Day 108 -- Day 0 (Transplant Day!!)

Thursday.  Today is the big day!!  Preston got his last shot this morning at 8:30. (He acts like it is no big deal. So brave!)  They also drew some blood, but thankfully that new line came in very handy for that purpose.  Susan, our clinic nurse has been so wonderful!!  She likes to call herself a vampire when she has to draw blood.  She is so nice.  Despite Preston's facial expression...we like her. :)

Susan then walked us down to the Red Cross facility in the hospital where they do collections for UMC.   They got Preston all hooked up to the fancy aspheresis machine and man, it is impressive!  Before they started the process, they had Preston pick out a few movies to watch.  We were in the old part of the hospital and they do not have cable there.  In fact, they had an old TV with a VCR!  Preston picked out a few classics! (In VHS:) 

This is the fancy machine that separates Preston's stem cells and returns his other blood back to him. This picture was taken about 45 minutes into the process.
---A little info...
*By the end of the procedure they collected 321 ml. 10 ml of that was red blood cells (A very small amount). They are not trying to get red, but some get collected no matter what. If there were no red blood cells, the color would be more clear, not the red that you see in this picture.
*It took four hours connected to the machine to do the collection. In that time it cycled Preston's blood 4.1 times, with only 1 cup of blood outside his body at any given time.
*The coil of tubing next to the stem cells being collected is a blood warmer. It makes sure the blood is the right temperature before going back into Preston.
*Preston is B positive blood type. Riley is A positive. Because of this they anticipated a possible reaction from Riley as he got the new cells. He ended up not having a reaction at all. (Thankfully!!)
*The most interesting fact is that Riley will now convert to B positive blood because essentially, he will have Preston's DNA.

Not long after these pictures were taken, Preston started to have a little cough.  Then his nose was getting very congested...  It quickly turned into a scary situation as his nose completely swelled with congestion and started to drain, his eyes started to water uncontrollably, his face started to swell, getting puffy around his eyes and his voice sounded different as his throat seemed to tighten.  The nurses stopped the machine and called -everybody- and the room filled up quickly with doctors and nurses.  They gave him a big dose of Benadryl and watched him.  His symptoms slowly got better.  We literally went through two entire boxes of the hospital Kleenex.  My poor boy!  Our children seem to be incredibly sensitive when it comes to allergic reactions... The doctors and nurses had no explanation as to why he reacted.  He is getting his own blood...?  They only added an anti-clotting factor and some normal saline.  They continue to be puzzled. ??

What an incredible brother!!  Preston has been so brave and completely willing to do what ever is necessary to help his brother.  After the collection was complete, they unhooked Preston and the cells were sent to the lab where they were counted and processed.  They needed to make sure there were enough cells for Riley.  If they did not have enough, Preston would have to come in the next day and do it all over again.  Thankfully we got the good news that they had enough!!  Preston was done!

We hung out in Riley's room until the lab sent them up.  Riley will receive the new stem cells just like a transfusion, through his port. 

Chelsea, the child-life specialist, decorated Riley's door with all sorts of football quotes and encouraging words. Chelsea wanted Riley to be lifted when he went out on his walks... to be cheered on and motivated.  What a wonderful thing to do for him!   

Kathie RN, Tina: RN and transplant coordinator, Lucy: nurse practitioner, transplant team, Dr. Katsanis

There it is!!!  The new cells finding their way in the tubing to Riley.  It was quite exciting!  Dr. Katsanis and the whole transplant team stood around watching, counting each drop as it left the bag and entered the tubing.  At the beginning, 14 drops per minute, then slowly increasing.  Our nurses stood over Riley checking temperature, blood pressure, and watching for any other signs of reaction.  This was a big moment. 
(In the end, it took 2 and a half hours for the new cells to go in.  Riley had to stay on all the monitors for 4 hours after the transfusion of new cells.)

After awhile, Preston was ready to head home.  It had been a big day and he had to be back early in the morning to get his central line taken out.
Preston, dad and I are so impressed with your willingness to sacrifice and help your brother.  You have grown the last few months, and I'm  not only talking inches...  (look how you've passed your mom up :) You have also grown in compassion and strength.  So proud of you!  We love you!

Our amazing nurses!!  Melissa, Brittney, Amy and Karen
All of the nurses signed a "Happy Birthday" card for Riley.  It truly is a new beginning for him... a new life.

Preston and Riley each got a "Bead of Courage" to signify the transplant to add the their strand of beads.  This one means a lot... Courage for sure!!

Labs today:

White blood cells: 2.5  (normal 4.5 - 13.5)

Red Blood cells: 9.0  (normal 13.5 - 17.5)

Platelets: 84  (normal 150 - 425)

ANC:  2275  ( < 500 = severely neutropenic