Friday, March 11, 2016

Day +157

Raul was able to come back up to the BMT floor today! We had hoped to yesterday, but he was having some low heart rates so they wanted to watch that and lower his Precedex a bit to hopefully help. He is still having some low heart rates now, but his perfusion and blood pressures have been fine so they are just watching it and lowering the Precedex a bit more.

While there is still a lot going on with Raul, I thought I would post some good news tonight:
1) Raul's engraftment from the beginning of the week came back and it is considered to be stable! They were last drawn on day +99 (I think), and these were drawn on day +154. His CD3 was down from 97% to 82%, and CD15 up to 31% from 24%. They will be checked again in about 1 month for his 6 month post-bmt work up.

2) It might be hard to tell in photos, but Raul's skin has improved. In person you can tell that even areas that looked okay before, now look much more "normal". His mild chronic areas have healed or shrunken significantly. His moderate chronic areas are starting to improve, and we have not yet seen significant improvement of his worst wounds but those will take time. And new areas, which there aren't many of, heal MUCH faster! His entire chest was open after CPR, a pretty significant trauma, yet all but the area around his dialysis catheter healed within 10 days!

3) Raul remains in kidney failure, but his kidneys are still enlarged. This is good news, as once they shrink is when you know you most likely will not get function back. We have actually been seeing tiny amount of pee too, which is very exciting! We didn't believe it at first yesterday, but sure enough, there were 19g! We lowered his CSA dose the other day, which I am guessing is helping, as last time we went down on his CSA he began to pee again too.

4) And finally, what might be the biggest news, is that this morning they told us that they consider his HLH to be in remission right now! He has had several weeks of good HLH labs, and we have started weaning his steroids (which will be a fairly lengthy process since he has been on them so long). Since he did seem to respond to the Campath, we have the option of doing another course of that should his HLH activate again. 


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