Tuesday +20 (4:15 PM)

Today is a pretty good day. Especially compared to the last few. Jackie was able to walk to all of her hospital and doctors visits today. The first appointment for IV antibiotics was at 8:30 this morning and we just returned to the apartment at 4:00. Neither of us had had lunch. The entire time was filled with appointments.

As far as Jackie's energy level I don't believe she rode the wheelchair once. In fact, she pushed it all day. Now, before anyone calls me "lazy" the docs suggest this. If causes the patient to exert a little more energy and it gives them a steady platform while walking.

The infectious disease guys don't have anything new to report. Jackie's fevers have moderated. They are running about 1/2 to 1 degree above normal and she is taking no Tylenol. Maybe this phase is past! The infectious disease team wants another CT scan later in the week. They have no particular reason other than to keep a close watch on her lungs. She has developed a few nodules, but nothing to be concerned with.

During one of the CT scans it was learned she has some kidney stones. At present they are causing no problems and nothing will be done. They may cause some problems in the future, or they may never cause a problem. She has had kidney stones before and they were not fun at all.

The hearing people report that Jackie has mild to moderate hearing loss at high frequencies. But, they don't seem concerned and there is nothing they can do about the problem. Only time will tell if she will recover the lost hearing.

She continues to suffer from a bad rash. Fortunately it is not painful and it doesn't itch. It certainly looks like it should be painful and itch, but so far that isn't the case. It looks like a sunburn. Not a bad sunburn but one that was on the verge of being painful.

Jackie's eye condition doesn't seem serious. There was some concern that it could be due to the CMV virus, which is a strain of herpes. Now for those who don't know, most people have a form of herpes. If you ever had chickenpox as a child, cold sores, mononucleosis, or shingles you have a form of herpes. The STD is herpes simplex 2. The other, more common type is herpes simplex 1. Herpes is one of those virus' that are always present in the system and outbreaks can be triggered by stresses to the body. Certainly a stem cell transplant and a new emerging immune system qualifies as a stress to the body!

Jackie continues to have some severe back pain. No one is able to pin down a reason, but it is pretty severe at times. Before noon today she had taken three Oxycodone (Rush Limbaugh's choice drug for abuse). When the eye doctor asked her to follow the tip of his finger as he moved it from side to side during the peripheral vision portion of the eye test Jackie flunked miserably. At that point I'm not sure she could even see his finger. I explained she had three Oxycodones on board and he didn't do any more drunk driving type tests. The pain this afternoon is better and she hasn't required anymore pain meds since about noon.

There was a good reason for Jackie's increase in energy level today. Her RBC count took a good jump. It was at 10.4 today up from 9.2 yesterday. This has a direct correlation to how much oxygen is being carried to her system and how much energy she has. Her WBC count also improved today. Yesterday it measured 1.3 (down from a record 3.0 a few days ago) to 1.7 today. Her neutrophils were at 770 so she is no longer officially neutropenic. Actually she has been above the 500 cutoff level for neutropenia for quite some time. Still, they like to see these numbers as high as possible. The higher the number the better the immune system. Jackie's platelets have rebounded a bit to 118 from 98 yesterday.

Some of the decrease in counts may be due to a very high level of mycophenolate. This is one of the anti-rejection drugs she is taking. They are going to check the levels and they may cut back on the dosage. They have already cut back on the amount of cyclosporine (the other anti-rejection) drug she is taking.

So in closing this afternoon... if she didn't have back pain, if she didn't have a rash, if she could hear well again, and if her eyes weren't blistering - she would be having a really good day! Actually she is feeling much better. As I write she is changing the sheets on the bed. Why? I have no idea - I guess because she can. They are only a few days old and housekeeping cleaned the apartment this morning. The comment from yesterday questioning whether the donor was male was certainly right on!

Bruce and Jackie
From Rochester, MN