Day +33 - Pathologist's report

Here's me looking happy after re-reading the pathologist's report from the bone marrow biopsy I had last Monday. You can also see that the whites of my eyes are finally starting to become visible. My eyes are less itchy now too, and they aren't getting wet and blurry all the time. The technical term for what happened is that I had a subconjunctival hemorrhage, and now that the itchy, blurry side effects are gone I feel that much closer to feeling normal.

The pathologist's report is a multi-page document detailing the results of the various tests that are run on the bone marrow biopsy and aspirate samples. The biopsy is the "core sample" taken from the hip bone and the aspirate is the bone marrow liquid that's sucked through the little corkscrew they stick in your hip. What was exciting, or non-exciting I suppose, about this report was that the overall final diagnosis was the shortest description I've seen on a pathologist's report so far. Essentially, there wasn't anything to talk about! Here's how it reads:

Final Diagnosis: Bone marrow 27 days post-transplant showing normocellular trilineage hematopoiesis with no evidence of dysplasia or increased aberrant myeloblasts.

Those have to be the sweetest words I've seen in a while. The phrase "normocellular trilineage hematopoiesis" means that the blood stem cells are maturing normally into all 3 blood components (red blood, white blood, and platelets), and the phrase "no evidence of dysplasia or increased aberrant myeloblasts" means that there are no dysplastic (abnormal) blood components or stem cells to be found. Basically, these flow cytometry and various other tests they run are the most sensitive kind of tests for this stuff, and can pick a single abnormal cell out of billions. Normally the final diagnosis includes several paragraphs on all the abnormalities and dysplasia found in each of the blood types, the presence of excess blast cells, irregularly shaped blood components, and lots of other esoteric problems which I'm sure gets the lab technicians all excited. So it was really inspiring to see such a short and healthy description.

It's been a month since the transplant and it already feels like 3 months. The days are flying by and we'll be at the next milestone on Day 50 soon. The next milestone after that is Day 80, when the SCCA lab will run chimerism tests on my blood to see what percentage of blood components are mine versus the donor. Technically I can be called a chimera, a person composed of two genetically distinct types of cells. In Greek mythology, the Chimera was an awesome fire-breathing monster with the head of a lion, the body of a goat, and the tail of a serpent, so maybe being a chimera is pretty cool :) Though the mythical Chimera was killed off by Bellerrophon, the guy who rode Pegasus, the famous winged horse. I'll make sure to be on the lookout for flying horses during my walks.

My white blood counts are finally starting to come back down, after skyrocketing off the charts as a result of the high dosage of prednisone steroids I was on for the first few weeks. I'm now down to 80 mg a day from 180 mg a day. The recovering white blood counts along with all the other good news lately puts a visible look of satisfaction on all the doctors I talk to. Here's a look at my latest white blood counts:



The only new issues that have crept up are these painful rashes in my armpits. Apparently Busulfan, one of the chemotherapy drugs I received before the transplant, stays around in your system and ends up as a toxic component in your skin. Anywhere your body rubs together causes a rash because of it, since the skin gets irritated by the toxicity. It's pretty painful when I lift my arms up, and the skin is broken and red under there, so I have to use powder regularly to keep it dry. The areas that aren't broken have this dark color, which then peels off to reveal new white skin underneath. It's really weird to see. The doctors say it's not uncommon and not to worry. The important thing, they remind me, is that it's not graft versus host disease (GVHD), so other than being super irritating, it's benign.

For the last few days not a lot has been going on medical-wise besides picking up supplies, doing my normal IV fluids or having Johanna change my Hickman dressing. I've been keeping busy eating, playing on the MacBook, staying clean, walking a few miles a day and working on little projects around the house. Friday afternoon I had coffee with some friends from work, some of whom I haven't seen in 2 months. We camped out at the outdoor tables at the pizzeria near our office, munching on pizza and chatting and watching the people go by. I could hang out there for hours doing that, and it was nice to be around my friends again. I think every other Friday I should stop by for more pizza, coffee and socializing.

Last Thursday we had snow, and I'm always happy to have snow in Seattle since it really doesn't last long and adds some variety to the place. Tonight we tried our hands at some pizza using fresh pizza dough from Pasta & Co and trying to get it as thin as possible without tearing. We have a little pizza stone and bought a wooden pizza flipper today, which is the key to getting the pizza on and off the stone. Our 3rd attempt finally produced a really nice thin crust, just like Italian pizzas!


Last Thursday's snow melting off the flagstone path



Our pizza adventures finally produced a nice thin crust. Yum.