D+47 & D+48: Cannula, schmannula

Day 46:

WBC 4.2
ANC 3402

Day 47:

WBC 6.9*
ANC 5796*

It's been a pretty tame weekend. No major emergencies. No great news. No bad news. Ryan's counts continue to grow, which makes dealing with everything else a bit easier. The * next to Sunday's counts indicates that I'm a bit skeptical. I believe that they drew the labs on Sunday right after he got GCSF (Growth Colony Stimulating Factory), which tends to produce big jumps in the white count. Nevertheless, we are still on an upward trend.

As Cheryl mentioned in a previous entry, Ryan's renal function is returning to normal and we are starting the cyclosporine up again. It's a real tightrope walk, because his creatinine has been hanging out in the 0.5 - 0.6 range. If memory serves, we got rid of the cyclosporine when we reached 0.6 last time around. Our current situation is a bit different (at least according to the docs), because Ryan's heart and lungs are in good shape. That means we can load him up with fluids to assist his kidneys without having to worry about pneumonia and fluid around his heart (at least, not yet). In related news, Ryan's nasal cannula is toast. I ripped that thing off his face the first night I got here. His oxygen saturation is consistently in the mid-90's, so he's kicking butt on that front.

We finally reached the 'therapeutic range' of cyclosporine on Sunday evening. The hope is that the GVHD will begin to recede as the cyclosporine does its dirty work. Recall that Ryan has the skin and gut forms of GVHD. They are both annoying (rash and diarrhea respectively), but it's really important to keep the gut form in check. It appears as though we are seeing some early results -- Ryan's fever is down and his diarrhea is becoming less frequent and there's less of it. In a new twist, Ryan may have yet another form of GVHD affecting his conjunctiva (conjunctivitis = pink eye). Poor kid. We're hoping that the cyclosporine will work its magic quickly!

Speaking of Ryan's eyes, he actually opened them for the first time in about two weeks on Sunday night. How bad do you have to feel not to open your eyes for that long? I think that we tend to lose some perspective in dealing with Ryan on a day-to-day basis. If each day is a little worse than the next, you don't really notice. Next thing you know, it's been a fortnight since you looked your kid in the eye. This is not exactly a happy place. Anyway, no need to ruin a good thing with a bunch of whining. Ryan does seem like he's getting better and being able to make eye contact with him is a really good thing. Natives rejoice!

Cheryl and I are switching roles this week. I will remain in Tucson with Ryan while Cheryl returns to Phoenix with Regan. My hope is that Cheryl will be able to relax just a little bit at some point and find some peace. Not very likely, but you never know ...