Monday, January 26, 2009

Counts finally dropping

I just got my latest blood counts, and the numbers are definitely trending downwards. On the left is a plushy red blood cell which I've got hanging from my IV pole to celebrate. Platelets are at 72 and white blood cells are at 0.7, not as low as they've ever been, but steadily dropping. It's weird to be cheering for them to go down, but it makes me feel a little better since it means the chemotherapy is doing its job. I was getting a little worried that I might be *too* healthy (haha yeah right) and that the chemotherapy might not have been strong enough. But based on the drop in white blood cells from just yesterday to today, I don't think I need to worry anymore.

Take a look at the charts below. The purple bar on the left was when I had induction chemo a few months ago, and the purple bar on the right was from the conditioning chemo just last week. The green area is the normal range, and you can see that the induction chemotherapy a few months ago finally knocked things into remission for the last several weeks. The recent conditioning chemo is causing a downward trend similar to the one that happened right after the induction chemo, before the counts came back up again.

White blood cells


Hematocrit (% of red blood cells in body)

ANC (bacteria-fighting ability)

So as you can see the main issue we'll be watching out for is infection, since my white blood cells are expected to stay around 0 for the next couple of weeks. They dropped like this when I had induction chemotherapy as well, and a whole rash of issues like liver problems, fungal infections in the lungs, and a slight case of pneumonia popped up because of it. So we'll be very careful for the next couple of weeks to make sure I stay really clean. We'll also be watching out for graft-versus-host disease, which comes up in 50% of transplant recipients in the first few months, and can range from a whole variety of things, like skin rashes and organ problems. I've already started taking medications to prevent it, but there's still a 50/50 chance I'll be dealing with some sort of GVHD issues so the doctors will be doing a lot of monitoring to catch things early.

One of my physician's assistants came by and brought a picture of a patient of hers who is celebrating his 25th transplant anniversary. He's living a healthy life and sends her a Christmas card every year. I got a little teary-eyed thinking about it, since it really puts the whole thing in perspective and how big of a deal I'll look back on this time 25 years from now. I hope it can just be something that I had to take care of and got it done, like getting a crown or a cavity filled. And maybe it will be. There are certainly other transplant patients who are running around in perfect health a year out from their transplant. Or maybe 25 years from now I'll remember this time as a celebration and will be looking at life as something to continuously savor.

Today a person from oral medicine came by to check out my mouth. This is one of the several clinical trials I signed up for to provide researchers with more data, but this particular one has a lot of benefit to me since it means I'll have constant monitoring over the mucositis situation. I remember the trial saying that they would come by every few days starting on Day 0, so today is the day. She inspected all corners of my mouth and noticed some thinness starting in the gums, as a result of the increased acidity in my mouth because of the extra mucous and saliva. She brought me a new toothpaste with thinner, softer bristles and added baking soda to my saline mouth rinse, which she says will help thin out the saliva. It feels good to be taken care of like this.

That's about it for now. Had a great lunch of Ivar's clam chowder and hard-boiled egg from the room service menu. So far salty food still tastes the best, so I've been sticking to things like pretzels, chicken noodle soups and egg sandwiches. The nurse just stopped by to add a new antibiotic to my pole o' bags, and other than the occasional blood draw or vital signs check, it's been a nice and quiet day.


Hep said...

Bring on the stem cells! I can't believe you're walking two miles a day. I'm inspired.

George said...

Is that plushy Red Blood Cell from ThinkGeek??

Yer just trying to get rid of the fake Stever... so will the real Stever please stand up... please stand up... please stand up...

wiki wiki wiki 1998 humour...

Farookh said...

we should set a date for 30 years from today. meet up, have beer, play some halo (what?! i'll save my xboxen...hehe), and reminisce our lives and have good laughs.

i've set it on my calendar...don't worry...i don't intend to be with MS for 30 more years. :)