"I have neutrophils"

Day 12

I heard my mom whisper these words on Monday when her blood tests showed the first measurable number of neutrophils we had seen in 4 days. In the world of SCT (stem cell transplant) caregiving, this is one of the important moments you hold your breath for. It means that the stem cells have started the engraftment process – found their happy place in mom’s bone marrow, started growing and making healthy cells.
A moment for celebration, indeed!

So, why are neutrophils so important?

Our bodies produce many different kinds of cells, and while we tend to categorize them into red blood cells or white blood cells, each of those simple categories really has a lot more detail within it.

Neutrophils are the most common type of white blood cell and the first type of white blood cell to respond to help fight infections and heal injuries. Made in bone marrow, neutrophils move throughout the body to where they are needed using the blood’s superhighway system. For most of us, neutrophils make up 50-80% of all white blood cells. Simply stated, they are the armed forces you want to have in the event of an infectious invasion.

When they gave my mom melphalan in preparation for her SCT, nearly all fast-growing cells were killed – the good (neutrophils) along with the bad (cancer) ones.

For days, as I monitored every lab result posted to her chart, I saw “Too few cells to evaluate” under all the white blood cell counts. Today, I see numbers that are even higher than they were yesterday.

Part of the Plan

I am writing because my mom is currently using all her strength to heal from this intensive process. While I have a feeling she may have written entire updates in her head, actually putting fingers to keyboard is too taxing for now, and you should know that this is part of the plan.

“Part of the plan” is something Mike, my husband, has reminded me a lot over the past week or so as the post-Day 0 process has added more and more speed bumps.

Day 6, my mom was admitted to the hospital because they identified a bacterial infection that was best treated and monitored in the hospital. That’s the same day she first had “too few cells to evaluate” for white blood cells. Both of those things were expected by the SCT team and part of the plan.

In the past week, Mom has needed platelets and whole blood because her body was depleted. Part of the plan.

While her white blood cell counts have gone up, she continues to get treatment for and fight the infection that got a foothold while she was neutropenic (without an immune system). We expected that this might happen, and it’s part of the plan.

I am regularly reassured that everything that is happening is part of the plan as the SCT care team and the oncology teams in the hospital continue to handle everything as if it were a familiar dance.