BMT: Aplastic (Day +1)

Clark’s bone marrow is now (almost) empty, and we are awaiting the new bone marrow cells to take root. This is the start of the “Aplastic” phase. It will take approximately 2 weeks from today for the marrow to start to show solid signs of growth. In this phase, Clark is at his highest risk of catching a virus, bacteria, or fungus. We have to be extra careful during this time.

If all goes well, our Aplastic phase will be pretty boring. To give you a taste, here’s what Clark and I go through on a daily basis.  This is an example of what each day over the next 4 weeks should Iook like:

The start of our morning is generally at shift change for the nurses.  This occurs at 7am.  After meeting our new nurse for the day, Clark receives his 1st set of his eye drops for his glaucoma in his left eye.  We repeat these drops 4 times over the course of the day.

Next, Clark receives his oral meds. One to protect his liver, an antiviral and anti-nausea med, and vitamin D3. Occasionally he will also have an antibiotic or blood pressure medicine when needed. Then we brush his teeth with a special “sponge” toothbrush to help reduce the acidity in his mouth and protect his gums and cheeks from bleeding. This is also done 4x throughout the day.

I’ll then pick up the phone and order breakfast.  They deliver food on a “room service” model.  We can order up to 5 times a day for Clark.  They have a large and diverse menu, and we can order Clark whatever we think he will eat.  They then deliver the food within an hour.  Normally he eats a pretty diverse breakfast of oatmeal, eggs, bacon, vanilla yogurt and milk.  We try and pick several different foods, knowing that his appetite is dwindling and that we might get lucky and have him take a few bites of several different foods before he tires of eating and goes back to playing.

In between breakfast and lunch, Clark has playtime in his crib, or by the window. Around this time, we are usually visited by the attending doctor and the resident doctor for their “rounds”. This is when we get a chance to ask the doctor any questions we might have.  The doctor uses this time to see how Clark is doing while informing us of anything new we will be doing that day.  For example: today we were told we will be getting a platelet transfusion.

Lunch varies, and I just try to keep things interesting with Clark’s food order, only so that he doesn’t associate one particular food with his hospital stay.  For lunch, we’ll typically get something like soup, chicken quesadilla, banana, yogurt, and a milk.

After lunch, Clark usually takes a nap.  After his nap, I will give him his daily “bath”.  This is actually a chemical bath with chloro prep wipes, since we can’t actually put his broviac bandage in water.  We then use this opportunity to change the linens on Clark’s crib. My bed also needs new linens daily, so I’ll usually do them at this time as well.  I don’t mind getting fresh linens every day, since thankfully I don’t have to do the laundry!

I try and get Clark dinner somewhere between 5-6pm.  This meal often includes mac & cheese, grilled cheese sandwich, soup, cottage cheese, whole milk and brown rice.  If Clark has been really good, we sometimes add in a chocolate chip cookie.

After dinner, the day winds down at about 7pm with another nurse change.  At about 8pm we do a whole host of oral meds and other IV medicines.  I will generally try and get Clark to go to sleep at about 8:30pm.  This varies greatly depending on how much he slept during the day (less sleep = later bedtime, surprisingly).

As well, throughout the day, there are also several diaper changes, IV fluids changed, and Clark’s vitals are frequently checked. The routine can become a little boring over time, but every time a nurse pops in, it is a chance to chat and do something that takes my mind off of things!

Boring is good at this point in Clark’s healing.  Surprises tend to be bad.  So as “boring” as it is, I kind of hope it continues.