Time to recap my latest office visit. At the beginning of year the doctor started reducing the dosage for some of the immunosuppressant drugs I have been on, specifically Tacrolimus and Mycophenolate Mofetil. Since that time, my liver enzymes have risen slightly. The past month the enzymes started rising even more, so the doctor has put me back onto a higher dose of Prednisone from 5mg every other day to 20 mg a day. This is what I was taking back in June 2011. The good news is this is no where near the super high dose of Prednisone I took in April 2011 (120mg) that started my steroid induced diabetes (since gone). So I shouldn’t have any problem with this dosage and hopefully, if it is as effective as last time, my liver numbers will be back down again within the next month.
So what does this all mean? There is just a lot of tinkering with the drug dosages that goes on over time. My donor cells are fighting with my livers cells, which at a low level is somewhat of a good thing if you have Graft Verse Host Disease (GVHD) issues as it causes a beneficial reaction to fight any bad cells still floating around in my body. But you don’t want to go overboard and let the fight get out of hand, because you reduce the general ability of your body to handle other illnesses not to mention you are damaging your liver over time. So it’s like a chemist pouring solutions back and forth between the vials until he yells “Eureka, I found it!”
Now it is possible to become a lifelong issue where I have to take a certain amount of drugs to keep this under control. Many people have gone down that route after a bone marrow transplant. But we still think that eventually this will all go away and at some point I will be completely off all drugs.
Still keeping active with no real issues other than occasional fatigue. I did play softball again for first time since July 2010, which was right before I got sick. Again the only real difference I noticed was getting winded more easily after doing a short run. My hemoglobin and hematocrit are still not in “normal” range, which is the main cause of fatigue from exercise. So looks like no inside the park home runs for me 😉
With the higher liver enzymes lately, I have been getting lab work every two weeks and seeing doctor every month. Let’s hope for the numbers to trend the right way in a couple of weeks 🙂