Tuesday +41 (11:30 AM) CMV, etc. update

We just returned from this morning's hospital visit. To update everyone on the status of the CMV treatments...

The doctors were not too concerned with the uptick in the CMV virus load. They felt that only one week of treatments wasn't enough to tell them much. They will continue treatments for another week before making any kind of determination. It seems it is common for patients to see an increase in the CMV counts even after the anti-viral treatments have begun. There are drug resistant strains of the CMV virus. If this turns out to be the case, there are stronger forms of treatment. One of the nurses told us it is not uncommon for people to be on Ganicyclovir treatments for at least a month. As I've mentioned before the Ganicyclovir treatments tend to suppress the blood counts. The good news is that Jackie's counts continue to be stable and, in most cases, improving.

Jackie's RBC (Hgl) count today was 9.7 down from 9.8 yesterday. This count has been trending downward slightly. Since it is the "energy level" count the lower the number the less energy Jackie feels. I think the highest it has ever been since transplant has been about 10.5. Prior to transplant he number was in the 12.5 range. As you may recall, they will transfuse red blood cells at a number below 8.0. This gives you some idea of the effect one might feel with changes in the numbers.

Jackie's WBC count was 3.8. This was an improvement from the 3.7 yesterday. With an improving WBC count comes an improvement in the ANC (absolute neutrophil count). The neutrophils are the agents that fight off the various bits of infections and bugs we tend to get. In fact, we were told that since her ANC and WBC had improved so much that it really wasn't necessary to wear the surgical mask all the time when out and about. Until now, anytime we left the apartment or car Jackie was required to wear the mask. They suggested we keep it handy and use it if around someone who is sneezing or coughing. They also suggest using it while outside and near any dust, debris, or construction. But, for example, it is not necessary to wear it inside a restaurant. Not wearing it makes one feel far more "normal".

Jackie's platelet count continues to improve as well. Her count today was 106 which was an improvement from yesterday's 91 and 76 as recently as four days ago. It is still down from the record of 167 a few weeks ago. The docs think the CMV and the medications are all depressing the counts. If the CMV can be controlled and the medication discontinued I think her counts will quickly all return to normal ranges.

As far as her general well-being; today she is feeling well. Her energy level is still low. Her palsy still continues and her GvHD rash is still in place. But overall, today she is feeling better than yesterday. She has learned to deal with the palsy. The rash doesn't itch and isn't giving her any problems at this point. Her biggest problem is lack of energy. She sleeps a great deal and tires easily. But, overall, each day seems to get a little better!

Sorry for such a long account.

Until later,

Bruce and Jackie
From Rochester, MN