Day 40, Hemolytic Anemia

Thank you so much for all the phone calls, texts, and facebook messages yesterday.  It was a LONG day.  Hunter was super nauseous, looked jaundice, was dehydrated, and lightheaded.  Your red blood cells carry oxygen all throughout your body, and that's what was really low.  He didn't even have the strength to sit, stand, or walk on his own.  I felt really fortunate I was able to get him to the hospital by myself.  It was one of those days that you're just glad it's over with and hope you don't have another like it.  Thankfully, we've got really good news to report for today.  

After I'd posted yesterday, it was confirmed that Hunter had antibodies in his blood.  This is our problem.  Hunter is producing plenty of red blood cells, but something (maybe a little infection) has triggered his antibodies to attack his new cells.  This is common with a BMT and called Hemolytic Anemia.  His liver and kidney are having to work really hard to process getting rid of all the destroyed red blood cells.  Treatment is high doses of steroids to settle his antibodies.  His white count is down from yesterday, so it doesn't seem like he's got a raging infection.  He is on some new IV antibiotics just in case.  Once we get the blood cultures back (24-48 hours) we will know more.    

I can't even pretend to understand all the science that's going on right now.  Even though it's been explained to me by several different doctors in easy to understand language, it's confusing.  I do know that because of the antibodies it took the blood lab a long time to find the correct blood for him.  His first bag arrived around 10:30 P.M.  We knew that he wouldn't feel better until he got large a large quantity of blood, so we were frustrated it took so long to arrive.  The important thing was to find the correct match for Hunter.  Each unit of blood takes about 2 hours to run.  He got 2 units of blood, then an antibiotic, then had his blood drawn then another antibiotic.  His hemoglobin was still really low, so he got bag 3.  As you can imagine, that didn't allow for much rest in his night.

This morning, his nausea was a little better.  He ate some cereal, got his dose of steroid, and took a little nap.  After rounds, the plan was to start on another IV medication (IVIG) that also helps keep the antibodies suppressed.  Even after 3 units, his hemoglobin was at 6.  He got a 4th unit, and we thought we would be repeating this same process tonight.  His "marker of destruction" (no idea what that is) was down from yesterday, so that was a big positive that the steroids were already beginning to work.  His coloring was much improved, but his appetite was still not there.  He is supposed to eat lots of protein while on steroids.  To someone without a desire to eat, tons of protein sounds fairly overwhelming.

After his afternoon blood draw, we were so surprised and happy to hear that his hemoglobin was above 8.  This means he doesn't need any blood transfusions tonight.  This is excellent news!!!!  Our nurse was shocked he responded so quickly to treatment.  This was before his IVIG was started, which should also help keep his hemoglobin boosted.  Also, this news saved Hunter from having to get a 2nd IV in his arm.  The IVIG takes 4-6 hours, so that didn't leave much time for blood transfusions or scheduled antibiotics.  Thankfully, his one line will be enough for today.  Extra praise!  Our day got much better with this news!

He may still need transfusions tomorrow and in the future until he gets back regulated.  The IVIG is a four day dosage and he will need steroids for several days too.  If you've ever had high dose steroids, you can sympathize with Hunter.  He feels jittery, sick to his stomach, and really uncomfortable.  He just doesn't feel good at all.  What's hard is that he knows he has several more days of the same thing-not sleeping at night and restless all day.

We are beyond thankful that Hunter has responded to treatment.  What an answer to prayers!  Peace and comfort for Hunter, and relief would be high on our prayer list right now.  We felt and appreciate all the outpouring of support yesterday, and humbly ask you continue to remember Hunter in his journey to healing.

And just because it's cute, he's some pictures of Benton's day....Auntie Michelle took him to swim lessons with Ben and Clara, time with the GG's (his Great Grandparents), then after a rest fishing with Uncle Chase.  Pretty good day if you ask me;)  Thanks Team Hanner, for loving our kids when we can't be there.

It seems like for every new challenge we receive a blessing to go along with it.  Yesterday, Hunter's clot pain was taken away.  Today we received a care package from a church here in the Houston area we have never even visited with gift cards for places Hunter would eat.  Tonight, our church family gathered together before the Wednesday night service in a time of prayer dedicated to Hunter and another family, the Boones, fighting cancer.  We are blessed by our support system!