Saturday, 5 May 2012

Moderate Rejection

Monday started with Daphne’s regularly scheduled homecare bloodwork.  Tuesday we got a phonecall that her liver numbers were climbing.  We went to 5F3 on Wednesday morning to get more bloodwork just to be sure. 

Thursday is Daphne’s other scheduled homecare bloodwork, so we got more bloodwork done that day.  However, we also got a phone call that day that Daphne’s liver numbers were continuing to climb.  They scheduled a liver biopsy for Friday to find out why.  The other bad news was that now her PTT was also too high. 

PTT has to do with blood clotting.  This wasn’t too big of a concern immediately because the doctors assumed the sample had been contaminated, which is very common.  The sample was taken from her broviac line which is treated with heparin to keep it from clotting.  If the heparin wasn’t completely flushed from the line it could cause a high PTT.  The simple way to correct for that was to take her to get more bloodwork through an actual poke, which we did later in the morning (11am).  Unfortunately now the PTT was even higher than before!  But what is even stranger, was that the 8am bloodwork from homecare (through the broviac line) was much lower, almost normal!  It was all very confusing. 

The PTT being high was troubling and would be monitored, but it was also very inconvenient.  Transplant really wanted Daphne to get a biopsy quickly, but were worried the radiologist wouldn’t do it with such a high PTT (too much risk of bleeding.)  So we were sent back to 5F3 for some more complicated bloodwork Thursday evening, another poke to get an uncontaminated sample. 

They did go ahead with the biopsy on Friday on the condition that Daphne receive FFP (fresh frozen plasma) before, during and after the procedure.  The biopsy went fine.  The sight oozed a little bit so a pressure dressing was applied, but other than that it all seemed fine. 

Late Friday evening, the first bit of results came back from the biopsy.  Turns out Daphne has rejection again, this time the rejection is moderate.  Last time it was only mild.  This time its being treated with high doses of prednisone.  The great news is that after only one dose Daphne’s liver numbers showed immediate improvement! 

As for all the blood clotting numbers.  I have no idea what any of that means.  Even the thrombosis doctor said it is very strange.  He said that Daphne’s other blood clotting numbers showed no problems and that if there was a problem the other numbers should indicate that before the PTT is elevated.  But they will continue to monitor Daphne.  I am hoping it’s just nothing.  Right now I am more concerned with her liver numbers and happy that they are improving. 

Right now we are home on pass, but will have to return before 10pm for more IV meds.  Then we will stay overnight for early morning bloodwork.  The plan is for Daphne to be discharged by Monday. 

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