When I am strapped for a post title, its nice to know I can always fall back on the calendar. JoJo is more comfortable today and her temp is down. There have been a few changes to the schedule so let me offer up a quick note.
Tomorrow, Thursday, JoJo will undergo a bone marrow biopsy. She was due for her next on Day 100. Given the circumstances, the doctors want to proceed now. It will provide better information from which to base some treatment decisions. It is less risky than the lung biopsy which the thoracic surgeons are uncomfortable undertaking (probably a bad word choice) until there is better infection control and higher platelet counts. We don't need more infection or bleeding complications. The platelet counts have not risen as much as expected with yesterday's transfusions. I don't have a good answer for why that is as yet.
We have three issues on the table. The first is a systemic gram negative infection. Searching the internet, I find nothing but horror stories about these, but the doctors while concerned, are not panicking and JoJo is better today than yesterday.
The second issue is what appears to be a fungal infection in the lungs. They are throwing all kinds of antibiotics at both infections, but until they get cultures, they won't know exactly what to use. The systemic culture is in the ripening process and there should be some results in the next day or two. To get a proper lung culture, they need to do the lung biopsy.
There is no good information to determine how much of this is related to infection and how much is related to lymphoma. The bone marrow biopsy will help in this regard. If there is evidence of lymphoma, they will reduce some of the anti-rejection meds and allow the donor graft to rev up its activity. That may lead to some graft vs host disease, which we just resolved, but it will also increase the graft vs cancer activity which would be a priority.
Does this make sense to anyone? It does to me, but I am not sure that I explain it well. More information will reveal itself over the next few days. For now, JoJo is stable and comfortable, I am on an even keel and we have a semblance of a plan. All subject to change of course.
Keep JoJo in your prayers please.
Cancer Sucks
As always you are both in our prayers. God bless you both and your family.
ReplyDeleteGood update Kevin. We are all concerned and care deeply.
Best of everything today JoAnne.
Much love and many prayers are on the way.
Carolyn D
So glad to hear that JoAnne is more comfortable. Hope all is going smoothly today and that the biopsy provides the information needed to hone the treatment plan. As always, sending postive energy, hope and prayers. Love to you both-
ReplyDeleteDenise