When biopsy four came back with a rejection level of 3A and a mandatory admission for IV steroids (sorry for the lack of a post on that one last week) it felt a little like a sucker punch to the gut. Everything that we had been told to watch for when it comes to rejection was absent. Olivia looked great and the echo said that her heart looked wonderful; but the biopsy said something bad was cooking under the hood. Enter a weekend stay for a three day course of steroids via IV that were about 12x stronger each dose than any previous steroids she had been given. We were also discharged on a nice new hefty daily dose of prednisone that makes Olivia's appetite insatiable and her sleep disrupted.
Yesterday biopsy number five threw a few more curveballs into the game. Pressures during the biopsy are still coming down and normalizing which is encouraging. Discouraging news was that Liv's BNP doubled in ten days indicating some underlying stress to her heart. Confusing is that her kidneys did not show the same sort of bump; which typically would indicate that the immunosupressant meds are stressing out the patient's body a bit. To confirm there was nothing else amiss, they ordered an echo which showed that the ejection fraction (pressures within the heart) were higher than they would like and an indication that her body is still trying to fight some of the rejection. To ease the staffs mind and ours they sent the biopsy results STAT and they were back by 4 with encouraging news 1R1B.
What we found pretty disappointing back in December was a sweet welcome relief. With that rear view mirror look, it seems like we may have overreacted a bit back then. Either way, it looks like things are on the right track and we clearly have to stay ahead of Miss Olivia and her surprises. Today I am just ever so relieved for the improvement.