It has been a dreadful and exhausting ten days, exactly as predicted. But also as predicted we are seeing signs that Isita’s ordeal may be nearly over. Yesterday, Saturday, was day ten. Marta was happy to see Isita perk up a bit. She watched iPad and even spoke a few words.
The optimism of the day made it all the more shocking when she vomited a lot of blood in the evening. Apparently this wasn’t as drastic – in medical terms – as it appeared, but from Marta’s description it could hardly have looked worse. I arrived back at the hospital just after this event, after three days quarantine having woken up with a cold on Wednesday. Poor Marta was exhausted as well as shaken.
The night was terrible. I don’t think I slept for more than 20 minutes at a stretch without Isita needing to spit, or turning her head away from the oxygen mask causing a machine to bleep, or some other disturbance. Spare a thought for Marta who has just done three such nights in a row.
While we are frazzled, the doctors, who were fairly concerned on Friday, are now much happier. Paula, who examined Isita this morning, described her condition as “stable”. Clinically, she is looking better and some of the key indicators are heading in the right direction. The excruciating dark-green, gut-melting phase of the mucositis seems to be fading. There is much less diarrhoea, vomiting and spitting; and less pain, although we are all trying to persuade the pain team not to reduce the level of pain relief too quickly.
She still has frequent temperatures, but lately not above 38.5C. The adenovirus count is miniscule. This means the antibiotics, anti-fungals and the brincidofovir anti-viral drug are doing their jobs.
There is one major set of side-effects still causing discomfort for Isita and worry for the rest of us. This is a combination of fluid retention in her belly, which is now swollen and tender, and the probable (and expected) onset of veno-occlusive disease of the liver (VOD). This is when the blood vessels in the liver get blocked.
They are giving Isita a drug which deals with this. Without going into the fine details, all these things require a lot of ongoing management. As soon as one bag or syringe of intravenous fluids or drugs comes down another goes up in its place. The pumps never stop beeping, vital signs are monitored constantly.
The best news is that Isita’s blood counts have started to increase slightly, which means that some new bone marrow must be functioning. It is still too early to say that the transplant has succeeded. They need a slightly higher count over a few more days to be confident. It is great sign, even so.
Since hearing this, we’ve been telling ourselves not to jump to conclusions and build up false hope. Despite that I have been on the verge of tears all day at the prospect of getting Isita through this. She slept soundly on my lap for two hours this afternoon and I was in a daze of happiness.