Wednesday +240 (Evening)

Jackie has not felt well for the past week. She has been plagued by some severe bone/muscle pain as well as nausea and stomach cramps. She has not run any fevers over the last week. Her fever of a week ago was likely due to the fact that she was once again neutropenic.

On Monday of this week she received another blood test. It was the best test in several years. Almost all of her counts were in the completely normal range! Her hemoglobin was in the low 12s. Her WBC count was 4.8 with a high neutrophil count. Her platelets were 208. The few blood components that were abnormal were only abnormal by a small amount.

For this reason it makes it strange that she doesn't feel well. She had another CMV test which was negative. It is my belief that she is experiencing some GvHD problems. Her Cycolsporine anti-rejection medication had been reduced to only 25 mg per day. Her Prednisone dosage had also been reduced to a very low level.

After consulting with the good folks at the Mayo Clinic the decision was made to increase her Prednisone dosage by a small amount. I think it may also be necessary to increase the anti-rejection meds slightly and then begin a slower tapering procedure. If her condition fails to improve we may need to make a trip to Rochester.

Until later...

Bruce and Jackie
From Pryor