Back in the present, as I reflect on all that Richard has been through, his recovery seems to be a series of small crises, one following this other. And he keeps surviving them... and so do I.
The next of these crises was his rising creatinine. By day 25, it was hovering around 2.0. Many of his medications were changed or eliminated and his cyclosporine was cut way down.
Around day 30, we got a call about 9:30 PM from the BMT unit. Another crisis. Richards CMV blood test was positive. We were instructed to come right to the hospital to get IV anti-viral medication. And so at 10:30 PM, Richard received his first dose of IV gancyclovir. Unfortunately the medication caused further havoc with his creatinine. It went up to 3.0. The dose was reduced and the creatinine stabilized at around 2.7. The gancyclovir is given IV until two CMV blood tests one week apart are negative. Then an oral medication called Valcyte ( valgancyclovir) is given until three blood tests a week apart are negative.
Richard's second test was still positive, but not any worse. The next two tests were negative so he was quickly able to switch to the oral medication. His creatinine stayed between 2.0 and 3.0, despite dose reductions that took into account his renal function.
CMV crisis resolved...or was it? Creatinine crisis ongoing.
Read more about CMV and bone marrow/stem cell transplants.