Day 200 – The Munchies and the Miracle of Steroids

Jeff has the munchies.  Our friend Joyce (a two-time autologous bone marrow transplant patient out six years from transplant) warned me about the munchies, a side effect of steroids.  She also said Prednisone is nasty-tasting.  I did not share that information with Jeff until he reported the fact to me.  Then I told him, “I know.  And I’m sorry.”  Oddly, the steroids can cause tummy troubles, too, and Jeff is having trouble telling whether his gastro-gurgling (audible if you are within 10 feet of him) is due to the munchies (over-eating) or the drug itself. 

It is common for BMT patients to take steroids for GVHD for long periods of time - many months.  In Joyce’s case there was no risk of GVHD because she got her own cells transplanted.  There was no battle between the host/patient (herself) and the donor (herself).  She took steroids for a bad infection, though, and had some tales to tell.  I did not share all of them with Jeff but I did tell him that Joyce confessed to being grouchy with her spouse while on steroids.  We are forewarned.  I suggested that Jeff discuss side effects with Dr. Porter when he sees him on Friday.

Of course, we know that steroids can work miracles.  We don’t know if Jeff’s liver function is improving; that will be checked again on Friday.  However, we can see and feel that his skin is benefitting enormously from the miracle drug.  He told me last night that he kind of misses my once or twice daily application of lotion and backrubs but it is very nice not to be itchy all the time.  Hopefully, his fingernails and toenails will get stronger and less brittle, too. 

The first few days of Jeff’s “steroid use,” I noticed Jeff’s face was really red at times.  I told him it looked “ruddy” which he heard as “rut-ty.”  He thought he was growing ruts and ridges in his face but I was referring to the color of his skin.  In fact, it was so red that I was concerned and made him take his blood pressure a few times.  He came with me when I gave blood at the Morrisville Presbyterian Church and the nurse who screened me for blood donation took his blood pressure, too.  All good!      

We got email notification from Penn Medicine that Jeff’s lab results were posted online.  Even though we already knew the results indicated a strong possibility of GVHD involving Jeff’s liver, I was curious to see his counts.  His hemoglobin was 12.3 which is about as good as it has been but not quite normal.  Many of his counts are looking a little better but the liver panel numbers and monocyte counts were so dramatically elevated that a medical degree was not required to see that something significant is happening. 

Dr. Porter ordered a pulmonary function test to make sure that Jeff’s fatigue is not due to damage to his lungs from the pre-transplant chemo/radiation conditioning.  Jeff went to Aria Bucks County today to take care of that.  He did not have to go down to the city – yippee!  A baseline test had been done in the spring - between his two hospitalizations - in preparation for his transplant.  His lung function is greatly improved.  “Phenomenal!” the technician said. 

Jeff spoke with his hospital pal, Jeff R., and made a date for the four of us to have dinner together in January.  Jeff has a delightful southern drawl, had been a horseman of some kind, and has a healthy dose of spunk.  I expect that both he and his wife will be interesting dinner company.