Day +17

Everything is still on track to go home tomorrow. It seems surreal and I'm not sure I'll actually believe it until I am physically home.

My counts continue to rise:
WBC: 0.7 (from 0.6)
ANC: 0.55 (need to be over 0.5 two days to go home)
HGB: 7.5 (was 7.1; maybe beginning to increase on its own?)
PLT: 18K (for 3 days in a row)

I needed magnesium in the IV again this morning, but then started taking oral supplements at lunchtime, so hopefully won't need the IV again.

I met with the dietitian, learned the outrageous caloric and protein requirements for the first 100 days (1700-2100 calories/day; 90-120 g of protein/day). This is because I'm re-building, and my metabolism will be higher for these first 100 days, and I don't want to draw on any reserves (I actually don't have a lot of reserves). It will be tough to get that much protein regularly, so I ordered some protein powder to add to smoothies and whatever else.

I met with the PT, learned I actually improved my balance and speed tests while I've been hospitalized (woot!), and got some great exercises to do for my upper body when I go home.

Dr. Pasquini explained the plan with regards to meds at home, labs and appointments, and discharge tomorrow. I asked him a question that had been bothering me the last few days. Everyone (him, nurses, etc.) has been commenting that I'm "early" with regards to seeing my counts go up as a result of engrafting. I started worrying that early was not necessarily a good thing, and what if it wasn't actually my new marrow, but my old, leukemic marrow breaking through to produce new blood cells. He reassured me that that was not the case and that there is a range and while it's much more common for engraftment to occur a little later--especially with bone marrow--that it's not a bad thing. The only time they get concerned is if you get to about day +21 and there is no sign of improvement. Even then, it might just be a later engraftment. Since I showed my first signs at Day +13, I was definitely in the early group.

My first post-transplant outpatient appointment was made for Tuesday morning. Dr. Hamadani is out of the office, so I will see his PA Katie.

I know it's going to be difficult to say goodbye to everyone tomorrow. I also missed saying a final goodbye to last week's team of nurses and CNAs since I never dreamed I'd be going home before Monday. Today the two people who have been the most constant in my stay happened to be in my room at the same time and they let me take a photo with them. One is Ari, who is a PA on the bone marrow team. When changes were made due to COVID-19, she was one of the PAs who took on the majority of the in-patient rounding. I have seen her almost every Monday through Friday since I've been here--through all four BM physicians rounding. She's got a wonderful, upbeat, matter-of-fact personality and it meant so much to see her regularly. The other constant in my life has been my "housekeeper"--Stacy. Stacy works every Tuesday through Saturday and from the very start was so warm, chatty, friendly and kind. I looked forward to her visits and we'd talk about everything from our families to politics.

Stacy, me & Ari

Much of today I was just generally restless and antsy. I don't want to pack up my room yet--both because it will look so empty and sad without my cards and photos and artwork, and also because I'm afraid it will jinx my ability to be discharged. So tomorrow I'll find out my counts and if I need any blood products, then will start packing. Greg will come at some point and then if all goes well, I'll be home. Like I said, I probably won't believe it until I'm actually home. But I can't wait.