The good news: David did NOT extubate himself today. Round of applause, please.
The bad news: I may have over-exaggerated the power of campath. Not on purpose, mind you. It really was supposed to kill all of his lymphocytes. Hiroshima, remember? Which, in turn, was supposed to STOP the progression of the GVHD. Yeah, well, David apparently does things his own way.
His lymphocyte count tripled overnight. Tripled?!?!? TRIPLED?!?! Lymphocytes are not our friends.
So tonite he’ll get a 2nd
bombing dosing of campath. Nagasaki, anyone?
While they haven’t completely run out of drug therapies that maybe be useful in containing the GVHD, the prospective agents that are left are quite fierce. Some think a meteor smashed into the earth and killed the dinosaurs.
He may need that meteor.
Today’s re-dressing took place in his room, along with a dozen or so of our not-so close friends. They managed to finish in 2 hours instead of 4. Each with their own opinions on the best way to promote healing, prevent infection AND keep him comfortable. Slather him with antibiotic ointment and wrap him up to keep his delicate skin moist. OR Leave the less vulnerable areas open and exposed to the air in order to let him dry up.
Shriner’s Hospital will be providing a consult tomorrow when the re-dressing takes place. David doesn’t have a 2nd degree burn, his skin just looks like a 2nd degree burn. His blisters and extreme skin loss are caused by inflammation from the inside out to the surface. Burns obviously develop from the outside down into the deeper layers of skin. So while Shriner’s are experts in the survival of burn victims, not GVHD, they may offer some insight on how to care for his delicate skin, how to prevent infection and promote healing.
Tomorrow’s session will be another marathon event.
Damn you , lymphocytes….