Day 10

Hemoglobin 7.5
Platelets 42
WBC 1.0
|Neutrophils| 0.3
Creatinine 1.62
Received Two Blood Packets

Today I felt exhausted and literally slept until 1930 and when I was up I felt like shit.  It is like the feeling you get when you have the flu and your body just feels awful.  The heme-onc fellow on service came in and talked to my dad and IRael (while I slept) and he thought I could be feeling this way because my kidneys are finally showing their stress and may not be filtering efficiently, thus giving me the toxic feeling..

My creatinine has slowly been climbing.  Dr. Oran (who is now the attending on service, hooray!) says it is because of the cyclosporin (CSA) I am taking.  CSA an important anti-rejection drug but is known to be hard on the kidneys.  Since my kidneys are already compromised it seems they just cannot handle the stress.  Dr. O hopes that I can stay on the drug until at least day 30 (it is just that good of an anti-rejection drug, and during the first month you need your A-team of anti-rejection meds).  There are other options, ones with a lower kidney toxicity, but CSA is the gold standard.  That being said, my doctors would rather have functioning kidneys than CSA.  So if my kidney function got too low they would take me off the CSA before they would dialyze me.  IRael told me that the heme-onc fellow also said my dose of CSA is going to be reduced in an effort to relieve the stress.

If I go off CSA the likelihood that I develop graft versus host disease (GVHD) increases, even on other drugs.  So we will have to wait and see how this pans out.

I have not really noticed a difference in my level of nausea since that sticker was applied to me.  It really has not had a good chance though, since I slept all day today and feel all gross anyway.  It has been effective in giving me terrible dry mouth, so at least I know I am receiving the drug.