More Complications

Dear Fods,

Debbie continued to deterioate today and she is taking on fluids even though they stopped giving her fluids. This complication is caused by a new problem called VOD (veno-occlusive disease). I looked this VOD up and it does not look good -- but it does describe Debbie's current condition. It says:

Veno-occlusive disease is a potentially serious liver problem caused by the high dose of chemotherapy. In patients with VOD, the blood vessels that carry blood through the liver become swollen and obstructed. This impairs the liver's ability to remove toxins, drugs and other waste products from the bloodstream. Pressure and fluids build up in the liver, causing swelling and tenderness of the liver. The kidneys may retain excess water and salt, causing fluid to build up in the body and swelling of the legs, arms and abdomen to occur.

In severe cases of VOD, build up of fluid that has leaked into the abdominal cavity may also put pressure on the lungs and impair breathing. Toxins that are not processed out of the blood by the liver may affect how the brain functions and confusion may result.

In order to help Debbie's respiration, they did an abdominal tap and drew 1 liter of fluid from her abdomen. So far today she is incontinent and out of it. While she tries to talk, she cannot speak, or get out of bed. We have a commode in the room but that now is a 2 person job. I have been with her this afternoon, Mike was here in the morning and is on his way back, Jester is coming up from her training in WVA and will cover the evening. We will do a similar rotation tomorrow. On Saturday, I will get Joey and prepare him for his visit with his Mom.

I spoke with Dr. Porter today and he is hopeful that the VOD will reverse itself and we should know that in the next day or so. Debbie is very uncomfortable and her legs, ankles and feet are now swollen as well. Porter also said that the Mylotarg failed and that there are leukemia cells in her blood. At the moment, however, he is most concerned about Debbie's breathing and the VOD. If the latter does not reverse itself soon -- we will need to go onto HUP's Home Hospice, in compliance with Debbie's directives.

Will keep you posted.

Debbie sends her love to all.