November 26, 2006 , Day 40
Good evening again! These updates seem to come closer and closer together every day! Maybe that's a good thing. Today was a relaxing day. We watched some of the games and did a couple of puzzles and that was about it. I did a lot of food experiments today, some were positive and some were !#$%^&. Anyway, I got some food into myself. I missed lunch because of a transfusion. They gave me benadryl just a few minutes before lunch came in. One of the last things I remember before nodding off was lunch arriving. When I woke up, it was gone.
They didn't take me off IV Cyclosporine yet, although they keep dangling that in front of me as something they might do tomorrow.
No Physical Therapist visit today. I didn't even go for a walk. I have officially proclaimed that today is a recovery day.
On the medical front, I am developing a rash again. It itches mercilessly. We are dumping lots of lotion on it. They are not sure if it is from an antibiotic, or from GVHD. I don't think I have described GVHD lately, so let me give it a go.
In simplest terms Graft vs Host Disease (GVHD) is like rejection in an organ transplant. So why call it something different? Because it works backwards. In normal organ transplants, the recipient's body rejects the new organ. In GVHD, the new organ rejects the recipient. This is because the rejection mechanism is contained primarily in the blood. Since I am getting a new source of blood, then the blood would reject me, rather than the other way around. The Graft (my brother's stem cells) don't recognize the rest of my body so they try to get rid of it. GVHD is commonly suppressed with drug treatments and immunosuppressants. Cyclosporine is the primary control agent I am getting right now. They discussed giving me Predisone to bring the rash down, if it doesn't clear up. GVHD can express itself in many ways. It can be very minor, or it can be life threatening. GVHD is monitored very closely to control it. Some GVHD is considered very positive in cases like mine, and they will probably try to keep my immunosuppressants at a level where there is occasionally some minor GVHD to promote something called Graft vs Leukemia (GVL) effect. The rejection of cells actually results in the destruction of those cells. If the graft attacks any leukemic stem cells that happen to be lying around, and destroys them, that is a good thing. In the protocols for treating many types of leukemia, there is a statistically significant improvement in prognosis if GVL is allowed to occur.
Blood levels: Dropped below transfusion threshold for HGB today so they gave me a unit of blood.
Blood Cell Type
Hope you all have a great week!
Ted and Menchie
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