Wednesday, 29 October 2008

Navigating Unknown Territory

Well, the speed bump has become unknown territory... Eric's blood counts continue to be low. A number of tests are pending including a chimerism panel that will tell us what percentage donor cells are present. In the meantime, more blood and platelets and regular testing to monitor status.

Thursday, 23 October 2008

Speed Bump

We've hit a speed bump this week with some low blood counts. Not sure of the whys yet, but I guess the BMT team will top him up and then try to figure out what's going on.

More to come!

Thursday, 16 October 2008

2 Units of A-

For the first time in several weeks, Eric got a couple of units of blood today. And this was the first time that he received his new blood type.... A-. It is very weird to think that his blood type is now different -- definitely seems like something from a science fiction novel.

The funny bumpy rash on his palms looks a bit better. When we went in for his weekly appointment on Tuesday, all the docs had the same shrugs -- not sure what it is or if anything needs to be done. Finally Dr Huebsch comes in... takes one look and says, those are milia -- probably malignant milia. And he sent his team off to research 'milia'. If you have seen baby acne on a newborn, that's what this is. Because Eric is an adult and his immune system is still in its infancy, these darn milia multiplied out of control. So, nothing to worry about -- the milia will remain as a interesting topic of conversation but nothing serious. Dr H has been in the BMT business for decades - nothing replaces experience!

The other minor rashes he had have disappeared. Was it GvHD? Maybe, maybe not.

Other than low hemoglobin that was giving him a headache, no issues -- all continues to go well.

An interesting comment from one of the doctors this week was that they consider Eric's transplant to be a full Allo rather than a mini Allo. I didn't get a chance to ask alot of questions and I guess I was just so surprised to hear that comment that I really didn't know what to ask.... I guess Iam glad that I am only hearing this now -- sometimes ignorance is easier. If I had known this was a full Allo a few months ago, it would have been one more reason to lie awake at night.

Wednesday, 8 October 2008

Out Damn Spot...

Eric has fascinating palms... at least that seems to be the consensus of the BMT team and the Dermatology team who all came to have a look yesterday. He has some minor rashes (wrists, ankles) that we are pretty sure is GvHD -- it's faint and not something that is bothering him or spreading quickly. All agree that we can safely watch it and see if it gets better or worse.

But then there is his palms. He has an odd looking rash on the palms of his hands that everyone agrees is 'different'. It just doesn't look like anything else they have seen - and it doesn't look like any pictures I can find of GvHD. Eric -- you need to take a picture and post it -- maybe someone out there will know what it is!

For now, they have discontinued his Septra (on the longshot that it's an allergic reaction). And his tracro levels were low, so his tacro dosage was increased. Now we wait and see.

And it took most of the day at the hospital for everyone to swing by and look at his hands. Some interesting conjecture from the various specialists. But no one as eccentric as House!

Other than that - all is well. Lots of Thanksgiving dinners coming up this weekend -- and lots to be thankful for!

Friday, 3 October 2008

Day 56

Hard to believe that it has been almost 2 months since Eric's transplant.

He's still doing very well - better than I could ever have hoped. He does have a very slight rash on his wrists and a couple of bumps on his palms. The BMT docs had a look at it on Tuesday but it's not significant enough to confirm that it's graft vs host disease (GvHD). Unless it gets worse, they have decided not to do anything. And as of today, it hasn't gotten worse and it's not bothering him. Typically GvHD will show up on the palms of the hands and soles of the feet first, so it is quite likely is a bit of GvHD as his new immune cells recognize the other cells in his body.

It's a bit of balancing act at this point... We want those new cells to recognize unfamiliar cells in hopes that the new immune system will kill off any cancer cells. Yet we don't want the immune system so stimulated that GvHD becomes serious. If the rash worsens or other signs of GvHD appear, they will treat with prednisone.

Other than that, his blood counts, weight, etc are all good. He has weekly appointments for bloodwork and to 'check him out'. Between visits, he still needs to check his temperature regularly -- fever is still a serious concern. His PICC line will stay in for a bit longer and he has to get homecare to change the dressing weekly. He's down to 4 meds -- Tacrolimus (immunosuppressive), Acyclovir (anti-viral), Pantoloc (an acid reducer) and Septra (antibiotic).

And that's how things are 8 weeks post transplant!