Today’s visit to hospital was about getting more IV fluids including magnesium. We both rode our bikes down to the hospital to ensure some early exercise on Melbourne’s 36 degree day.
Interestingly my magnesium levels are now back in the normal range of around 0.7 although this will vary considerably depending on the level of cyclosporin drug.
I met a new Registrar, Emma who went through the standard questions and asked about my general health.
In a nutshell I am feeling quite well with the exception of my ‘chemo brain’ which is severely restricting the capacity I have to do anything during the day. I am limited to very simple tasks such as colouring, jigsaw puzzles etc. The days are long.
Emma checked in with the head consultant Amit Khot and his advice was to hold off on two doses of cyclosporin and then reduce it to 200mg per dose twice a day from 225mg (originally it was 250mg/dose). This should improve my kidney function, which as you know is a bit off with very high levels of creatinine.
The current creatinine measurement is around 175 and the doctors would like it to be below 150. If it gets higher than 200 then they will probably want me to get back in to hospital for more constant IV fluids. The extra IV fluids together with the reduced cyclosporin dose should help.
This is all a big balancing act as reducing the cyclosporin is likely to introduce some graft vs host disease (GVHD) which is desirable but has to be closely monitored and managed. The GVHD is most likely to manifest as problems with my Gastro-intestinal tract (mouth ulcers, nausea, vomiting or diarrhoea) or an itchy skin rash. Stay tuned!
The other news from the day was that I still don’t have my results from the recent Bone Marrow Biopsy, which should be available on Friday.