Day 51 ....another bump

Friday, November 9, 2012

Dillon had a period of no nausea yesterday and a small appetite......followed by uncontrollable, persistent,violent wrenching all night long.  The way it is coming about now indicates a complication of some sort.....this is not your garden variety post chemo, post radiation, post BMT stomach issue.

He was evaluated by the GI docs this morning after vomiting 5 times in 2 hours this morning and  12 times overnight from midnight until 6.   They are going to do a battery of tests including a scan of his pancreas, a barium swallow x-ray, and upper and lower endoscopies with biopsies.

The main suspect is graft versus host disease, which is a common complication in BMT patients, though it presents itself in different parts of the body in different people.  GVH is complex, but in a nutshell this form is the new immune system attacking his gut as it perceives it as foreign material.....sorta the opposite of when you hear of organ transplant rejection where the persons body attacks the new organ.  They say it is actually good to have "a little" GVH" because the new cells will also attack any stray lymphoma cells, if there are any, and it is a sign of a full takeover by the new cells, which is what we want.    The research shows that people who get some degree of GVH actually have a better long term outcome.  It is treatable/manageable if caught early, and this would be considered early...so that is good.  Treatment is......more meds of course .....just what a sick belly needs, right?

They diagnose GVH of the gut via biopsy.  So a tube with a camera will go down Dillon's throat and they will look all around his esophagus, stomach, and upper intestine.  They will take tiny little biopsies from a bunch of places all throughout the GI tract.  He will be sedated for this procedure.

Another possible diagnosis is an inflamed pancreas, which they are scanning and there is treatment for.

Then another possibility is some sort of anatomical malfunction or deformity.....that his gut just is not working right.  The barium swallow x-ray will show that sort of thing.

In the meantime, my boy is completely and utterly miserable and there is not a thing I can do to help make him more comfortable. He can hardly even sleep.   That is the worst part for me right now....I am powerless.