Wednesday,

Day +5 since Bonnie’s bone marrow transplant (BMT) and thus far everything is going as well as the BMT team expects and anticipates. Bonnie’s counts continue to decline. As a refresher, the normal range for white blood cells (WBC) is 4200 to 12,000. Today Bonnie’s count is 1500. The normal minimum baseline for hemoglobin is around 12, and Bonnie’s has dropped to 9.6. Normal platelet range is 100,000 to 150,000, and Bonnie is currently at 84,000.

Bonnie has a severely compromised immune system that has been suppressed and is once again neutropenic, which means the WBCs that are neutrophils are non-existent so she has nothing to fight infection. This is however, what the BMT wants to see as the donor stem cells are grafted into the bone marrow cavity. If Bonnie did have a strong immune system, it would fight these new cells.

Those of you following this blog since May, may remember that when Bonnie was previously neutropenic , she was put on a neutropenic diet which prohibited most fresh fruits and raw vegetables, including salads. The good news here at Karmanos though, is the recent adoption of a “non-restricted” diet due to extensive clinical studies completed at MD Anderson Cancer Clinic in Houston which showed no significant difference in infection rates between leukemia patients following and not following the restricted diet. Because of this, Bonnie is able to eat salads, tomatoes on sandwiches, and fresh fruit.

Fatigue continues to be the major issue for Bonnie, which is normal in these conditions of being neutropenic and a declining hemoglobin count. She still walked 2 miles yesterday (not all at once) which is encouraging. She is experiencing numbness in her toes and feet, and up into her calf, which is uncomfortable when she crawls back into bed.

Please pray that the fatigue will be manageable and not limited her ability to walk, which is so critically important. Also pray that all the other side effects that we are waiting to appear will be limited, particularly mouth sores, which can get quite severe and in many occasions creep all the way down the throat to the esophagus. They can get severe enough that it limits or prohibits the ability to eat resulting in a food bag IV. This is the first thing the doctors ask about and check on as they do their daily rounds. Bonnie had a few mouth sores with the previous rounds of chemo and they are extremely painful, so we are praying that they will be limited to non-existent.

Another day in the life of Bonnie living at Karmanos. She continues to be resiliently and incredibly strong emotionally through this process which is an answer to many prayers. That’s not to say she doesn’t have any moments when her emotions are challenged. She does have those times when it’s hard, and with the frailty of our human nature it’s to be expected. Yet we continue to look to Christ who is our Rock who says in Isaiah 51:12 “I, even I, am He who comforts you.” There is no trial that we will ever face that God can’t comfort us.

Steve & Bonnie