I talked with Dr Rossetti yesterday, and yes, he had seen all of these symptoms that Beth was experiencing, no, none of them, taken alone, is all that serious, and yes, all of these taken together have weakened her and will likely make her recovery somewhat longer.
That said, she was feeling a bit better yesterday and this morning, though the clot is still a worry, and her hand had swelled up a bit more.
By the way, did you notice her smiling in this photo? She has always smiled nicely for photos, and she did so here, even though she was dreading the thought of having another central line put in. This one was her third, plus the clot-inducing PICC line in her arm.
Finally, I had a chance to sneak Dani into the hospital for a few minutes last night. The policy is “no children under 12” in the room, though even Dr Rossetti has allowed us to break that rule on occasion. Still, it made for a nice moment for both girls.
I had a chance to talk at length with one of the “practice” doctors (in Dr Rossetti’s practice) about all of this stuff that’s going wrong with Beth. The symptoms she is experiencing are loosely related (because they are typical for some transplant patients). But even when you add them all up, they’re not too serious. She is experiencing some pain, but a we’re just seeing a bunch of loosely related nasty things.
Here’s a breakdown of some of the symptoms and what’s causing them (as best as I can tell):
BK Virus: I had thought this was going to be the biggest threat, but the doctor said it’s not. It’s definitely the most annoying and painful, and there is a chance for it to head up to the kidneys and cause some damage there, but it is minimal. This is what causes the frequent and painful urination. They’re continuing to give a lot of IV fluids to flush the virus out. Her urination is still painful, but an ultrasound just revealed that her bladder is emptying – urine is not backing up, which is good.
CMV Virus: This is the more serious of the two viruses; it is being treated with Ganciclovir, and the numbers appear to be going down.
The swollen legs: This is partly from the fluids, but partly because she isn’t eating enough protein. It’s the same kind of effect that we used to see in the big bellies of the starving kids in the World Vision commercials, except that it’s happening in her legs and feet.
MRSA: This is probably the least of her problems. She has some degree of ability to fight infections, and it doesn’t really come up as a problem.
The clot in the arm: There are two places where a clot could form: at the end, which is more serious (because the end reaches into the large artery that enters the heart), or somewhere nearer where the catheter enters the vein (the plastic is causing irritation). It is also incredibly swelled and very painful. They are giving her a mild treatment to dissolve the clot.
That’s a summary of what she’s facing. It’s all very painful and annoying, but no real danger to her health at this point.