T+61: Worrying Developments, Tense Days To Come

The blood count from this morning confirms that Kay's cell counts are dropping. Tests rule out graft-versus-host problems, meaning that the source of the problem is Kay's bone marrow. For some reason her bone marrow activity is being suppressed. The most likely cause of this is the anti-viral drug that is being used to combat the CMV virus in combination with anti-bacterial drug that she gets to protect her from lung infections. Both these drugs are known to suppress bone marrow activity. Also the timing fits, the drop in bone marrow activity more or less corresponds to the moment that the anti-viral dosage was increased a few weeks ago.

As a result the medics have switched Kay onto different anti-viral and anti-bacterial medication. The disadvantage of this is that the anti-viral has to be given intravenously meaning that Kay will have to stay in hospital for, most likely, many more weeks yet. This is the good news.

The bad news is that the alternate explanation for Kay's reduced blood counts is a that her leukemia may have returned. This can be ascertained by doing a bone marrow biopsy, which the medics have planned for Monday. If Kay's blood counts stabilize before Monday then the biopsy will be cancelled. But if they continue to deteriorate, then the biospy will be done to determine the cause. There are other bone marrow related reasons for a reduced blood count, but I gather that none of them are very pleasant.

So we face some very tense and worrying days. In principle the next blood count will be on Friday, but it is unlikely that the change of medication will have an effect so quickly. We will have to wait until Monday before there is a blood count that may possibly reflect the changes of meds. But even that is not certain. It may take longer for the effects of the medication change to be come apparent. If a biopsy is done, I assume that there will be a MRD measurement done and this takes a week. So I think that we will have to live with this uncertainty for at least a week.

Needless to say Marion and I are very upset by this turn of events. Marion is very emotional and I'm barely hanging on to my self control. The idea of having to spend (another) week living on the edge of total disaster is not attractive. But, yet again, what choice do we have?

On the other hand Kay's general condition continues to improve. She is more active and more alert. She needs less oxygen and she is drinking more and eating the odd thing. This is a good thing. But still, my worry is that there may be no relation between Kay's general improvement and whatever is suppressing her bone marrow. But I have to put the brakes on such thoughts and hang on to the positive things: the timing, her generally good progress so far, her improved condition, etc. But yeh, it's difficult. I'm absolutely dreading the arrival of darkness and attempting to sleep. I think the furies will be out in force tonight.

Right now I think that we can use all the support on offer. Please leave your comments here or send them to "my-first-name" at howe-family dot org.