Feed A Cold; Starve A Fever

It's really a strange thing to have someone else's immune system. Once the stem-cells graft into Krista's bone marrow, they will build a whole new immune system. Previous allergies, immunizations, and immune reactions will be history. In the past, Krista's body had often rejected un-matched platelet transfusions, indicating this by spiking a high fever. With the new immune system, she is likely to no longer have that problem.

So, is this a glimpse of things to come? The platelet transfusion she got yesterday has taken hold. Her platelet count went from 9,000 to 37,000 after the transfusion, and were at 30,000 this morning. If that were the end of the story, she would be doing really well.

The problem is that even with the platelets at a safer level, she has developed a fever. UCLA uses a metric thermometer, and anything 38 degrees Celsius (100.4 Fahrenheit) or higher is considered a fever. The nurse says that a fever is the only indication they get if the patient gets an infection. Infections are fairly common with transplant patients. Since Krista has virtually no white blood, the doctors have to target infections quickly or it can get dangerous. And, to top it off, a fever can also destroy platelets.

Last night Krista's temperature hit 38 degrees. The nurse became much more animated as she explained what it meant and what they needed to do. They ran lab tests on urine (in case of bladder infection), blood taken from her regular ports (for systemic infections), and blood taken directly from a different vein (to make sure that the port line itself isn't infected). They started her right away on a broad-spectrum antibiotic. When the fever continued to rise up to 38.4 C (101.1 F), they gave her Tylenol and had her put ice packs on her body. They've managed to keep the fever down around 38 C, but it's still there.

We should get lab results tomorrow, but in the meantime, they've adjusted the antibiotic and added a new anti-fungal based on some preliminary results. She's also going to be evaluated for a nutritional drip since she hasn't been able to eat much. If her tongue swells any more than it has, they are going to put her on steroids; but they don't want to do that unless necessary since that inhibits white blood production.

But the eyes of the LORD are on those who fear him,
on those whose hope is in his unfailing love,
to deliver them from death
and keep them alive in famine.
We wait in hope for the LORD;
he is our help and our shield.
In him our hearts rejoice,
for we trust in his holy name.
May your unfailing love rest upon us, O LORD,
even as we put our hope in you.
(Psalm 33:18-22)