Today I had another PICC line central catheter put in to handle the onslaught of daily blood draws and possible transfusions over the next several weeks. I don't regret pulling the Hickman line a few weeks ago, since a few weeks ago everything was going great and there wasn't any reason to keep it.
Today's blood draw are showing that the counts continued to drop over the weekend, even with the Neupogen shots I'm getting. They say it could take a week to see any response to the shots, but the docs are skeptical and give it a 10% chance. My bets were on the steroids, and I'm frustrated that they didn't have any affect since that seems to have been the only variable that really changed between when things were fine and now. The good news is that the steroids have completely wiped out my skin GVHD. They have also given me a ton of energy and are probably responsible for me being in as good of a mood that I'm in, given all this. I actually enjoyed myself this weekend! Oh, and my chimerism results from Friday show that 100% of my granulocytes (bacteria-fighting cells) are still donor cells and 51% of my lymphocytes are still donor cells. This is good, since it means my donor stem cells are still camped out in there and that they weren't wiped out by my old immune system. That would have been a graft failure. Right now they're calling my condition a graft dysfunction. This is sort of good news, since it means there could be an alternative to curing the problem that doesn't involve wiping it all out again with another transplant and starting over.
My oncologist consulted with the transplant team at the Hutch today, who will be presenting my case at their weekly conference to figure out how to proceed from here. In addition to options such as hoping the cells wil recover on their own, there has been talk of doing another transplant with cord blood, re-transplanting with the same donor, or treating this as an entirely new disease like Aplastic Anemia. So after Wednesday we should have a better idea of a plan going forward, unless the counts start suddenly going up by themselves in the next few days. Luckily I feel fine physically and Johanna and I did a bunch of fun stuff this weekend, though our spirits are down a bit especially each time after leaving the doctor's office. I don't think we're overly *worried* about the future, since the doctors are smart and we've gone through tough stuff before. It's just dealing with the drama and the realization that it looks like we're up for another tough fight and all the gearing up required to go through with it. But you gotta just take things one day at a time. I'm not in the hospital or anything and can still function like a normal person day to day, so I can't ask for too much more than that at this point.