Just think, a week ago Wayne was transitioning out of ICU. Amazing, what could be better? Yes, I hear you say… “HOME” and he is working hard to that reach that goal. All good work should be rewarded and it seems that Wayne is receiving the fringe benefits of a short stay in ICU. Who would think that going to ICU could have such positive outcomes? Of course, he should get some benefit from giving us the scare of a lifetime and for all your hard work, positive thoughts and prayers.
Fringe benefits that came as a result of his ICU stay: (answers to “how can this be?” found above) 1. Fluid restriction lifted along with diuretics being held. And can you believe this – no additional edema. He is still “puffy” but in spite of being fragile, his kidneys are working. Prior to his ICU excursion he was getting diuretics twice a day to reduce all the edema and going potty CONSTANTLY! Wayne’s body is now being put to the test of doing the work of getting rid of the fluid and seems to be up to the task. 2. IgE antibody hemolysis slowing. Because Wayne was in ICU, the medication Rituximab, given to destroy the arrant antibodies that are destroying his RBC’s was held. And it is still being held. We are hoping this is an indication that his naughty immune system is behaving better and most importantly the GvHD did not flare up. Now at night he will not be starring at you with his yellow eyes, creepy! 3. Best of all.. Steroid reduction – big time!!! The first thing that his doctors did when they suspected pneumonia was to reduce the steroids -A LOT. And they are continuing an accelerated taper. His current dose is 30 mg of prednisone, can you believe it! A drastic measure, in the eyes of the physicians, but worth the risk. Why take away such a critical drug for the management of all of the complications Wayne has developed? His body was so weak from all the steroids it was more important to give him a break, let him build some strength and then deal with the consequences of decreasing the steroids. Of course the big risk is the dreaded GvHD. So far, so good, GvHD did not flare up. Is this another indication that his naughty immune system is behaving better –what a break that would be! 4. Holding off Neupogen. This medication is given to treat his severe neutropenia (WBC count below 500). Neupogen stimulates the growth of white blood cells. For now, it appears that his bone marrow is recovering from the GvHD along with earlier infections and is slowly beginning to produce WBC’s on it’s own. He still needs blood products and has a way to go but at least he is not severely neutropenic. 5. Oxygen, now, only through the night. One of the complications of pneumonia is the fluid accumulation in the lung and surrounding the lungs. This fluid increases the work load Wayne has of breathing. He can NOW do the work on his own during the day but by bedtime he is plum tuckered out. You can easily imagine how tiring this would be if you think of the fatigue and trouble you have breathing when you only catch a cold. Just imagine if you didn’t have good strong muscles to do this work. 6. No septic response!!!! This really is amazing, especially as he just recovered from a bout of sepsis, which frequently puts the person at an increase risk for developing sepsis again. 7. Pressure sore on behind, showing great signs of healing and he is able to sit more comfortably. He really could use a “booty!” That really would be some FRINGE BENEFIT!!