Tuesday Nov. 8

The following is a mix of notes from Lee and Marcia:

It was a hard day for Emily (Linda's daughter, visiting from U Pitt). She broke down when she first saw Linda; it was the first visit since the summer. Linda was very happy to see Emily and wanted to hear all her news. The rest of the day seemed to be OK until it was time to leave. The nurses were putting in a new IV, and Linda was in pain and extremely uncomfortable. That was especially hard on Emily. Lee was able to calm down Linda and she fell asleep before he left.

Marcia said that Linda is still infected but the culture is negative. They will wait 48 hours and then put in a new picc line. The source of the infection was the gut lining which is inflamed, and is allowing bacteria to enter the blood stream. Bacteria likes to stick to plastic and antibiotics cannot tackle plastic, therefore the plastic picc line had to be removed.

Her mental state is a result of all that she has been going through. Everything contributes to her being delirious and her craziness. Regarding her brain, there should be no permanent damage. She should come back 100%.

Regarding nutrition, she lost the picc line and they do not want anything going into her gut yet, so it will be 48 hours before they can do anything for her.

Best case scenario, they get the GVHD under control and the gut gets working. Worst case, fighting the GVHD brings down the immune system and they expect infections. The antibiotics undermines fighting the GVHD with steroids. If both hit the wrong way long enough, they run out of room to maneuver.

Dr. Loren said she thought Linda could pull through this. She is young and healthy. Stress and the long running medications can lead to heart problems, but that is not an issue with Linda since her vital signs have been normal. Bottom line, there is a reasonable amount of hope and Dr. Loren thinks she can recovery even though she is still very ill.

Good news 1, white blood count is going up nicely.

Good news 2, Linda will not remember any of this. (Unfortunately, that isn't true for the rest of us!)