Monday, September 10, 2007

day +20

This morning my dad and Clare joined me for my first outpatient appointment with Dr. Castro-Malaspina. It was nice to see him, Ally, Cecille and the others at the clinic again after three weeks. My counts were very good which leaves both Dr. Castro-Malaspina and Dr. Mayer, the fellow, to believe that my donor's cells engrafted well. I'm scheduled to have a bone marrow aspiration next Monday after my follow-up appointment with Dr. Barker since Dr. Castro-Malaspina will be upstairs on attending duty on the transplant service. The bone marrow aspiration will determine for sure what percentage of the stems cells are mine or my donor's.

They informed me that the stool sample I last submitted before being discharged came back positive for the Adenovirus. Though this website focuses on children, its explanation of the Adenovirus I found to be clearer. The Adenovirus, I was told, is not an uncommon virus. The hope is that the virus will remain in my GI tract and that my donor's T-cells will recognize and then, take care of this virus as is the case normally in healthy people. If the virus leaves the GI tract and spreads to my bloodstream, however, then treatment would be required. Oh boy. Let's hope this doesn't happen. The treatment's side effects I was told can be harsh, especially on the kidneys. The virus could be responsible for the persistent watery diarrhea that I've been having recently. The Magnesium supplements that I'm taking are likely to also be contributing to the problem, but Dr. Mayer said it's important I continue to take the Magnesium because it's restoring the Magnesium that's lost as a result of the Tacrolimus. A deficiency in Magnesium could result in nerve sensitivity. My blood was screened today to see if the Adenovirus had reached my blood yet. The results should be back by tomorrow.

Dr. Castro-Malaspina said it's important that this Adenovirus be taken care of soon, because if at some future point I develop GVHD it may be difficult to determine if the diarrhea is being caused by GVHD, this virus, or something else such as the medication. Establishing a diagnosis and prescribing a treatment may become more difficult. If the diarrhea isn't cleared up soon, Dr. Mayer suggested that a colonoscopy may be recommended to determine its cause though he doubts its GVHD because I'm not experiencing any pain or have any rashes.

I clarified the correct dosage of the Tacrolimus with Ally this morning as well. I had made a mistake. I need to take 2 mL not 1 mL.


Comment Anonymous Emily said...

I'm glad to hear the doctors are thinking positively about your graft. I hope you recover from the virus quickly and that it doesn't complicate things and put you in more discomfort. Lots of love to you and Su!

Em & Tim

7:13 PM  
Comment Blogger Darrel said...

I hear you on the androvirus in the GI track...that is no fun! It's like experiencing a sudden lose of "cabin pressure" if you catch my drift. Glad to find you still in good spirit and doing well. You truly are a prizefighter!

12:35 AM  
Comment Blogger Adrienne said...

Hi Duane, Sounds like you're still doing well. You amaze us. Keep it up.

Hugs, Alison

12:31 PM  
Comment Blogger Duane said...

Thanks Em and Tim!

8:46 PM  
Comment Blogger Duane said...

I like your "cabin pressure" reference, Darrel. You hit it right on the head! Thanks for your continued support!


8:47 PM  
Comment Blogger Duane said...

Thanks Alison.

I communicated with Adrienne. She seems excited about starting out at Columbia. I'm sure she'll do terrific!

Talk to you soon,

8:48 PM  
Comment Anonymous Anonymous said...

Duane after my auto transplant I had diarrhea whenever I had oral magnesium but I could tolerate well the intravenus mag. which I performed myself at home once a day.

4:40 PM  

Post a Comment

<< Home