Welcome back to Billy's Page # 43, There have been   visits to this page !

 Sat. 27 Mar. 2004  80°   727-898-7451 Room # 272 A

Welcome back to Billy's Page.Today is Day +23 on Billy's BMT calendar. Todays counts are: WBC @ 7.95, RBC @ 2.75, Hemoglobin @ 8.2, platelets @ 24,000, and Billy's ANC is 6360. Billy had a pretty good night last night, although he did show a slight fever of 101.6° for some time. Once again, the cause was not infection related. Both Dr. Barbosa, and Dr. Ayala were very pleased to see Billy doing so well. Alicia spent the night at Home so that she could attend the Funeral service for little Caitlynn, who passed away last week after her battle with cancer was lost. She is one of our Special Angels, who will now watch over Billy, and all the other Children of 2 south west. Please say a Special Prayer for Caitlynn if you can, she will be deeply missed.

Billy had a fairly good day today, and was in his usual good spirits. Yes, he did have an episode of vomiting, but shrugged it off, and had some lunch *wink*! I started to remove all the furnishings and things from Billy's room last night, and Alicia continued the process this afternoon. We have to get Billy's room ready for when he comes home. Not saying that Billy's room was a mess before, but we need to get his room "sanitized", or as germ free as possible. We are removing EVERYTHING, having the carpet cleaned, and only putting back the bare essentials( right sweetie!!). After Billy's immune system can handle a little "Dust", we'll return some of the things, and donate the rest to our local Childrens Charities.
Please Pray for Billy.........................

Welcome back to Billy's Page.Today is Day +24 on Billy's BMT calendar. Todays counts are: WBC @ 6.82, RBC @ 2.61, Hemoglobin @ 7.7, platelets @ 23,000. Billy's ANC is 5446. Billy's counts are down somewhat, and since the Hemoglobin count is now below 8.0, Billy got a transfusion of red blood this afternoon to boost his Hemoglobin up a bit. This is the 1st red blood transfusion since the BMT was done 24 days ago, which in a way, is a good thing. Billy's temps have remained in check, at around 99° or so, which is also a good thing*wink*. Billy had roast turkey again for dinner last night (he really likes it), and once again, it managed to stay "down". Billy is becoming more comfortable with eating again by mouth, and his nausea has mainly been when the nurse would "flush" his broviac lines with saline, or heparin after meds are infused. If the flush is done slowly, Billy is fine with it, but if the flush is pushed too fast, Billy will most likely vomit because of it. Billy had a pretty good day today, and actually woke up a bit earlier than usual, he was feeling a bit weak though. Billy wanted me to order him dinner before I left for the evening, usually he'd wait till Alicia got to the Hospital before he ordered dinner. He wanted roast beef tonight, with carrots and green beans*wink*. Billy is surly getting his appetite back, and sooner than expected! One thing I'd like to make perfectly clear, All Childrens Hospital has a Great menu for the Children, and all meals can be ordered whenever you like, It is called Room Service. You can have bacon and eggs at 8pm if you like, or roast turkey for breakfast!! The Hospital food isn't your typical "Hospital food". As a matter of fact, it is some of the best I have seen, and the portions are more than enough.
Please Pray for Billy.........................

The Soprano's are on tonight..........*wink*

Welcome back to Billy's Page.Today is Day +25 on Billy's BMT calendar. Todays counts are: WBC @ 5.29, RBC @ 3.58, Hemoglobin @ 10.5, Platelets @ 24,000. As you can see, the blood transfusion yesterday has boosted Billy's RBC and Hemoglobin counts up a bit; Billy's platelets are even up 1000. Billy's ANC today is @ 3597, Down a bit from yesterday, but still in the normal range. Billy was able to have some cereal, along with apple juice, and a banana early this afternoon. He was a bit uneasy in the stomach, but kept his food down, and pretty much took it easy. He did vomit a bit a few hours afterwards though. His stomach is still a bit tender from the chemo drugs that effected his mucus membrane's, and the lining of his stomach. This is the plan that Dr. Petrovic would like to see happen: Billy will be off TPN (IV foods) by Wednesday, taking his anti-biotic meds by mouth starting tomorrow, in preparation for going home late next week, or early the following week. A bone marrow aspiration will be done on Thursday to see what percentage of Donor marrow now occupies Billy's. We are looking for 98% or better(fingers crossed). This procedure will be done as in the past, Billy will be sedated, and his left hip area (back)will be numbed. A large needle will be inserted into his hip bone, and a few cc's of marrow will be removed for testing. This is the day we have all been waiting for, and or dread*wink*. Dr. Petrovic is Very Optimistic, and has nothing negative to report, as usual*wink*. She has been reluctant to say things lately, because she doesn't want to "JINX" all the good that has taken place in Billy's BMT process!!*wink*. To this day, Billy has NOT suffered too much with any of the awful side effects that come with a bone marrow transplant, and we hope we are PAST that point. As always........"day by day."

We would like to thank The Diva's of the Net, Lady gator, Joanne, Peg, kathryn, Judy, and Sue, for the wonderful card Billy received today. We would also like to thank Pam C., from NC, for the package Billy received today, that was very thoughtful, Thank you. Click the camera below to see the goodies *wink*.
 Click to see the Neat things Pam sent!!
Please Pray for Billy.........................

Welcome back to Billy's Page.Today is Day +26 on Billy's BMT calendar. Todays counts are: WBC @ 4.38, RBC @ 3.52, Hemoglobin @ 10.9, platelets @ 22,000. Billy woke today around noon, and was a bit uneasy in the stomach; This has been the case for the past week or so. Billy was able to take his meds by mouth today, without any complications. Billy has always had a problem with swallowing pills, but so far......so good*wink*. Billy's WBC are down a bit, but still remain in the "Normal" range.

Once again I'll point to the "NORMAL" blood count levels, which are:

WBC: 4.0 - 10.5
RBC: 4.20 - 5.60
Hemoglobin: 12.5 - 16.1
Platelets: 150.000 - 450.000

Billy hasn't had G-CSF (neupogen) since last Wednesday, and his WBC have been slow to decline. Dr. Petrovic's visit today was very good, she did show some concern for some "rash like" sign's on Billy's abdomen. This could be from the Cefepime (anti-biotic) that Billy has been getting. This drug will be stopped tomorrow, so we hope the rash will go with it! Dr. Petrovic doesn't think it is a sign of GVHD, although a rash is one of the telling factors. A rash would be visible on the palms of the hands, as well as the soles of the feet; Billy is all clear in those areas. Dr. Petrovic is Very happy with how Billy is responding to the BMT, and she is more than optimistic*wink*.

Thank you Gail L. from Alabama, Billy received your card today!
Please Pray for Billy.........................

Welcome back to Billy's Page. Today is Day +27 on Billy's BMT calendar. Todays counts are: WBC @ 3.90, RBC @ 3.53, Hemoglobin @ 10.8, platelets @ 21,000. As you can see, Billy's counts are still low, but pretty much stable. Dr. Petrovic said today, that it appears that Billy is beginning to show signs of platelet engraftment! I almost hit the floor when I heard those words come out of her mouth. You see, the platelets are usually the LAST of the blood cells to come back, and start to build on their own. She believes that Billy PROBABLY started to en graft on day +12, two weeks ago!! This explains the fact that Billy is not experiencing any of the "typical" adverse reactions to the Bone Marrow Transplant. Billy will be off yet another IV drug tonight, he will get his dose of Cyclosporine by mouth (pill) from now on. Remember all those "IV tubes" I showed you the photo of (Click Here)? Well, we are down to just one! Billy is still a bit weak, but is showing a steady improvement in his energy level. Billy did have his usual bout with nausea this morning, and as told by Billy, "it was no big deal". Billy had his broviac dressing changed this morning, you can click on the camera below to have a look! Billy is now OFF of TPN(IV nourishment), because he is doing so well with food by mouth! We are one step closer to "Going Home" with all the steady progress being made by Billy. Dr. Petrovic will be doing the bone marrow aspiration tomorrow morning, around 11:00 or so.

Definition of a Bone marrow aspiration:

The patient is placed in the lateral decubitus position, with the top leg flexed and the lower leg straight. The site is prepared, cleaned with an antiseptic (usually Betadine) scrub, and draped, exposing only the biopsy area.

The skin and the area down to the periosteum are infiltrated with a local anesthetic (eg, 1% Xylocaine) using a 10-cc syringe with a 25-gauge needle for the skin and a 22-gauge needle for the remaining area. Approximately 10 cc of 1% Xylocaine is used.

A skin incision is made with a small surgical blade, through which the bone marrow aspiration and biopsy needles are inserted.

The bone marrow aspiration needle, with a stylet in place, is inserted. Once the needle contacts the bone, it is advanced by rotating clockwise and counterclockwise slowly until the cortical bone is penetrated and the marrow cavity is entered. Usually, a sudden change in give is noted when the marrow cavity has been entered.

Once within the marrow cavity, the stylet is removed, and, using a 20-cc syringe, approximately 2-3 cc of bone marrow is aspirated for pathology slides.

The material collected for bone marrow slides usually is not mixed with any anticoagulant. It is processed immediately by a technologist; this avoids any cell morphologic artifacts. If additional marrow is needed for cytogenetics or flow cytometry, these subsequent specimens are obtained by attaching a separate syringe and aspirating approximately 5 additional cc of marrow at a time to be placed in an anticoagulant-containing tube (EDTA [ethylenediaminetetraacetic acid] or heparin, depending on the situation).

Once the aspiration is completed, the specimen is processed by the hematopathology technician, who selects the marrow particles to make the appropriate slides for pathology.

The marrow aspiration needle is removed, and pressure is applied to the site with gauze until bleeding has stopped.

Following this procedure, a bone marrow biopsy usually is performed as well.

Several layers of gauze are applied to the site with an Elastoplast on top to immobilize the gauze, and the patient is instructed to check the site frequently, to report any bleeding, and to keep it dry. The dressing is removed 48 hours later.

OUCH!!! 

 Click to see Billy's Broviac dressing change!!
Please Pray for Billy.........................