Yesterday Greg returned to the hospital for another injection to help improve his white blood cell count. There has been a slight improvement since the doctors decreased Cellcept (one of his transplant meds) but it wasn't the improvement they were hoping for. At this point decreasing the Cellcept even more is not a viable option because it would put Greg at too great a risk for rejection.
Since something needs to be done, the doctors decided to try eliminating Valcyte - one of his other medications. Valcyte protects Greg against CMV - a virus that 80% of the population (at least where we live) has been exposed to. Like chickenpox/shingles, CMV is a virus that stays in your body once you have it and when you become immunosuppressed the symptoms can pop back up. For most people CMV causes flu-like symptoms, but for Greg and other immunosuppressed individuals, it can be far worse. Interestingly, Greg is part of the 20% of the population that has not had CMV, but his donor was part of the 80% that had CMV. So Greg never had CMV, but his heart did! How odd! Typically in cases like this, the transplant recipient would remain on Valcyte for 6 months. However, having such low WBCs leaves Greg susceptible to a whole host of infections, so they've decided to stop the Valcyte (at approx. 3 1/2 months) because Valcyte can decrease WBC production.
Greg will continue getting weekly blood tests to check his WBC count and to see if he is developing CMV. If he develops a low-grade temperature and abdominal discomfort we are supposed to call immediately because that might indicate CMV. The hope is that they'll be able to catch it early enough and knock it out by putting him back on Valcyte if he doesn't start to develop CMV. But the real hope is that his WBCs improve and he doesn't develop CMV at all! In the meantime he needs to be extra-cautious to not be around anyone who is sick and to wash his hands frequently, etc.
Greg is really glad that there will be less injections because they have caused incredible soreness - aches in his bones - and lots of fatigue. He slept 18 hours straight on Sunday and most of the day Monday and Tuesday as well! This is typical for someone receiving the injections - which is part of the reason they want to try stopping the Valcyte.
Would you please pray for Greg? That God would protect him from CMV and that his WBCs would improve? He ended up at the hospital 4 times last week and twice this week already and is feeling really discouraged by that - I know he would really appreciate your prayers in that area as well. I've also been feeling pretty down this week. Please pray that this verse would be true of me, "You keep him in perfect peace whose mind is stayed on You, because he trusts in You"(Isaiah 26:3) - it's easy to feel despair looking at all that is happening in the world, but if I focus on Christ and who he is and what he's doing, he promises peace. What an amazing promise!
Thank you for your prayers,