We're still in the hospital. Since my last update, Andrew got a repeat echo, which showed that the heart vegetation/endocarditis disappeared. That was unexpected, but multiple cardiologists compared the images and confirmed there was a vegetation initially and now it's gone. This points to it being an infection vs. clot, and the antibiotics were effective. We're hanging on to that good news.

On the bad news front, Andrew's platelet infusions have become much less effective. His levels haven't been stable enough to go home or restart a blood thinner. His hemoglobin has also been too low, so he's gotten a lot of red blood cell infusions too.

Wednesday night, hematology made a somewhat controversial decision to give an injectable medicine called Nplate to try and increase his platelets. It comes with its own clotting risk, and it doesn't always work, but he needed a Hail Mary. It takes at least 2-3 days to start working.

His platelets jumped from 16 to 35 on Thursday morning, the highest in two weeks. We were hopeful this was an early sign of the medicine working, but the platelet number has since gone down and hit 6 this afternoon. On Monday, the blood bank will analyze samples in order to better match him with platelets that have a certain antibody. This often works for highly immunocompromised patients, and it could stretch the time between platelet transfusions by a few days.

This afternoon, they found some evidence of an upper GI internal bleed—a potential issue caused by the low platelets. He's getting two units transfused now and will get labs again around 10pm. If the platelets have increased, it's a good sign that whatever is bleeding inside isn't immediately eating up the platelets.

We were hoping that Andrew would get discharged tomorrow and then get another infusion (with the cross-matched platelets) on Monday in the clinic. We'll know more soon about whether the potential GI bleed throws that plan off.

Andrew's ready to get out of here. He's feeling much more himself and anxious to stretch out and sleep in his own bed. He's had a lot of visitors, though, and really enjoyed the social interaction. We're hopeful for more of that this week at home.

I'm including a picture of us with his palliative doctor, who we were happy to spend a lot of time with each day.