Another long day in Houston resulted in a little good news. The liver biopsy was positive for GvHD. My GvHD biopsies usually come back as inconclusive. I have several keloid scars on my back from previous multiple skin punches testing for this little monster. The lung biopsy was inconclusive. Dr. K. is proceeding as though it's GvHD since my breathing has eased on steroids. She's also keeping me on a few steroids while the lung cultures continue to grow. Who knew that it could take over a month for a fungus to show up in a petri-dish?
As it stands, the plan is to start a steroid taper. I'll alternate 64 mg of medrol with 32 mg every other day. 2 more days of IV cancidas, then I will switch over to voriconazole, which comes as a pill. My PICC line will remain until Dr. K. can be sure that the switch doesn't irritate my liver. The rest of my 2 page med list remains the same.
For those that would like to know, here's my blood work:
WBC: 18.2 K/UL <--------- No worries, that's high due to steroids
RBC: 4.34 M/UL
HGB: 13.9 G/DL
PLT: 203 K/UL <---------- The platelet crash is in full effect. Thanks, Medrol.
ANC: 16.47 K/UL <--------- Medrol
ALC: 0.87 K/UL<------ Last week this was high, now it's low.
AMC: 0.56 K/UL
No eosinophils detected. That's most definitely due to steroids.
Alkaline Phosphatase: 103 IU/L <--------- NORMAL
LDH: 866 IU/L <-------- So close!
Alanine Aminotransferase: 88 IU/L <------ Suddenly, my liver enzymes are like the little engine that could, but got stuck at customs.
My APN was impressed by my glucose results. 135 mg/dL. She was expecting something over 200 mg/dL due to steroids. Most transplant patients become diabetic for a period. I was last go around. I have been vigilant about the snacking. If I can restrain myself, I limit myself to fruit. I've had more than my share of Halloween candy, though. I like to think that I've managed the collateral damage. The excessive treadmill time may also be helping. I still have my old glucose meter and a box of testing strips, just in case. If I must, I'll start giving myself insulin injections, again.
I've been ordered to see my local oncologist next week for more blood work.
All in all, things are looking good.