Naomi’s visit to the clinic on Monday was fairly positive. Her WBCs did not bottom out as low as last time. With a total WBC count of 1900 and ANC of 700, she is showing some progress. Her hemoglobin and RBCs increased from last Monday. Her platelets doubled and then some! From 116,000 to 273,000. That is amazing and I think she is now allowed to learn to ride a two-wheel bike without training wheels.

While playing in the room tonight, she was swinging like a monkey on the edge of the bed. Micayah told her that it was dangerous, but she ignored him. He then told me that she was acting crazy and doing dangerous stuff. I think he is a bit more worried than me when it comes to Naomi, and rightfully so!

Anyway, I told him that I thought she was fine and there is not much that is terribly dangerous for her these days. Her smile was huge. I probably should not have said that!

Naomi’s liver enzyme and bilirubin levels are wonderful. Her kidney levels, however, are not as great, and show a need for her to definitely drink more liquids. So, I stopped for coconut water, carrot juice, herbal tea bags, and lemonade on the way back to our room. She must drink more and I am trying my best to keep it from getting boring.

I also had a talk with Naomi about increasing her fluids to help engraftment. Her cyclosporine levels are impeded by high kidney function levels. When the creatinine is high, it can interfere with the body’s ability to absorb the cyclosporine. The cyclosporine prevents GVHD and helps engraftment. So, not drinking enough means higher creatinine and uric nitrogen levels These high levels mean the cyclosporine in not absorbed as well. The cyclosporine levels being below normal therapeutic range means it takes longer to recover. The dr did not put her back on an IV hydration overnight. She wants Naomi to drink enough on her own. I appreciate that and am willing to take a few hits for it.

All-in-all, it was a good visit and we are able to go another week between appts this week! This afternoon, upon returning back to the RMH, I got a lot of filing and bookkeeping and paperwork accomplished. I continue to prepare for the next school semester, too, as new books are arriving for five grade levels. K, 1, 4, 5 and 7. It is times like these when I am thrilled to have a curriculum to follow and do not to reinvent the wheel by making up my own anymore!

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