back again

Shanean was admitted back into hospital at 300pm today. This will be a long one this time - well over a month to 6 weeks
Its a big ordeal this time - including a bone marrow transplant from christene and it will go something like this
Week 1 - conditioning chemo and 3 days of radiation - this will destroy her bone marrow (again)
Week 2 - bone marrow transplant + various therapies to prevent the donor cells rejecting her body
Weeks 3 - 6 - "crash" time as the donor cells engraft and rebuild her immune system back up again. It will be a bit of a waiting game but will be 14 to 28 days at least - sometimes longer
She will be discharged when her blood counts have returned to normal and there is no sign of infection or other complications. When she is sent home she will be on regular medications to prevent infections (primarily of the lungs) and prevent the graft-versus hoost disease

Graft versus host disease

This occurs when the donated stem cells identify the patients body as foreign and react against it. A small amount of the disease usually means the transplant is working but too much of the disease can be very serious. She will be on drugs to prevent the disease for 6 to 9 months after the transplant. There are 2 types of the disease

1. Acute gvhd - occurs in the first 100 days and causes a skin rash and may affect the gut and liver causing diarrhoea and jaundice

2. Chronic gvhd - occurs after 100 days and can be many things - skin rashes, lungs, gut and liver - it can be treated hoowever in some cases it is persistent and is difficult to treat so we don't want this one.

Given christene is a perfect donor match the risks are lower though not eliminated. Also the fact that christene hasn't had babies also lowers the risk for some reason

Finally - as shanean's whole immune system will be destroyed she will have to be re-immunised for all the diseases given to her as a baby and child such as polio diptheria hepatitis whooping cough etc

Shanean is doing ok - she is in quite a bit of pain from the tumours and the impending ordeal is a tad nerve-wrecking (to say the least) - but she is a very tough cookie and is ready to take it on