update Friday Nov. 4

Lee's frustrating Friday:
I left Marcia's house at 7:30 and arrived at the hospital at 9 (2 accidents and 2 construction delays tripled the travel time). Linda was not improved from yesterday, being jaundiced, tired, confused and in pain. Dr. Kim stopped by in the morning to see Linda. She was sad to see the relapse, but could not add to what I already knew about the situation. She did tell me that Linda's fingernails (which are curiously formed now) are that way because of the stress of the GVHD attack a month ago. She told me not to worry because they would grow out normally in time.
Dr. Stadtmauer arrived at noon, and was not happy with Linda's condition. The Retuxin is supposed to improve the situation, but it has only been two days since she started it. He is concerned about infection (which would not be noticeable given her current condition, but could be causing her listlessness), so they are going to take a chest x-ray and blood tests to rule that out. They will also lower the pain meds, which might be causing drowsiness. Her white blood count is up, which is probably due to the Retuxin's side affect. The bilirubin is still high, and will probably stay high for a couple more days until the Retuxin has its effect. He said we should be seeing an improvement from the new meds early next week. He is still optimistic about Linda's eventual recovery.
Linda continued to sleep fitfully, and I said goodbye at 2:30.
PS I thought an early afternoon drive would be easy, but apparently Fridays are "special". I spent 2 hours going 10 miles on the Schuylkill, and then another slow hour on a crowded thruway extension. Three hours on a normally 1 hour trip. I'm going to bed. I hope Linda can get some real sleep too.
- Lee

Addendum:  Dr.Loren visited Linda after I left, and gave Marcia a call who just gave me an update.  Dr. Loren expects that Linda's listlessness is due to an infection.  The chest x-ray did not clearly show anything, but the blood tests will.  When the blood tests come back in a couple of days antibiotics will be started immediately.  The upside of this is that an infection will be cleared up quickly, while a GVHD problem is more complicated.
- Lee