Day 32

Hello Team Tom,

First, thanks for being on Team Tom. Whether you prayed, gave blood, watched Gabriel, visited Tom, kept Tom in electronic company, made food, sent packages, helped me out at work or some combination of these wonderfully supportive acts: you are on the team. And this has been a strong team. I often say: "If your partner has to go through a bone marrow transplant this is the way to do it." We're blessed and touched and excited.

Particularly we are excited because Tom's numbers finally shot through the roof yesterday. Most significantly, those elements of his white blood cells that are the most essential part of his immune system really took off:

• White Blood Count: 3.8 k/uL (low end of normal is 4.0)
• Absolute neutrophils: 1.5 k/uL (most prominent marker of his immune system function)
• Red Blood Count: 3.59 m/uL (lowe end of normal is 4.2)
• Hemoglobin: 10.6 g/dL (low end of normal is 13)
• Hematocrit: 30.2% (low end of normal is 38%)
• Platelets: 129,000 k/uL (low end of normal is 150,000)
• Basophils and eosophils (just coming onto the radar from zero today)

Steve's stem cells and Tom's body have made peace, as the boys predicted. Tom hasn't felt ill since Thursday. Nausea and vomiting are also a symptom of Graft vs. Host disease (GVHD). So, as far as we can tell Tom's GVHD is mild. He feels strong and had a great time cruising around the sixth floor of Helford Hospital yesterday. Tonight bible study will be in the lobby. Tom has had only one red blood transfusion in the last two weeks and may not need another transfusion for some time if at all.

And (drumroll please) Tom will be coming home this week. Tom's blood counts are just fractions away from meeting the "send this guy home" goals. He's eating solid food (another "check") and is infection free (a minor bacterial infection from two weeks ago has passed). In preparation to return home Tom will be weaned off of i.v. medication and back onto oral medication. He will also undergo some tests, most significantly another bone marrow biopsy (wince). But, all so worth the reward.

Tom's mom is coming to stay with us to help complete the 24-hour observation period that will ensue over the next 30 days after Tom's release. Tom will visit City of Hope several times a week during this period and likely through the remaining 100 days of the acute transplant period. Over time the number of necessary visits will decrease and Tom will begin to get back to a normal routine.

I can't tell you the overwhelming relief that has come over me in the past day. I can feel all of the emotion and tension that had built up begin to seep out of me and the tears that I withheld for fear that they may never stop come more freely and are cultivated with joy. We can expect a few more challenges, particularly with keeping Tom free of infection, but he's definitely coming to the edge of the forest and approaching a bright open field.

On Sunday when Gabriel was marking off the day on his calendar and announced that Daddy would be home in five days. I began to fear that Tom wasn't going to be home by the time Gabriel marked that final date. So, I calmly said, "You know, Daddy might not be home in five days." He paused for a second, then turned to me and asked why. I said, "Daddy has some things he has to do at the hospital and he may not be able to get them all done by Friday." He paused again and said nonchalantly, "okay," and went about his business. Small crisis averted just by having a generally happy kid.

Gabriel and I have had great days and tough days, but overall I have just treasured this experience. Tom and I are both working parents. So, in the mornings and evenings we share Gabriel-related responsibilities and similarly throughout weekends. And, though I would never recommend single parenthood, I feel fortunate to have gotten to spend so much time with Gabriel, especially these last few weeks when we tapered off of the play dates. It reminded me what I'm missing when I'm trying to do a load of laundry or run to the store without a preschooler in tow. He really does add great color to what I think of as mundane tasks that I just need to get done as quickly as possible while Tom plays with him. There are so many cliches out there about the time we lose with our kids worrying about the business of living. It takes focus, work, and, in our case, a health crisis to allow the wisdom behind those cliches to sink into my bones. I'm making a mental list of the blessings that have appeared both quietly and with a clatter throughout this process. And it's all a nice confirmation of the divine plan that is so foreign to the plans of humans.

With love and anticipation, The Highland Park DuBranskys