Little by little, she’s getting through the multitude of complications she’s been dealing with. The BK virus, which was manifesting as a urinary tract infection, has pretty much cleared up. Her CMV virus numbers (the more serious of the two viral infections) came back negative on the last test. It had been off the upper end of the scale, in the millions. They’ll take another test on that tomorrow, and have the results Tuesday. If that’s negative, she should get to come home.
She’s still pretty beat up. The blood clot is still there, making her right arm to look like Popeye’s arm. She still has those signs of malnutrition, too – her taste buds seem to be fried, and she still gets a bit of nausea when she eats. In addition to the fluids they were forcing into her (for the urinary tract thing), the lack of protein in her diet made her swell up, basically, from the waist down, like the bellies on the kids in the World Vision commercials.
Now comes the healing process, we hope. Exercise should clear up the swelling. We’re planning to take her for walks. She’s asking me about food again. (Food that I cook is considerably better tasting than what she gets in the hospital. That’s the sort of thing that could get her eating properly again!)
All in all, if GVH doesn’t flare up, we should continue to be able to say she’s beat the leukemia. True, there are more Chimerism tests coming. But beating a disease like leukemia is very much a kind of miracle in our day. Now that this is behind us, she should gradually be able to heal from all of this.
This is serious enough to be concerned about it. I mentioned that Beth has tested positive for two viral infections. I’ve got an inquiry into the doctor, but it seems to me that, while they are treating these things aggressively, they can become serious enough to cause serious worry.
BK Virus: “BKV is a particular problem. BKV is a human polyoma virus that is ubiquitous in the environment and infects children at an early age. Although the most effective treatment has not been established, there has been some success with antiviral agents such as cidofovir and vidarabine. Preventive methods include mesna (2-mercaptopurine sodium sulfonate) combined with forced diuresis and continuous bladder irrigation.” An earlier journal says: “Mesna and forced diuresis are equally effective in abrogating the urothelial toxicity of preparative regimens for BMT. Since HC after BMT is virtually always associated with persistent BK viruria, strategies aimed at the prevention or elimination of viruria in BK seropositive recipients are warranted.”
CMV Virus: “As a consequence, T-cell chimerism after BMT should give a positive prognosis with respect to control of CMV.”
She seems to be covered with respect to the T-cell chimerism; as for BK, she’s got the urinary tract infection symptoms, and also, orange urine. They are giving her lots of IV fluids. On top of this, she’s got the old MRSA infection (at least it’s present enough for them to bring out the yellow gowns), and so it seems as if we’re going to have to sit on pins and needles for a bit.
Beth has something like a urinary tract infection going on. The urinary tract thing has been driving her crazy for days. She’s tested positive for both the BK virus and also the CMV virus. My understanding is that both of these are very common, and wouldn’t be a problem for folks who have normal immune systems. But it’s also common for folks who have had transplants (and the related immunosupression) to have to fight off these viruses.
So she’s back in the hospital, and they’re treating this with “aggressive IV fluids”. She’s already had an ultrasound on her kidneys, and everything there appears to be fine.