Sunday, August 16, 2009

Behind Door #2...

Approximately 75-80% of American adults have CMV. That's cytomegalovirus, and it's pretty certain that it's a relative of herpes, epstein-barr, and mononucleosis. It lives in the body, happily cooking along and not really showing up in healthy people.

About 20-25% of American adults do not have CMV. That means their immune systems have never worked up the antibodies to fight the virus.

CMV is an opportunistic virus, meaning it shows up when your immune system is depressed for some reason or other, and when the virus is activated, it can cause nasty illnesses -- and, in a pregnant woman, birth defects for her child. It can arrive as the flu - aches, fevers, sore throat. It can cause gastrointestinal distress. It can cause retinitis (and eventual blindness). It can attack the liver, the joints, and I bet it can even get your teeth. It's not generally passed on through casual contact... and it dies very quickly outside the body.

Anyhow, given the percentage of folks who are already positive, versus the percent who are negative, when transplants take place there's a 20 +/- % overlap of positive donors and negative recipients. They give hefty antivirals right after transplant to keep the virus at bay. After that, approximately 20% of the 20% go on to develop CMV.

Guess who hit that jackpot?

I started feeling crummy about two weeks ago, right as my family were all arriving in town for Sarah and Brett's wedding. My arms and legs really hurt, and I was t.i.r.e.d. By last Sunday I couldn't drag myself off Big Red, and slept almost all day. I also had a fever and a sore throat. By Monday I started to feel tight in my chest, and I broke down and called Nurse M.

6:00 Tuesday found me in my favorite University hospital giving all sorts of bodily fluids to the cause. Dr. H saw me and after 30 seconds said "I'll bet you $100 you have CMV." Yeah, like I was going to take that bet. :-) I knew I'd be back in on Thursday for more venous spelunking (soon will have another "recent misadventures" post) so figured I'd get meds then.

Woke up from my procedure Thursday morning to my darling Interventional Radiology docs saying "you are being admitted but this is totally not our fault -- we would let you go home today..." And I just laughed. I found myself in the same room I was in when I left the hosp in April, with the same nurses. Ahhhhh, home.

I got Thursday afternoon "off" and Friday was poked and prodded in various ignominious ways, and received a "PICC" line, which is basically an at-home iv that runs from inside my elbow, up around my shoulder, and stops just short of my heart. This is a quick and efficient way to get meds throughout the body ... with the effectiveness of oral medications on CMV still under scrutiny, fluid is the way to go.

Saturday consisted of lessons from the home health nurse, more visits from the infectious disease docs, and coming home. It will probably be the end of the week before I start to feel better, at least I hope I do by then. I am still sleeping all the time. As of this moment I've been awake for an hour and three-quarters and am longing for sleep. But I'm sure it will work.

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