SIMON'S PLACE | Transplant

Our doctors have advised us that the period of Day +4 to Day +10 is likely to be the worst of it. Simon's pain level has definitely increased, and his continuous dose of morphine was increased today to 0.2 milligrams. It's still a very small dose. Simon is getting good at pushing the button to get an extra 0.5 mg as needed (but not more often than every 10 minutes, and not more than 4.5 mg total in 4 hours).

Despite his pain, drowsiness, and itchiness (an effect of morphine), he had some very lucid moments today and worked energetically on a coloring project this afternoon with Mary. We also read ALL of "The Animals at Maple Hill Farm", a long-time library book favorite and recent gift to Simon from Mary's friend Sandy Gregerman, whose children really loved this book, too.

GLOSSARY

BLOOD COUNTS
WBC (white blood cells; infection-fighters) normal range: 4.5-13.5 K/MM3
Hemoglobin (carries oxygen in blood, low=anemic) normal range: 12.5-16.0 g/dl
Hematocrit (not totally sure, but related to red blood cells) normal range: 36.0-49.0%
Platelets (blood clotters; low means risk of internal/external bleeding) normal range: 150-450 K/MM3
ANC (absolute neutrophil count; basic measure of immune system) normal range: 1.8-10.1 K/MM3

GLUTAMINE an aminio acid that can reduce mouth sores after intensive chemotherapy. Not commonly used at UM Hospitals, but hightly recommended by other parents in our Neuroblastoma listserv community. Dr. Yanik said it would be OK to try it and ordered it for Simon.

MYEOLOABLATIVE destroying of bone marrow. Pre-transplant chemotherapy is designed to kill off all bone marrow in the body. The transplant introduces new cells to create new marrow.

NEUPOGEN white blood cell production stimulating agent; injected subcutaneously while WBC is low.

TRANSPLANT

GLOSSARY