DAY +51: a Decent Report Card from DFCI

Today, Susan saw Amy Joyce, Dr. Soiffer's Nurse Practitioner, not Dr. Soiffer. This is good because Nurse Practitioners and Physician's Assistants are almost always more informative and more fun to talk with than the physicians they support. Here's what Susan learned:

• blood counts are decent
• the platelets are still low (attributable to the Valcyte Susan is taking as a protection against CMV infection), but not so low as to be a concern or require an infusion
• bilirubin, which we have been watching as a marker for the status of the liver and so Susan's VOD condition, is about the same, that is to say elevated; however, today's ultrasound indicates that the portal blood flow reversal, a feature of the condition, has reversed back to normal; it's fair to expect now that the VOD is beginning to subside and that the ascites will follow (and, of course, that the bilirubin levels will move back towards normal)
• Nurse Practitioner Amy also says that, based on palpating and appearance, the ascites now looks to be improving, a development corroborated by the fact that Susan has lost another 3 lbs since Monday
• feeling cold all the time, which is one of Susan's complaints, is, according to Nurse Amy, a pretty usual thing ("we see that all the time," she said) and not cause for concern
• the chest X-ray results were not available in time to review before Susan left, but Amy listened to her lungs and said they sounded fine and not to worry about the cough

All things considered, it was a good report. Amy did remark that Susan looked a lot better than the last time she saw her. Of course, the last time Susan was hiding under a blanket curled into a ball and closer to comatose than alert. The next DFCI visit is scheduled for Wednesday, 7/29. Many thanks to Cici for driving Susan forth from Spencertown and back again.