Day +460 : Follow-up - Liver function reading continue to climb

My Blood Count Today:
Red Blood Count (HB) = 151 (Normal 130-180)
Platelet = 163(Normal 150-450)
White Blood Count (WBC) = 5.5(Normal 4 - 11)
Absolute Neutrophil Count (ANC) = 2.97 (Normal 1.5 - 8.0)
ALT = 787(Normal 30 – 65)
AST = 404(Normal 15-37)
GGT = 621(Normal 15-85)
ALP = 169

I am fine today.

I have my post transplant follow-up today. The blood test result revealed that my liver function continue to deteriorate. The ALT reading increased from 504 to 787 while the AST reading increased from 202 to 404. The GGT and ALP reading reduced slightly compared to the last follow-up two weeks ago.

The liver function test result revealed that the GVHD is a little bit out of control. The doctor will take more drastic measures to protect the liver. I have to return to day care ward to have intravenous steroid for the next few days :-( I believe this should serve as a quick mean to suppress the immune system in order to reduce its “attack” on the liver.

Apart from this, doctor arranged a series of tests tomorrow – lung x-ray, respiratory, and CMV(cytomegalovirus) test. Though the oxygen saturation test showed a result of 97%, doctor would like to carry out the lung x-ray and respiratory test as I have a very slight difficulty in breathing for the last few weeks. Doctor also mentioned that he heard that my lung is "tight".

The doctor will also decide how to manage my case tomorrow. One inevitable course of action is to alter the anti-GVHD medication; either increase the dosage of Ciclosporin (the drug that I am taking now) or simply replace it with other anti-GVHD drug such as Cellcept and Tacrolimus in which both of them could cause severe side effects.

With the change of anti-GVHD drug, I might need to take the very expensive Valtrex (anti-virus) drug again :-) The cost is RM11.3 per tablet and I need to take 3 tablets per day which is equivalent to RM33.90 per day (Almost the cost of one BBQ duck 烧鸭) :-( This time, I need to purchase the drug first and then take a long process to claim back from the government through my wife.

Not only have I had problem, my youngest two children Aaron and Adriel started to vomit this afternoon possibly due to virus infection:-( My wife brought both of them to see doctor, but the vomiting does not stop until now. They can’t even keep a small volume of fluid. My wife called our family doctor in the evening and he advised us to admit the children to hospital in fear of dehydration :-(

After discussing with my wife, we decided to observe a little longer before taking the next course of action. I asked my wife to give them a few table spoons of 100 Plus not long ago and they manage to keep it for more than an hour now. I believe they will keep the drink as it is too precious for them to throw it out :-)

As we are going to have a 3D2N church camp in Pulau Pangkor from this coming Saturday to next Monday, I hope they will get well before the camp. And I also pray that my body will response to the treatment the next few days; else I will miss the camp this time.

Anyway, I just leave everything to God as He is in control :-)

See you next post :-)