Sunday, February 8, 2009

Day +12 - Counts increasing, skin rash disappearing

Not much to report. Today was relatively uneventful, which is excellent news. Slept great, no fever, no tossing and turning, woke up with only a minor headache which was quickly resolved with some Imitrex.

The doctors came in to report that all my counts are still increasing, which I am still in shock over. Yesterday my Neutrophils were at 0.8, which was a big deal since they cleared the important 0.5 threshold. Today they're at 2.72! Part of this is due to the steroids, which tends to push new cells from the marrow quicker. We also expect them to bounce around down a little bit, but still! Platelets are also up from 45 to 119! These are some really strong cells, baby. Again, we also expect them to bounce around a bit and they could go quite a bit back down, but so far things are looking very good! I'll put together some more graphs later. One of the reasons they explained that it took so long for my counts to return after my induction chemo, is that we had to beat them down until they were nearly dead, in order to wipe out as many leukemia cells in the process. So those bruised and badly beaten cells took some time to recover. On the other hand, with a stem cell transplant, the chemo dose to the old cells was essentially lethal, leaving no man alive. So instead of waiting for badly beaten cells to recover, the new stem cells were healthy and raring to go, requiring the methotrexate chemo to actually tell them to hold their horses a bit. Now that the methotrexate is done, it will be interesting to watch them go full bore, expecting some up and down bumps along the way mind you.

The skin rash is disappearing thanks to the steroids, and the doctors are keeping a close eye on it. No fevers to report in the last few days, and I'm still eating solid food, though now it's down to Carnation Instant breakfast milkshakes and chicken noodle soups and milk. My mouth is still holding together, but the skin is very thin and flimsy and after I eat there is a lingering pain for about 20 minutes. But, if it can hold out until the engraftment really kicks in, all I have to do is keep what I have left and the the new skin cells will start growing and then I'll be all set. I'm also finding it more difficult to talk, which is annoying.

Yesterday I had a new attending physician named Dr. Deeg, who is highly recognized and is a specialist in MDS, the exact disease I have. The attending physicians rotate out every month, presumably so that they can continue focusing on their scientific research and not spend the whole year doing in-patient rounds. I've had 4 attending physicians so far, Dr. Storb, Dr. Turtle, Dr. Doney, and Dr. Deeg. All of them have high credentials and have been incredibly smart. In fact, Dr. Storb was one of the founding members of the Fred Hutchinson Research Center and worked with Dr. Thomas, the man who developed the bone marrow transplant way back in the 60s and 70s and who won a Nobel Prize for it. Dr. Storb is also really funny and cool, and though he's in his 70s (he doesn't look it), he still kayaks from his houseboat every morning across Lake Union to work. I remember hearing Dr. Deeg's name from as early as June, when my general oncologist would call him up to consult on treatment plans for me, since Deeg is an MDS specialist and is at the top of his field here. So it's amazing having people like Dr. Deeg handling my case, doing rounds and coming into my room every morning to look me over and talk about how things are going. It's awesome to have that kind of care available to you and someone like that inspecting your body and treatment schedule every day.

The docs are starting to taper down the IV drugs so that I can start taking them in pill form, presumably so that can get me discharged. Woohoo! Barring no complications and that the skin rash disappears, it could be soon now. Unfortunately, the evil eye look will be around for another few weeks. The docs don't really care too much about it since it will go away on its own and isn't problematic, so I'll probably have to wear shades for a while or risk scaring off little kids and coffee baristas. Actually little kids will probably think it's cool.

The usual visitors came by today (johanna, mom, dad, cindy, brian), and I got my 2 miles of walking in, so all is well. I think I'm going to get some sleep early for a change tonight.



Simon said...

Yay, stem cells! Man, those little guys are eager to get the heck out of the hospital and start checking out Seattle. Or maybe they got all excited about going scooting? Someone should tell them that it's kinda cold and rainy out there.

So glad to hear you're getting world-class care - it's only what a world-class guy like you deserves!

See you soon!

- S

Captcha of the Day: prostent: (n) A stand-in for a real tent. e.g.
Dude1: "Dude, did you see those cool new tents at REI?"
Dude2: "Yeah, but those aren't the real deal - they're just prostents. They don't dare put the real ones out"

farookh said...

yippeeeeee! go stem cells go!

btw, loved the idiom usage:
"leaving no man alive"
"raring to go"
"hold their horses a bit"
"to watch them go full bore"

i am thinking it is the new stem cells. :)

Jenny said...

awesome. the nuetrophil count jump is amazing. Greg's never rebounded that quickly after chemo.

Sounds like the system reload is working as expected! keeping our fingers crossed that you don't come across an undocumented bug! but XP has been around a while now so you should be safe! :)

take care - thinking of you here in bangkok...jenny and Greg

Anonymous said...

Overall good news! What can a person say except congrats! Your news just made my day. I will check back in a day and I am sure I will read more good news. Ciao.

Beth said...

Jeff and Beth

George said...

Sure "Western Medicine" has had it's hands on your recuperation.

But when faced with the evil eye their "precious science" waves it off as insignificant.

However "we" all know that when the villain, in this case MDS, is about to be offed the villain must always go out screaming and with a bang. Just like in Fatal Attraction. You thought she had drowned... but up she comes from the bathtub.

Villains must make a dramatic exit. And in this case your eyes are where they are holding up. Now normally I'd tell you that you must gouge both of your eyes out straight away. But since we know now through modern technology that eyes just aren't pretty to look at and full of strange fractals... but they are also used to SEE.

Thus I will ask you to ignore my advice of gouging out your eyes and just to give the little buggers a few more weeks to vacate.

Nic said...

This is all so awesome it's ridiculous! Great, great news!!!

Vanesa said...

Wow, these are great news! So glad to hear you are doing much, much better.

I am not a very religios person, so I do not pray. I take Yoga on Friday mornings, and the teacher always tells us to dedicate our practice. Last Friday, I dedicated my practice to you. I'm not saying that is why you have improved so much over the weekend, but sure it didn't hurt. =P

PS: I am not crazy, I know that you feeling better has nothing to do with me dedicating to you my Yoga practice, but good energy is still good energy.

Cassie Wallender said...

Go counts, go!! :-)

Steve, I'd like to come visit but as usual there's weird crud going around the office. Just know we're all cheering you on!

Trevor said...

Dr. Turtle??? That sounds kind of sinister. But whatever it takes! Whatever it takes to get those blood cells raring and going full bore ...