Day -2: Last of the chemo, moving to isolation tommorow

Nadia had her last dose of chemo today. Good-bye fludarabine! She has started on an immunosuppressive called cyclosporine. The stage is almost set for the battleground that will be her body, where a new immune system from the donor stem cells will try to fight off Nadia’s remaining immune system and take root in her bone marrow. This fight is far from over, it is really just beginning.

Tomorrow we move into the isolation room. It is important to try and keep all possible vectors of infection at bay while the immune systems inside her body fight it out. Keep in mind, this time we want the home team to lose. We want them to lose quickly and cleanly. We want the visiting immune system to take over, make Nadia’s bone marrow their new home, and save Nadia’s life. It will be a hostile take-over and we are hoping to minimize collateral damage. So we welcome isolation. We welcome a germ, virus, dirt-free environment. Bring it on!

We are ready for day 0 on Monday.

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Meet IVy. Nadia is tethered to this apparatus all the time now. The central brain administers up to 4 fluids at a time, including drugs, bloods, platelets, medicine, chemo, hydration fluids, and even cord blood stem cells. All these fluids are administered through her Hickman line, which is a 2 port catheter that goes into her chest, travels subdermally (you can actually see the line under her skin) up to her jugular, in through her jugular and down to her hart. We have seen some monsters like this on the ward, some with 3 brains on 3 poles and lines everywhere. We assume the more lines the more complicated the care. We will see how IVy changes with treatment. IVy will be Nadia’s companion for a long time.

Nadia’s first masterpiece – paint on paper (with a little help from her mom)

Tara and Nadia hanging out on the tree-fort-like crib.