Friday +158 (Morning)

The doctor just left the room and we have no news - which is good news. Her cultures are all still negative and as I mentioned yesterday her smears are negative for fungus. So far she is still negative for CMV. If she were positive it would have likely presented in the culture by now. So what is the problem?

The current thinking is that she is facing some GvHD in the lungs. This is very common. It can be very serious, but usually it is manageable and treatable. If she still has negative cultures by tomorrow they will begin to treat her for GvHD. Treatment for GvHD will consist of steroids; probably oral. Steroids are a very effective treatment for GvHD. Of course long term usage is not good. If she does have GvHD it can (a) get worse; (b) stay the same; (c) improve. Only time will tell which will be the case. To date, Jackie has not presented any symptoms of GvHD which is somewhat unusual. Usually if GvHD is present, some sort of skin rash is also present.

It is only supposition on my part but I would think if the diagnosis is GvHD they will begin treating her with Prednisone. My guess is they would want to wait several days to a week and get another CT scan. If she improves they would release her, but continue to monitor her progress. One of the problems with steroids is that it can quickly decrease blood counts. Of course we all know what that means. As always, the choices will mean walking the edge of the sword.

We were encouraged by the doctor's report this morning. We've had this guy before and his bedside manner is the best in the hospital. He reassured us that the decision to admit Jackie was more related to Mayo Staff coordination than her general health. Since they didn't know what they were dealing with they wanted to make certain any problems were dealt with BEFORE the weekend. This is the sort of thing that would never be considered in Tulsa.

Jackie is actually feeling quite well. She still has a low-grade fever (100.1 5 minutes ago). Intermission: the infectious disease doc just came in.

The infectious disease doctor again confirmed that cultures were still negative. If Jackie had a bacterial infection it would likely have turned up by now. If she has a fungal infection cultures wouldn't turn positive until later today or tomorrow. They will continue to treat her to cover every possible contingency.

To continue, Jackie is feeling well. She is up, active, and currently eating breakfast.

So, I guess no news is good news. I'll update as soon as I know more.

Until Later...

Bruce and Jackie
From Rochester, MN