Today we found out that Ann has tested positive for CMV or cytomegalovirus. This means that at some point in Ann's life she came into contact with the virus, probably at a early age, and her blood is positive for the antibodies that are needed to fight it. It doesn't mean that she currently is infected with CMV. Although the virus can be latent and dwell for long periods of time in the host body.
CMV presents a problem to transplant patents of all types just because of this latency. It can be active or dormant inside the host body for long periods of time, being safely controlled by a healthy immune system. The problem for transplant patients as you might have guessed is that after mobilization they no longer have healthy immune systems, and won't have one for quite some time. In that type of environment CMV can attack the kidneys, stomach, lungs and even the brain. In extreme circumstances like that the virus can become life threatening.
However, just because Ann is positive for the CMV antibodies doesn't mean that she will develop a CMV infection. It is more of a case that the possibility exists. What is frustrating (to me in particular) is that the Doctor's and Nurses seem to lack an effective method of quantifying the exact chances that this will become a problem later on (if at all).
They did offer Ann the chance to become part of a study involving a drug call Maribavir which is supposed to suppress the cytomegalovirus. Sort of the same way that Valtrex suppresses Herpes I suppose. However, after reading over the study it left me and Ann with a load more questions than answers. The side effects of Maribavir are not really well defined, and the study has a whole lot of ECGs (echo cardiographs) being taken of Ann's heart. If heart trouble during transplant (or even after) is a side effect then Ann's not real eager to participate. That her heart is healthy and by all accounts "normal" in MDA's findings, is one of her saving graces.
In other news today Ann's chemo started. She had a bag of Melphalan at around lunch. So far we have no adverse effects to report. I'm sure that those will begin to manifest themselves several days from now, as the impact of chemo is always delayed by several days after receiving it. At any rate Ann is active and feeling well. She has been practicing on her Spirometer (see picture) and even managed to walk a cumulative mile around the transplant wing (5 laps = 1 mile).
We found out that there is a physical therapy class that meets 4 times a week where the patients do light stretching and some resistance exercises with large rubber straps. In addition there is some exercise equipment, but it has to be reserved. I went ahead and ordered Ann a foot bike anyway so she can do something when she doesn't feel like getting out of the room. That way she dosen't have to wait for the equipment to become availiable. What did people do in the dark days before the internet, broadband aircards and amazon.com?
Finally we are still waiting for our bank (CapitalOne) to straighten out the problems with the check from the sale of our house. I am about 2 degrees away from booking a plane trip back to Baton Rouge and reading someone the riot act in person.