Brad is feeling a bit more comfortable today, as some of the new meds from yesterday seem to be helping. He’s also getting a lot more rest than he had been. (I’m writing this in his hospital room as he sleeps.) One new development is that he has been needing insulin shots, as his blood sugars are spiking. I asked the nurse about this, thinking it might be because the TPN is so high in sugar. But it’s not that; instead, it’s a common side effect of the steroids he is on. One more medication, one more set of side effects to control.

I’ve noticed particularly, during this whole thing, how quickly the cascade of interventions and medications builds during such a highly technical, complex procedure as the one he’s been undergoing. One symptom demands a medication, but that medication produces new side effects, which require other interventions and medications to control. It’s all a lot for his poor overtaxed—and now very weak—body. But the alternative, as they say about aging, is a lot worse.

His eyes are about the same as yesterday, and he’s having trouble opening them despite a triple threat of drops and ointments (steroid drops, erythromycin ointment, and artificial tears). And when the eyes are open, he’s having a bit of trouble seeing out of them. The ophthalmologist did seem to feel that the problems are due to ocular GVHD, which is a rarer type of GVHD—more commonly, eye problems show up much later post-transplant and tend to be more along the lines of dry eyes. (There’s a clinical distinction drawn between “acute” GVHD—severe problems that show up within 100 days of transplant—and “chronic” GVHD, which are ongoing, typically less serious complications that emerge post-100 days.) The ophthalmologist who consulted on the case also noted some problem areas on his cornea, and now we are waiting for the corneal specialists to come and take a look at that.

In better news, not only have I learned how to spell ophthalmologist, but also earlier today Brad asked me to read to him, so I read aloud a bit from Ulysses, the Eumaeus episode in which Bloom and a drunk Stephen Dedalus meet an equally drunken sailor. I opened Brad’s Kindle to it at random, but the rambling (not to say shambling) style of the narrative, which mimics drunken conversations, seems like a particularly good fit for someone whose pain meds have him drifting in and out of consciousness and understanding. James Joyce’s rendition of drunken speech even managed to get a few chuckles out of Brad, which seemed to me like a good sign.

On a random note that is not a sign of anything, I just noticed that now that it is February, the days are aligned with the dates: Day +24=2/4. So, there’s that. Surely Joyce would have made some play with that coincidence.