(Image of Clostridium difficile from Wellcome Trust, a UK biomedical research charity.)
Other than a slight C. diff infection, Vivienne is doing very well today. Her methotrexate level remaining in her blood needs to decrease; today it needed to be less than 1 (it is .79) and tomorrow she will be discharged if it gets to .1 or close. This strikes me as a quicker recovery time than her previous two chemotherapy cycles, which I am advised can result because they adjust the chemical composition slightly each cycle based on the labs from the prior month. Accordingly, improvement in the patient's management of the medication is expected.
With those technicalities in line, I do have to admit that Vivienne is having some nausea and is a little bit fussy. Her appetite remains incredibly strong, and she is keeping down a significant amount of her food. I think this is the best we can expect, in the circumstances.
Lab tests yesterday showed a Clostridium difficile (shortened to " C. diff.") infection. This likely resulted from her antibiotic treatments from a couple weeks ago eliminating the "good" bacteria in her body that would typically keep the normal population of C. Diff in check. Alternately, this bacteria is EVERYWHERE, there are in fact 4 patients on the floor who have it right now. They are not particularly worried, are thrilled I am feeding her with probiotics because it will help clear this up, and don't intend to give any treatment.
It does mean that Vivienne is on Contact Isolation, which means Mom and Dad need to be especially careful to wash hands before entering and (the one we always forget) after leaving Vivi's room. The doctors and nurses wear gowns, gloves and masks when they come in, to reduce the risk of spread to other patients. If the infection hasn't cleared up by the time we next come to clinic or to be admitted, Vivi will have to enter through the Isolation Unit in the medicine room. It sounds MUCH more dramatic than it is.
Vivienne is sleeping now, after eating a nice big meal, playing the blankie game, smiling a bit and bicycling her legs energetically for quite awhile. She seems to be resting really very comfortably.