August 10th 2016
Alexx here. My mama says its time for an update…so here ya go. Please excuse me for not being as eloquent and/or verbose as usual, I’m sleep deprived.
She was transferred back to the BMT unit one week ago. Her medical issues were becoming too complex to manage on the rehab floor and it was safer for her to come back to the BMT unit. She’s bummed but understands that this is just a bump in the road and that she needs to forge ahead with her warrior strength.
1) BK virus—its still in the urine and is now detected in the serum in very low levels,(trending down as of today); treatment is still not indicated at this time. The medication they could potentially use is called Cidofovir but they want to avoid it because it is toxic to the kidneys
2) Hematuria–she still has blood in her urine with occasional clots. This is primarily due to the BK virus. They consulted a wonderful urologist who believes that this is exacerbated by the foley catheter causing constant irritation. So the foley catheter was removed and she is doing well without it.
3) Acute Kidney Injury: Her creatnine (which is a number that is reflective of kidney function) started uptrending 2 weeks ago and then took a big jump. They involved nephrology and urology at this time. She developed left sided pain and an ultrasound showed that there might be a blockage in her left kidney, something called hydronephrosis. This could be from blood clots or inflammation of the bladder, all secondary to the BK virus. Yesterday she went for a cystoscopy where they shoot dye up towards the kidneys to look for blockages. It showed that both kidneys had partial blockages, the left more so than the right. This is from inflammation of the bladder causing thickening of the walls and then blockages. They placed 2 small plastic stents from her kidneys to her bladder to help relieve the blockage. Hopefully the Creatnine will start to go down over the next few days. She tolerated the procedure well.
4) Pneumonia: She developed a cough a week ago, no fever or shortness of breath. Since it lingered they did a CT Chest which showed a mild pneumonia on the right side. She was restarted on antibiotics and should resolve with a 7-14 day course.
5) HLH/CMV/EBV—thank god these numbers all remain negative
6) Bone Marrow: she is still requiring transfusions but overall they are starting to see signs of recovery; she received a few days of Granix which is an injection to boost her white blood cell count
7) Immunosuppresion: still waiting for this to recover, this will take the longest.
So overall she is stable and hopefully we can resolve these lingering medical issues and get her home soon!