T=0: Reflections

If I had to find a single word to describe yesterday it would be "understated". Considering the immensity of the implications of receiving donated stem cells the day passed quietly and without any great fuss and bother. Since the radiotherapy Kay has been pretty tired and yesterday was no exception. She slept for a while in the morning and then again later in the afternoon. She spent the rest of the time playing with Nattie, etc.

The transplant was scheduled to begin around 1pm, but in the event it was around 1.30 before it kicked off. The transplant coordinator arrived with a very full transfusion pack containing at least 500ml of processed blood and stem cells. One interesting point is that Kay and the donor have the same blood group, so it was possible to transfuse Kay with the donor's blood without any further complexities. Also, Kay's blood group will not change as a result of the transplant. As the transfusion started, we gave Lauren a call so that we could have a bit of a family moment to mark the event.

In theory the transfusion shoud have taken about an hour, but the volume and density of the blood made it quite thick. To prevent potential damage to the cells the transfusion is normally run in using a gravity feed, ie no pump. Because of the thickness, the nurse ended getting a taller stand and then, when that didn't help, putting the stand on a table. The blood pack ended up hovering around ceiling height but still the flow rate was low, it took around 3 hours or so before the transfusion finished. During that time the lead nurse or the transplant coordinator stood around holding the stand on the table. I have to say that I was pretty nervous about the blood pack falling or something and therefore did not offer to take a turn holding the stand!

Due to the volume of fluid transfused, Kay's blood pressure rose somewhat and her heart rate dropped. But this was considered to be no big deal. Kay ended up sleeping through the late afternoon and early evening. She appeared to be fairly unaffected by the moment, which I suppose could be a good thing. I talked to her at one point and said that I hoped that the stem cells would now quickly find their way into her bones and start doing their thing as soon as possible. Kay nodded in agreement and but was about as reflective as things got.

For a day with so many emotional and philosophical implications there was surprisingly little said. I think that we're all in some state of emotional limbo where we have ceased to feel strong emotions or react to (the philosophy of) a situation. For my part, I was (and am) so tired that I felt like I was underwater all day. Everything seemed to be happening as if in a dream, in some kind of slow motion.

The problem now is that Kay appears, superficially, to be in pretty good shape, just a bit tired. It's difficult to imagine that we're a long way from being out of the woods yet. My mind keeps wandering towards the idea of going back to work on the basis that there's not much happening here. But every time this thought crosses my mind I have to remind myself that we have a child with no immune system who has yet to show the full effects of the radiotherapy. It is pretty much certain that she will get infections from one source or another and foolish to think that we'll continue the next few weeks so quietly.

I was about to write that we should consider ourselves fortunate that things have proceded so quietly but a) given the events of the last six months this is a patently ridiculous thought and b) it's a demonstration of the minds incredible ability blank out the memories of pain or c) I'm too tired to maintain any perspective. Still, let's hope that the next weeks proceed in such a routine way that I'll become bored and want to be back at work as soon as possible. But I think that for the time being I'll continue with a conservative approach. In the circumstances and with our history, you never know...