Deep breath. Week six.

My weekend at home was just what I needed. I came in to the hospital on Saturday afternoon for a visit and a feeding, but otherwise had a nice break from Friday night until Sunday noon, complete with children, sunshine and friends.

I had hoped this week would be brighter, the week we might go home, but that seems less likely now. Today at 2:00 Samson will have a sample of his bone marrow tested, to see what is going on in there. I am glad we are doing this test, because four weeks out from transplant, his blood counts are not what they should be, and we need some answers. I began to feel worried last week, despite the doctors' reassurance that all seemed normal. Today, while they are hopeful for positive news, it is clear that Samson's doctors are beginning to have questions themselves.

The ANC was up to 288 on Day 19, then down for three days, then a jump up to 384, and down again the next day. The last four days have remained steady, but low: 176, 168, 154, and today 168. The total white count has gone down. Five days ago it was 1.6. The next day, 1.1, then 1.2, then 1.1, and today 0.7. Red cells are down today also, and Samson is getting a transfusion of those right now, premedicated with steroids and snoozy-making antihistamines to fend off allergic reaction.

I am not sure whether I feel worse for myself or for our favorite nurses when they have to bring in the blood count sheet and look at me in the morning. The last few days we had Carmen, and today through Wednesday, Cheryl. I don't know what it must take to be an oncology nurse, but I can tell you I am grateful these two women chose this job at this place at this moment. They are a big part of what makes my days bearable.

If I look for the positive, I am encouraged that Samson just seems better than he did last week -- his energy, his color, his spirits. But even that is not entirely true; after a couple of days of starting to eat, that has fallen off over the weekend, and he had little appetite yesterday or this morning. He was also vomiting again this morning.

Samson had to stop eating this morning at 8, in preparation for his anesthesia this afternoon, but tomorrow the plan is to reduce his IV nutrition in case that calorie load is diminishing his appetite and discouraging his eating.

Of course, everything we do will depend on what his marrow looks like. Some testing will not come back for several days, but my understanding is that slides of the marrow will be made immediately after the procedure today and some information may be had by the end of the day. I am ready for news, whatever it may be, so we can figure out the next step. I think the best news we might hear today would be that all looks normal, they are seeing some baby cells getting made in there, and we just need to keep waiting. The pathologist will take a closer look at the slides but because of prep time that won't happen until tomorrow.

I am hoping my doctor communication will be better this week. Every Monday comes with a new team of doctors on in-patient duty, and they do their rounds each morning in their spiffy yellow outfits and masks. I liked the attending physician last week, Dr. Greg Thomas, but he is not a transplant specialist, and we didn't have a great resident or fellow on duty last week. There is a new attending on this week, Dr. Bill Chang, who seems young but smart, and is a bone marrow transplant specialist, which is helpful. Dr. Nemecek, our main doctor, is tuned in to our case, but she doesn't come around every day unless she is the in-patient attending, or I start making crazy demands. Also, the fellow on this week is particularly interested in transplant, plus is a nice person and good talker; he was on in-patient duty our first couple of weeks and I really like him. A fellow, in case you aren't into doctor hierarchy, is a person who has finished his residency and is getting specialized training in something, like oncology.

Finally, I asked Samson's general pediatrician (Aaron calls her a "real" doctor, as opposed to the hospital people) to call and talk doctor with Dr. Nemecek, and then relay to me, to make sure I am getting the scoop on what they are thinking. It would be ideal if I could have this conversation with Nemecek myself, but I don't think I should get too hung up on that. I know she knows what she is doing, even if a conversation with her is not so much give-and-take but more like hearing an announcement, and I know our Real Doctor loves Samson, and would sit and talk with me for a year if I asked, so the combo of those two might be just the ticket to me getting the information I want. What do I want? I think sort of a road map: what are the possibilities here, how generally we might handle the different outcomes, and what our expectations of success would be in different situations. I am not one for getting too bogged down in what-ifs, but I want enough information to cope with the waiting, and to prepare myself for possible bad news.

And so, deep breath, hello week six.