"An order of platelets & red blood cells please"

Happy Good Friday everyone,

From today's title, it should be pretty evident that Dane's blood needed some help yesterday. With the exception of the red blood cell tranfusion he received on day 2 in the hospital in January, we had dodged the blood transfusion bullet thus far. However, he has been receiving some pretty heavy dosages of medicine the past couple of months that affect his bone marrow so his blood was bound to need a little "boost" eventually. Although he still had some decent color and energy yesterday morning, the lab results showed his hemoglobin was down to 70 and his platelets were only 9. Given we were facing a long weekend and the fact his counts could have still been dropping from the medicines he received on Tuesday, the oncology team decided it was time for platelet and red blood cell transfusions.

I've "plagarized" the information below from the Internet to help explain what Dane needed and why ...

- Platelets are tiny cells that are found in the blood and their function is to help it to clot. Platelets are made in large numbers by the bone marrow (the spongy material inside the bones). Sometimes the number of platelets in the blood is lower than normal. This may be because of illness (including cancer, leukemia or certain blood disorders) or it can be a side effect of chemotherapy treatments. Transfusions are usually given when the platelets are less than 10 (Dane's were 9 yesterday), as this is when there is a much greater risk of serious bleeding. A platelet transfusion generally takes about one hour to administer.

- Like platelets, red blood cells are developed in the bone marrow. For a red blood cell transfusion, the blood you get must match or be compatible with your blood type (Dane is A+). You may get a red blood cell transfusion if you have too few red blood cells (anemia). Anemia causes weakness and fatigue. To measure Dane's level of red blood cells, his doctor checks his hemoglobin level regularly. Transfusions are usually given when the hemoglobin level is less than 70 (he was right on the cut-off yesterday). For a child Dane's size, a red blood cell transfusion generally takes about three hours to administer.

When Dane was tranfused in January, it was because the leukemia was causing the bone marrow to malfunction and not make enough red blood cells. At this point, it's not the leukemia that is causing the issue, it's the effect of the chemotherapy on his blood production. So although we would of course prefer he not receive other people's blood, we are not as scared about why he needs it right now. It's also very stressful knowing that low levels could result in a very serious bleed.

Given the number of hours it takes for transfusions, once we received the news we had to go this route yesterday, we hunkered down for a long day. However, Dane had a few issues along the way with the two transfusions, so it ended up being an even longer visit - 9:30 am - 6:30 pm. He had a slight allergic reaction to the platelets and so he was given Benadryl to help with the symptoms - a slight rash and stomach ache (which promptly put him to sleep for about an hour). He was also complaining of a pain near his IV site when the red blood cells were going in which the nurses figure was due to the cold blood. We had to stop and start a couple of times before he was comfortable so that delayed the process. He was a trooper the entire time and when he woke up this morning full of energy, rosy lips and cheeks and "Dane attitude", we were reminded of the boost he gets from a transfusion. He really seems to know the difference, because he commented first thing today how much more "energetic" he feels.

Given Tuesday and Thursday were full hospital days, he didn't make it to school very much again this week. He has a four day break now for the Easter long weekend and I'm hopeful the next couple of weeks will be better scholastically. It's a good thing he's a bright little guy or we'd really be stressed out about his lack of attendance.

It's supposed to be plus 5 and sunny here this afternoon so we are preparing for our first bike ride of the season (no need to panic, I'll be walking while they are riding). They are looking forward to it because we've promised a trip to 7-11 for a slurpee on the route.

Happy Easter - Janie and Dirk