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September 10, 1999

 
Hi, this is Valerie from the Fed again. I just got off the phone with Dianne and she asked me to update everyone on what's been happening with Jenny.

Jenny has continued to struggle with severe nausea and diarrhea. On Sat., 9/4, she was admitted back into the BMT ward at the U of M Hospitals. They have run a multitude of tests, trying to determine what's going on.

They were concerned that it could be Graft Versus Host Disease (GVHD) in the stomach. Thankfully, these tests were negative.

They diagnosed that she has C-diff, which is bacteria which attacks the stomach lining. Both the chemo and the antibiotics she has been taking have damaged her stomach lining, allowing the C-diff to take hold.

Additionally, she has the Aneno virus. This virus often occurs in newborns then stays dormant. When a person is immune suppressed, such as after a BMT, it attacks the liver. She has inflammation of the liver, which is called hepatitis. She did test negative for hepatitis A, B, and C so the inflammation is being caused by the virus.

Both are treatable, but she is still unable to eat or drink anything. The medicines are more effective orally, but she can't keep them down. Therefore, she is receiving a less-effective treatment through her IV.

Her temperature is good and hasn't had any fevers. Her ALT, which is a measurement of enzymes produced by liver, is coming down which is good. It was as high as 298, is today is 61. Her Bilirubin, which is produced by the liver and causes jaundice, remains high. However her high Bilirubin counts are not but not as important seeing the reduction in the ALT so they feel progress is being made.

They are able to keep her dehydration in check with IV's. They have been reluctant to give her TBN (intravenous feeding) as this is hard on the liver. However, as she hasn't eaten in many days, they will be starting this tonight or tomorrow.

Jenny is sleeping most of the time and continues to have periods of delirium. When she is awake she is very remote and talks little. I'm sure she just doesn't have the energy to put forth the effort.

The family has been very concerned. Her continued immune suppressed state has provided opportunity for these viruses and bacteria to take hold. They feel it is important to get her back on the road to recovery soon before something else creeps in.

Please keep Jenny and the entire Smith family in your thought and prayers. Your concern and support mean a lot to them.

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