March 27, 2012

Day 0: Sean, Meet Stem Cells; Stem Cells, Meet Sean!

30 mL. 10 minutes. And then it was done.

All those weeks of anticipation, research, sleepless nights, endless worrying all led to a moment today, this moment at 11.15am, when the cord blood was delivered to our room in a blue esky, waiting to be transplanted in our little man.

Our small room felt even smaller when everyone piled into the room and shut the door. Sean had woken from a nap half an hour earlier, and was happy to play in his cot while everyone fussed around him. There were 5 adults and a baby in the room in total, with another adult standing outside looking in. Laura, our clinical nurse consultant, had been feeling unwell for a few days leading up to the transplant and didn't want to run the risk of passing on any bugs to Sean, so she stayed outside the room and watched and listened through the intercom.

In the room with us were Kate, our lovely nurse for the day, Anne (the nurse consultant who coordinated the worldwide search for the compatible cord blood for Sean) and Carol, who was performing the actual transplant. Anne was there to guide Carol through the procedure, as this was a teaching hospital after all and Carol was being trained to do the cord blood transplant.

With the cord blood delivered and sitting in a green tray, the nurses busied themselves with the prep work to get everything ready. Carol drained the cord blood into a large syringe, and prepared another syringe to rinse out the pouch and get every last precious stem cell out for Sean. Then there was another syringe to flush everything through thoroughly. Kate distracted Sean and played with him while Carol got everything ready.

I took many photos before Anne took the camera off me and told me I must be present in the photos for this very important milestone. Anne continued to take photos throughout the procedure, before handing me the camera towards the end.

Under the very watchful eyes of Anne, Carol connected the syringe holding the cord blood, and at precisely 11.26am, Carol pushed down on the syringe and the cord blood flowed into Sean.

Carol was careful not to push the blood through too quickly, and Sean was happily playing with his toys until almost the end, when he went quiet and a look of inquisition crossed his little face. Anne's years of experience told her that Sean knew something was going on, and that he was beginning to taste the transplant in his mouth.

Anne, along with everyone else, had warned us that the cord blood would have an odour to it - something akin to creamed corn. The smell was due to the preservatives used for the cryogenic process and the chemicals used to wash the cord blood. During the transplant, it was likely that we would be able to smell the odour, and we were told that Sean would most likely be able to taste it, and we would be able to smell it on his breath afterwards. I was expecting this overpowering smell to fill the room, and while everyone else around me commented on the smell, I wasn't able to get a whiff of this creamed corn scent.

The whole process took 10 minutes, from start to finish. After the cord blood was pushed through, Carol flushed the line and then capped it off, and that was it. More people came into the room to congratulate Sean on his transplant, and Sean started waving to everyone, as if to greet them all. One by one, the nurses started heading out the door again, and Sean waved fond farewells.

Kate did Sean's obs every hour for 4 hours after the transplant, and Sean was fine. Sean even had a sleep in the afternoon, as if all the excitement wore him out.

We will forever be grateful to the American parents who donated the cord blood from their little girl, so that our medical team were able to find it and match it to Sean, and extract those precious life saving stem cells to transplant into our little boy to give him a second chance at life.

Our family and friends from all over Sydney, Australia, and the world checked on us throughout the day, via various modes of communication, and we are so blessed to have these wonderful people in our lives.

There was nothing more to do now, except wait and see how Sean's body will react to these new cells. Those little cells need to find their way to their new rooms in their new home inside Sean's body, and Sean needs to continue being brave and strong and let these cells settle in.

The next three weeks will be crucial in the transplant schedule. This is when the doctors predict Sean will become really sick, as the chemotherapy drugs settle in and kick Sean around a bit. Sean currently does not have an immune system, so he is susceptible to any little bug floating around in the air. The new cells that are floating around inside Sean's body have the ability to attack Sean (a disease called Graft Versus Host Disease, or GVHD), and if this happens, it could range from a small skin rash, to something much bigger. Jonathan and I will need to keep a close eye on Sean during this time, and let the medical team know if anything looks or feels amiss.

In the meantime, Sean's appetite was still holding, and he now had a new favourite afternoon snack - cheddar cheese. Our little man is a cheese eating machine!

Sean is now fast asleep; his way of helping the new cells settle into their new home, and I'm about to crash. I didn't get to sleep until 2.30am after being unable to stop thinking and worrying last night, so I'm extremely exhausted. Emma, our night nurse, has promised to look after everything, so I'm going to sign off and get some sleep.

Chemotherapy finished. Transplant completed. The hard part begins. We're ready. I'm ready. Finally.

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