His liver enzymes are still elevated but only 1 or 2 of them and not all, there is only minor evidence of GvHD on his skin and his mouth is slowly but surely improving although he can not taste everything yet.
Unfortunately the viruses are still present as they were last week; ADV in the stool and HHV-6 in his blood plasma. He has been started on additional anti-virals to try and contain them. The doctors are also keen to reduce the immune suppressing steroids as quickly as they can to enable his t-cells to multiply and attack the viruses and so in the past 7 days they have reduced the dose from 12mg twice daily to just 5mg twice daily.
Each time they are reduced Ryan gets a temperature, although it cannot be assumed that the reduction in steroids is the cause, each time it has to be treated as a potential infection. It happened again this week and the doctors said the cause could have been one of 4 things: the reduction in steroids, the engraftment of the new stem cells, the virus or a bacterial infection. Either way in the past 24 hours the fever is subsiding and the steroids have not needed to be increased again.
It has been 11 days since the stem cells were infused but there is still no sign of his blood counts improving; today he is having a blood and platelet transfusion. They usually appear 10-14 days after infusion and so we are hopeful to see signs of engraftment in the next few days.
Ryan is mostly feeling very tired, quite understandably. There is so much going on in his body. But the doctors are very pleased with his progress and are still talking about possibly discharging him mid-week if he continues as he is.
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