From this picture, you can see that I am again at home, with Daisy laying on top of the sofa above my head. A pretty wonderful spot to be. My pass home yesterday was of course amazing, although I had a lot of nausea, significant fatigue and basically drifted in and out of sleep the entire day. My stomach is having a bit of difficulty adjusting to food again. It's par (more likely an eagle) for the post-transplant course and it was sure incredible to be home in my bed or on the sofa while feeling yucky.
This morning I checked back into the hospital and was pleased to see all my belongings had been removed from my room and were on a cart. That's the sign that you're too healthy to be taking up a bed on Unit 57, and they instead move you to 57B next door, where they have 4 day-beds in unassigned rooms used to transition inpatients to outpatients. I received some fluid, had bloodwork done, saw Dr. Chaudry and had my medications refilled. The pain in my abdomen is virtually gone, and my bloodcounts are all normal. The watch now is for Graft Versus Host Disease (GVHD), and he let me go home until Monday, pending any new developments in my symptoms. Hard to imagine that I'll spend the weekend home, although now that I've tasted the "good life" again, it's equally as hard to imagine going back to Hotel 57.
GVHD occurs because the new marrow recognizes the new body as foreign and tries to attack it. A similar thing happens when an organ is transplanted - the immune system recognizes the new organ as foreign, and tries to attack it. The difference with a bone marrow transplant is that you are transplanting the immune system itself, and therefore the entire body is foreign. Where and what is attacked is unlimited and unpredictable. In both cases, anti-rejection or immune suppressive drugs are administered to limit the strength of the immune system in its attack. Gradually, these drugs are reduced if possible as the new marrow is accepted. Acute GVHD occurs in the first three months post-transplant, and can be severe. Chronic GVHD shows up after the three-month point but up to several years post-transplant. Steroids are often administered to counter GVHD when it arises, especially if it is acute, but some chronic GVHD does remain forever. In my first two transplants, I had GVHD in various forms - liver, skin, eyes, GI tract, and tendons. Obviously, if GVHD hits the lungs, heart or other key organs, it can be extremely dangerous.
There's your lesson on GVHD! I did write the above paragraph purely from my eleven years of experience with transplants. Feel free to investigate more reliable sources! Basically, the doctors will monitor the levels of the anti-rejection drugs in my blood, consider any symptoms I have, and adjust the dose of those drugs accordingly.
Today I feel a little less nausea and am VERY excited to be at home for the weekend, knowing there is no room waiting for me back at the hospital. Since it's really the Canada Day weekend, and the red and white will be flying everywhere, consider it a tribute to all of you, who helped me arrive at this point. Enjoy the outdoors, your friends and family this weekend! Cheers... Tricia
