Walking the Tight Rope

I definitely have plenty of GvHD now. They dropped my Tacro dose down to 1 mg per day a few weeks ago when I had very little GvHD. Tacro is short for Tacrolimus, which is the anti-rejection medicine.

I now have a lot of skin GvHD. My liver enzymes have been up for a week or so, so I may have some GvHD in the liver, which they will not gamble with. And I may have a little in the GI tract. So it looks like I'm batting 1.000.

Now for the tight rope analogy. We want a fair amount of controllable GvHD since that's evidence the graft (new system) is working. We especially need the graft to work now on the Richter's Syndrome lymphoma. But you simply can't risk losing the liver. So it's a balancing act.

The nodes under the right arm seem to be down some after the massive Rituxan infusion on Thursday. And my arm is not as sore, which means the nodes are not pressing against the muscles as much. I'll see Dr. Keating again on Tuesday to see what he thinks of the progress we got from the Rituxan. Then we get to decide what to do next.

So that's where we are. I go to clinic tomorrow morning just like every Monday and Thursday. I'll get blood work done first as usual. What the liver enzymes say will determine what they do with the Tacro level. Sounds like we're reading tea leaves, doesn't it? Sometimes I wonder myself.