, just enough time for me to drive the 12 minutes back to the apartment, swim for 30 minutes, shower and change and get back, but I just didn't have it in me. I told myself I'd get to it later. While we sat there, another patient's husband was chatting loudly on the phone, as they all do, and telling his friend that they were almost ready to leave for the day, but had to wait for her shot of Neutrogena. As always, I was grateful for something to laugh about.

As it turned out, that laugh would have to carry me through the day, as things were about to get heavier. Beth found out from a friend of hers that the housesitter/petsitter had gone AWOL. She is extremely attached to her cat and dog, and had stressed to him at the outset that he needed to commit to staying there the entire time. There is a history to this, part of which is that when her last dog disappeared, never to reappear, the same person, a family member, was also petsitting. I had wondered at the outset why she felt confident about these arrangements, but it wasn't really my issue.

Of course, when you're a primary caregiver, anything can become your issue. We decided that the neighbors could take care of the cat and the dog would need to be taken to a kennel, so Beth got on the phone and made the arrangements. She was very agitated throughout this process, and all I could do was try to keep her focused on the logistics. Here's a hint from the front lines: don't take any chances with the pet thing. I'm not a pet person, but I know that people who are get very worried about their pets. When you are recovering from a stem cell transplant, or helping someone recover from a stem cell transplant, the last things you want to have to worry about are Fido and Fluffy. Make sure you have 100% reliable accommodations for the pets before you embark on this journey--preferably a kennel or other professional care. The bonus is that they can also bathe the animal before you pick it up, so your home environment will be cleaner.

Luckily we have another sister who lives in the same town as Beth, so she could help with some of the arrangements. She had also arranged to come for a visit on Sunday so I could go and hang out with a local friend of mine whom I haven't seen in a few years. When my other sister (I'll call her OS for now, since I don't know whether she wants her name in my blog) got here, we started to compare notes and realized that the pets were not the only worry. A few other strange things had happened during the tenure of said caretaker. As I said, this is nothing new. We have some unreliable, untrustworthy people in our family, and Beth has been taken advantage of in the past because she wants to trust everybody. Another hint from the front line: if you have a dysfunctional, unreliable family, try to replace it as much as possible before undergoing any intense medical procedure. You really don't need your family members upsetting you at a time like this. Beth was distraught about her pets, and about the duplicitousness of someone that she cared about. OS and I were worried about what all this was doing to her health.

By this time I was late getting to my friend's house, but she understood. I had a couple of glasses of wine and some homemade chicken soup and she helped take my mind off the madness for a few hours. She also sent some chicken soup back with me.

When I got back to the apartment later that evening, we talked about the family situation more, and got to bed later than we had been accustomed to. Those of you who know me well, hang on to your hats. I've been going to sleep before 11pm every night! This is partly because I'm exercising every day and also because we have to get up and go in to the clinic every morning.

I was very concerned about how all the family turmoil would impact on Beth's medical progress. I also realized at the end of the day that I had skipped my exercise for the first time in 12 days.