Day +250 : Follow-up

My Blood Count Today:
Red Blood Count (RBC) = 129(Normal 130-180)
Platelet = 118(Normal 150-450)
White Blood Count (WBC) = 6.4(Normal 4 - 11)
Absolute Neutrophil Count (ANC) = 4.928 (Normal 1.5 - 8.0)
Potassium = 4.1(Normal 3.5 - 5.2)
ALT = 265(Normal <51 )
AST = 44(Normal < 41)
GGT = 327(Normal < 51)

I am fine today. I went to do follow-up this morning. The blood test result showed that my liver is quite badly affected by GVHD. The ALT (Alanine Aminotransferase) level increased to 265, a value which is 5.2 times more than the normal level. On the other hand, GGT (Gamma-Glutamyltranspeptidase) is also increased to 327, a 6.4 folds increase than the normal level :-(

High levels of ALT in the bloodstream mean that there may be liver inflammation or damage while high levels of GGT may indicate the inflammation or damage of bile duct.

Persistent dry mouth and eyes also indicates that I am now having chronic GVHD, which doctor said would take a few months to cure. The doctor supposed to cut down my Prednisolone (steroid) dosage but when he looked at the result of my liver function test, he decided to maintain the dosage. He also wanted to see me sooner, so my next follow-up will be two weeks later.

After the nurse drew my blood sample this morning, I went to visit a friend in an isolated ward in the haematology ward. One doctor spotted me and said, “What are you doing here? I know you are very kind but he got bacterial infection! Go away from here!” She also reminded me that I am on immunosuppressive drugs now and thus prone to infection.

I was later worried that I might be at risk of infection because I entered the isolated ward. After seeing the doctor in the General Clinic in the afternoon, I returned to the hematology ward to find out what type of infection my friend had. The nurse told me that my friend was infected by a type of bacteria called Salmonella which causes foodborne illness (food poisoning). It can only be transmitted through contact with the patient's faeces or food contamination. What a relief! Next time I have to be very careful in visiting patients.

When I told this incident to my wife, she scolded me, “Busy body you! You are getting more like your eldest sister!” :-)

See you next post :-)