Just a quick update on an interesting week. Friday my dermatologist shared pathology results to confirm the skin changes are Graft-versus-host-disease. She called Dr. Brown, my transplant doctor, and he immediately started me on a high dose of prednisone that afternoon. Monday I started PUVA, or light therapy, which means taking medication an hour before standing in a tube that shoots UVA light for a few minutes. I'll do that three times a week and see if that helps stop the rejection.
Today I went to the hospital to see Dr. Brown and he has added cyclosporine to the attack on the GVHD. Cyclosporine is what I took post transplant #1 and 2, and when I had GVHD in the past - it suppresses the immune system as does prednisone. They will also need to monitor for other signs of GVHD (liver, eyes, etc) as well as the host of side effects the prednisone and cyclosporine will provide. I am all too familiar about those - and any of you who knew me in the Fall of 2003 will perhaps recall the "pred-n-zone" I was in for a while. The dose I am on now is less than 2003 but still quite significant, so uncertainty is the key word right now. They will also need to monitor cyclosporine levels in my blood for toxicity, as well as glucose levels from the prednisone and magnesium and calcium levels as prednisone will cause bone loss. And a bunch of other levels and things...
I also saw Dr. Campbell this morning, the plastic surgeon who did the skin graft on my neck in 2006 - he extended my antibiotics another week and will do a biopsy a week from Tuesday to see what is going on there and if it has any connection to the GVHD.
It's all a bit of a blur right now but the summary is really - a lot more medication with a variety of side effects to hopefully counter the rejection disease before it progresses further (the skin spots have increased, thickened and are hardening - they could be debilitating if they continue) - and more treatments and bloodwork appointments.
The good news is that currently the skin is not painful and that they are being aggressive to counter the GVHD. And with Ryan's situation close at hand, I am thankful that it is GVHD and not a relapse.
It is rather amazing what can happen in a week! Good night...
