John had a long day with many alert periods yesterday and a rough night where he couldn't really get comfortable to sleep well. The nurses eventually gave him some meds to help with pain and sleep and bumped the oxygen up to 70% to help him get enough in his blood. Today he has been catching up on his rest; hoping he gets lots of rest tonight too.
The pathology reports came back mostly negative. Maybe the biopsies just didn't include the problem tissue, or maybe all of the antibiotics, antifungals, and anti-viruses have sort of sterilized the area, or maybe the fevers are caused by something besides an organism. There is an indication of a fungal infection (but not which one) so an extra antifungal was added today. The docs will see how John responds and if he starts to feel better, they will begin removing some of the meds.
The blood counts were holding up this morning but they fell by the afternoon. John is getting some platelets tonight.
John is getting more food through the feeding tube and seems to be digesting most of it. His blood sugars are high enough to require very small doses of insulin; at least now he only has to be tested once every 6 hours instead of every hour. He winces even in his sleep when he has to have his fingers pricked for blood. We'll be so happy when he doesn't have to do that anymore.
The CMV numbers are down too which is more good news.
Still no signs of graft v host either which is also great news. We can't do photopheresis while using that port for dialysis; but, so far, so good. Let's hope it stays this way because he already has more than enough to deal with and because if they needed to do both they would have to put in another port. The tacro (used to suppress the immune system and gvhd) was restarted today at a lower dosage. And, the steroids (also used to combat gvhd) were changed to an IV form.
Dialysis continues to go well and the renal docs are happy with kidney function. Today more fluid has been added than drawn off and John has a lot of edema; it will be good when we can draw more fluids off again. It will help with his skin sores and with comfort in general.
Renal docs are happy with that function and believe normal activity will return when he is off the drugs like foscarnet which are hard on the kidneys but necessary to treat the CMV. BUN and creatinine numbers are good.
John has slept almost all day which he needed and I hope he sleeps all night too without spiking another fever. Think that about covers it for today; let's hope for an easier tomorrow.
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