Wednesday +28 (8:00 PM)

Jackie had a much better day today. While her nausea continued and she ate very little it was much improved. Her energy level was also much better today! She was able to walk to the hospital appointments today without the aid of the wheelchair.

We spent most of the morning in the hospital again today. After the hospital visit and blood work she had an inhalation treatment. The inhalation treatment lasts about 20-25 minutes and is done each month. Doing this eliminates one of the pills she takes daily. The reason for the treatment is it acts on a long-term basis to guard against any lung infections. The series of pills she was taking to do the same thing tends to decrease some of the blood cell counts.

I enjoyed a long conversation with the doctor with regard to exactly how GvHD works and why the incidence of GvHD declines in most patients with time. Without going into details the simple answer is that donor cells become desensitized to the host cells and slowly turn off receptors that cause them to attack the host cells. It is like having an allergy. If you are exposed to whatever is causing the allergy you will likely develop a resistance to the offending substance. Anyone who ever underwent allergy shots knows what I am talking about. The better the match at the antigen level the better the chances of having a minor problem with GvHD. The donor database has improved to the point that the Mayo Clinic rarely does unrelated donor transplants that are not at least a 9 of 10 antigen match. In the early days many of the transplants were 6-8 of 10. The Mayo actually did what are referred to as haploid transplants that were 5 of 10 matches. Of the 25 transplants that were completed as part of a study 24 people did not survive the process. Most people died as a result of infections from the common cold. The reason? Because there is no known drug that can be given prophylactically to prevent or inhibit the disease. In transplants massive amounts of anti-viral, anti-fungal, and antibiotics are given to replace and supplement the immune system.

I don't have blood results. They were not ready by the time we left and I did not call or go back for results. I will have today's results tomorrow.

Until Later,

Bruce and Jackie
From Rochester, MN