Release from IPOP Likely to be Delayed

It is very likely that my discharge from IPOP to Outpatient Services will be delayed by a week due to some recent complications.

The good news first. My echo cardiogram from last Friday shows that there is no fluid around my heart. Apparently CT Scans of the Chest are notorious for showing what looks like fluid and Echos, which give a much clearer picture, either confirm or disprove. The coughing that I have seems to be a simple case of post-nasal drip.

Two more things that are contributing to my general feeling of lousiness are Oral Thrush and the beginning of Graft vs Host. Oral thrush produces creamy white lesions on the tongue and inner cheeks and is common among people with compromised immune systems that are on a constant diet of antibiotics. If left untreated it can grow down the esophagus. The lesions can become painful -mine are not. To treat I was given a oral rinse and a "wait and see".

Graft versus Host Disease (GVHD) is a common complication following an allogeneic stem cell transplant. Twenty to 50% of patients undergoing a stem cell transplant with a related donor develop it. It is triggered by cells called T-cells which are a type of white blood cell that can recognize which cells belong in an individual's body and which cells do not. When a donor's T-cells are transplanted into a patient, they perceive the patient's organs and tissues as foreign cells and orchestrate an immune system attack to destroy them. Fortunately, most patients transplanted with stem cells from a related donor experience only a mild or moderate case of GVHD that resolves itself over time with treatment. Although GVHD can be very serious for some, it is too soon to write about all the "what ifs".

My GVHD seems to be in the first acute stages - skin redness, a rash and just generally not feeling well. I am unsure what my long-term treatment will be, but I am scheduled for a skin biopsy tomorrow which will confirm or deny the presence of GVHD.

On Friday, which is Day #59, I will receive a bone marrow biopsy. From the biopsy they will examine the marrow to be sure that everything is as it should be. I will also have a blood test done to determine how much donor and how much patient marrow is in my body. I've been told that in the near future I will have to get another series of Lumbar Punctures and intrathecal chemotherapy treatments in my spine. All normal precautions for the type of leukemia I had. God I'm tired!