A Working Theory

Shirley got a 2-for-1 deal today with both an Endoscopy and a Colonoscopy.  Neither procedures found anything of concern that would be a cause for her anemia.  With internal bleeding ruled out, attention has focused on her medication list.

A consultation between her local pulmonologist, Dr. Glavin;  her transplant physician Dr. Lease; and a hemotologist, Dr. Li who was called in to provide insight has resulted in a theory that potentially two of her medications are to blame.  One, Dapsone, which is taken to prevent a particular strain of pneumonia, is being stopped as of today.  There is an alternative, once-monthly treatment that will provide the same protection.

The second medication, Mycophenolate, is one of her anti-rejection drugs. They are going to cut her dose by 50%.

Following yesterday's transfusions, her crit level went from 20 to 29. They will monitor her levels daily to ensure that they don't take another precipitous drop. With any luck, this will resolve the anemia issue and we can get back to her regularly scheduled rehabilitation.