We sat together on the edge of the bed. Talking about how the cells would find their way into their new home. She leant on my shoulder. Exhausted. She had been on oxygen since early morning after her oxygen saturation had fallen overnight. A chest x ray showed an accumulation of fluid around her lungs. A result of all the fluid she had received with the stem cells the previous day. It was Day 1, Saturday, the day after her transplant.
“Am I going to feel this bad from now on mama?” her voice was quiet.
“We’ll just have to see how it goes, Jesi. It might be a while.”
“How will I have visitors or do my tutoring?”
I remembered a few weeks back. Jesi had been sitting on the lounge at home, perhaps it was with her Math tutor. She seemed light hearted when she had said she knew it was going to be tough.
“This is the tough part Jesi.” The beginning of it, I thought.
She probably wished she was still sitting on the lounge at home doing trigonometry. Drawing doodles on her answer sheets that she and her tutor would laugh about.
“When I think about it, I try to remember to invite the cells into my body. To welcome them. They’re mine now.”
I smiled, remembering how, when they were hanging on the IV pole the previous day we had talked about giving the cells gratitude for being available to her, for making their home in her body, for helping her to be well.
It had been just after 3 pm and we had been asking the nurse when the cells would come up from the cryobank since noon. “They must be sick of me calling,” she replied. Then, finally they called the ward. The cells would be ready by 3.
The nurse started the pre-hydration fluids around 1pm, and while Jesi and I squeezed into the tiny bathroom, Jesi sitting on a shower chair, me crouching beside her with the warm face clothes dodging the IV pole and the half dozen clear plastic IV lines that ran from the pumps into her central line. The nurse knocked and asked if she could give the IV Benadryl. It and oral Tylenol were given an hour before the start of the stem cell transfusion to help prevent reactions. Jesi had just spiked a slight fever, so the Tylenol would help with that too.
On Friday morning, before the transplant, Jesi did not feel like talking. She had not slept well and had woken in the middle of the night breathing rapidly, her heart thumping. She complained of a tightening in her chest. The doctor was called and after a chest x Ray showed no change from the previous one, she was able to fall back to sleep.
It was just after 3pm. There was a knock on her door. Three staff members came in with a bunch of colorful balloons. One was holding the large bag of fluid, pale red, not the creamy colored plasma I had expected. “They’re here.” They were singing Happy Birthday and marching as if in a procession. When Jesi saw them her face broke into a smile.
I squeezed her toe gently.
“What do you think Jesi?”
“Seeing them makes me smile,” she replied looking at the big bag as the nurse hung it on the IV pole.
There were over 750 mls of fluid in the bag. The largest volume of a transfusion I had ever seen.
Somehow it seemed more intimate than a bag of packed red cells would have been. Jesi had had so many blood transfusions I couldn’t even count them, but this bag of cells were especially for her. I recognized by the color of the fluid that they had left the red cells in. Jesi’s old blood group must have been compatible with the donor’s, otherwise they, like the platelets would have been spun off.
“It’s a large volume but that’s great”, the nurse must have ben reading my thoughts. Then she turned to me and asked “Do you want to start the infusion?”
“Sure, I’d love to.” And I watched her program the pump for 2 1/2 hours.
While the transfusion was going Alan and I packed up everything in Jesi’s room. We had just learnt that there was another room available further down the corridor. Two nurses pushed Jesi in her bed and the IV pole through the ward. Her new room seemed lighter, a feature wall was painted bright yellow and she had a view of the small garden wedged between the various wings of the building.
Chris and Kari had arrived and fast set up in Jesi’s new room, Chris cleaning all the Bananarama tiles with antiseptic wipes before he and Kari settled down around Jesi who sat over the edge of the bed to play. I watched her struggle with exhaustion, but the temptation to play with her siblings overcame it.