Tuesday, January 1, 2013

Treating the BK virus as an outpatient

I received this during my hospital stay.
I was released from the hospital on Friday after my third treatment with the antiviral, Cidofovir.  I was tolerating it well and it was decided that I could continue with my treatment as an outpatient. That was fine by me.  So, I had the weekend "off", and started my treatments on Monday morning.  The day before Christmas.

The treatments were the same as in the hospital.  I take the Probenecid before I leave, the saline IV is started when I get there, followed by the Cidofovir, and then more saline IV.  I take the final two doses of Probenecid afterward.  I'm still getting a few side effects, but they aren't too severe.  I get a headache that is helped significantly by tylenol, and I feel tired.

My lab values remained quite stable throughout this.

                        Mon                Wed               Fri                  Mon             Wed          Fri
creatinine         1.62                 1.79              1.67                1.78              1.79           1.70
BUN                 51                    49                 45                   52                 52             45

My Potassium is down to 4.5 which is very good.  I'm hoping to not have to take the kaexolate for that soon.  My BGs are remaining good.

Unfortunately my viral titer numbers aren't so good.  When I was diagnosed with the BK virus, it was at 5.54.  I was drawn after two Cidofovir treatments and it wasn't much lower.  I was drawn again on Friday, and found out this Monday that that level is 5.03.  Not a significant difference.  Since it was New Year's Eve day, I had a hard time getting hold of a doctor that knew anything about this treatment.  I was feeling that I should not be having this treatment that is so stressful to my kidneys if it wasn't working.  But, I'm not the one who makes that call.  I finally got a doctor with the help of a very responsible and caring nurse who knew about my case.  My doctor was on vacation, and according to his office staff, completely unreachable.  It was a frustrating day.  The doctor that I spoke with said that I should continue with the treatment on Wednesday, and he would discuss it with my doctor in the meantime to decide what to do next.  He said that the viral titer still could drop off quickly.  He also said that the next treatment option would be to give me immunoglobulin treatment.  I'll have to google that to see what it entails. My nice nurse told me that its another IV treatment, but not as intensive as for the Cidofovir.

No New Year's dip in the river for me this year. With my picc line in, I'm not watertight.  Gary braved the cold though, and it was still a fun day.

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