It’s now been 142 days since the transplant on November 18th, looks like this is only the second time I’ve written about this since I came home in early December.
Around day 30 they did a chimerism test, to look at my white blood cells and see how many were from me and how many were from the donor, and it was good, indicating all donor. On day 102 they did a bone marrow biopsy and another chimerism test, and both had good results: no sign of leukemia cells, and again, all donor, no me.
So things have been going about as well as can be expected for all this. I’ve been gaining weight, though slowly, two steps forward one step back. They’ve been slowly reducing the amount of immunosuppressants I take and I should be off them completely in a few months, unless I get some of the more severe symptoms of graft-vs-host-disease. They also reduced my visits from weekly to every-other-weak recently, which is nice.
A few appointments ago the doctor told me I have very elevated levels of iron, maybe 10 times a normal amount, though he said it wasn’t cause for concern. He explained how our bodies hold onto iron pretty well because meat is difficult to get in nature, and with all the blood transfusions I had last year my body accumulated a lot of excess iron. So the solution apparently is to donate blood, except in my case they’ll have to throw the blood away, so it’s basically blood letting. So I immediately thought of that SNL sketch with Steve Martin as the medieval barber/doctor who uses bloodletting for everything — “Gilda, get the leeches!” (And according to that wikiepdia article this sketch was done a few times, which might explain why that quote I just used isn’t in the transcript I found. Or my memory might be wrong.)
So we haven’t started doing that yet but it’ll be once a month for a while until my iron is in a more normal range.
In general I’m feeling alright. I’ve been working on modeling jewelry again and am working to better organize how I share it here, I’m enjoying that a lot.
I’m trying to embed that SNL sketch below but it doesn’t seem to work, I can’t even get it to play when I go to the site, but here is a link if you’re interested. Or if you have Hulu apparently it’s on there too.
Edit: figures, now that I’m ready to post this the embedding seems to be working, thanks NBC!
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So I came home last Monday from the transplant process, the hospital stay wasn’t quite four weeks long. I think I went in on November 11th and left on December 5th.
So far things have been going about as well as can be expected, I’m still having some issues but that’s normal. The transplant process itself went fine, and the next 100 days will be careful watching for symptoms of graft vs. host disease, so I’ll have a couple appointments a week for a while, if things keep going well it’ll drop down to once a week.
I’m sort of quarantined a little bit, they want me to avoid crowds and school aged kids, but I can have visitors, they recommended keeping it to no more than 2-3 at a time.
My sense of taste is probably the worst symptom at the moment, it makes it pretty hard to eat. Oddly I can still smell food pretty well, but most of it tastes kind of bad. Sweet things are decent, but salt is very absent.
That’s about it for now. Just a lot of waiting and taking my time with things.
So I was released on Wednesday, the 19th, and have been home the last two days. My ANC was 320 Wednesday morning, which was really discouraging, since it had been 400 the day before and they had told me if it remained at 400 I could go home. So I spent a few hours thinking I’d be stuck there at least a few more days. But then later in the day they told me that they don’t think anything weird is happening, my numbers are just kind of bouncing around a bit, which is fairly typical, and since I’ve been through all this repeatedly they trust me to look for signs of infection and seek medical help if I have any complications. And since I was just waiting around to recover, I might as well do that in the comfort of my own home. So I got to go home! They wanted to give me a blood transfusion before leaving, cause my hemoglobin was like 7 something, and outside the hospital they want it to be at least 8, so they did a transfusion and then another blood count and it was really good news, my ANC had gone up to 370, my hemoglobin was 9 I think(?) and my platelets had ticked up a little bit from the morning as well.
They did a bone marrow biopsy on Monday, but it was kind of too early, there were blast cells, which could potentially be leukemia cells, but they may also just be normal healthy cells that haven’t matured yet. So they’ll want to perform another biopsy sometime soon, this week probably, and if that looks good I should be all ready to start the transplant process at MGH. On Monday I’ll go in for a more routine checkup to make sure the numbers are looking good, and then my hope is, if all that checks out, we can go into the transplant process as soon as is possible. I’m nervous about it, but I’m more nervous that any waiting is giving the leukemia cells more time to regrow.
Someone contacted me about reworking the octopus to be smaller. I’ve wanted to redesign a lot of things about it for a long time, so I might actually try to do that finally. It has me digging through old project files trying to decide how to go about it. I had also begun a cuttlefish model not long ago, so I might just start with that instead. I think I should learn about rigging the model up this time, so I can more easily rearrange the legs in the future.
So my ANC has started to bounce back the last few days, 0 to 40 to 30 to 80 to 90 and then 160 today, and so I’ll probably be going home sometime in the next few days, maybe Wednesday Thursday or Friday (not likely tomorrow).
I had an infection last week, my temperature briefly spiked to
I thought about titling this post “biopsy negative!” but decided that could be misinterpreted, and “biopsy positive” could definitely send the wrong message, so I went with the primitive sounding “biopsy good”.
So this morning the doctors came in to tell me they didn’t find any signs of the leukemia in my bone marrow, so I’m back in remission. Now it’s a matter of waiting likely another 11-21 days (could be shorter, or longer), for my immune system to regrow enough to fight off infection on it’s own. Then, assuming I’m in good health (which seems likely right now, I walked three miles last night without difficulty), then I’ll head to Boston to begin the transplant process. I guess there’s a chance I could get a fever, as I did in the past, before my immune system is mature again, in which case that would delay things a bit, but once I’m strong and healthy we’ll try the transplant.
I’m nervous about the transplant process, there’s a lot of uncertainty, but in my favor are my age and health, and this is the best shot at curing me, or at least prolonging my life for a good while, so I’m also anxious to begin — the sooner it starts the sooner I’ll be able to work on recovering and finding out if it worked or not. And also the less likely the leukemia cells will regrow into a problem again.
I guess I could mention too, I’m at the stage where the later chemotherapy effects are starting to happen, my hair is just beginning to fall out, and my sense of taste seems to be changing again, though it’s hard to explain exactly how. In both cases they seem like relatively harmless effects, I’ve been lucky that my digestive tract has remained pretty healthy, and my mouth too. Sores in the mouth are a common symptom and so far I haven’t really had that, though a couple days ago my platelets were very low and I apparently accidentally bit my cheek while eating a cookie, and a blood blister formed right away. But I got a platelet transfusion the next morning and I’m not much of a bleeding risk again for now, and the blood blister is going away quickly.
Chris, the Creative Visual Artist for the Norris Cotton Cancer center, (where I’ve been treated all this time — which just reminded me, someone asked for my address and I forgot who…), asked me to share some of my photography for an artshow later in October, so I need to write up an artists’ statement and get a couple pictures printed, and framed, to be hung. That’ll be fun. And after I post this I’m going to go back to fiddling around with some programming ideas, see if I can get back into the programmer mindset.
Thanks for reading!
So I’ve been back in the hospital for two weeks now, I finished the last dose of chemotherapy a week before last Friday, and have been waiting for my numbers to drop and rebound. Right now my ANC (immune system cells) are practically zero, white blood cell count is at 0.1; hemoglobin and platelets have dropped and I’ve had some transfusions, a couple red blood transfusions and a platelet transfusion.
I’ve been walking a lot, usually a two or three miles a day, often without supervision, which is nice, because I haven’t had issues passing out in months, and have been feeling pretty good.
Because today was day 14 since beginning the “re-induction”, they did another bone marrow biopsy. When I came in this time my doctor told me how the first time they did a bone marrow biopsy back in February, my marrow was 100% leukemia cells, and after that first induction it was down to 5%, and after the first re-induction it was clean, which is considered remission. This time the bone marrow was 5% leukemia cells, and we used a different pair of chemotherapy drugs, because it is assumed that the leukemia cells which survived the previous drugs are most likely ones that have adaptations that protect them from the previous drugs. So I’m not worrying much about whether this one worked or not, though I didn’t really ask the doctor about odds specficially, so I guess I’m a little uncertain in that sense.
Assuming the biopsy they did today is clear, and I’m again in remission, the plan will be for me to wait here until my ANC recovers, and then probably head straight to Boston to begin the transplant process. If I’m weak they might send me home to regain strength first, but I think I’m pretty well in that respect, probably mostly due to the daily walking. I feel quite well, though I think my hair is beginning to fall out again, which is expected, and my taste may be getting weird, which may be an indication of my tastebuds dying off, which is also expected, and also tended to happen with each of the consolidation chemotherapies.
Meanwhile my app broke when Apple updated their operating system to iOS 10 recently, so I scrambled to update it, and today it got approved and updated in the App Store, which is a relief. It also served as a refresher course in programming, which is good because I have some ideas I want to explore, to get more comfortable with what I’m doing. So I’m excited about that.
Other than that I’ve got a lot of waiting and time to kill. I’ll update again when I know something about the results of the biopsy!
So I was re-admitted to the hospital on Monday for another round of induction chemotherapy, it consisted of two new (to me) drugs, each administered once a day for five days, so last night was my last dose of each. Now I’ll be hanging around for the next three weeks, waiting for my counts to drop down and then rebound, after which I’ll head to Boston for the transplant process.
So far it’s been pretty easy going, I’ve been walking a lot, which is both good for my health, and allows me to avoid painful shots in the stomach that they give to most patients to help avoid clots from forming in the calves. Today they disconnected me entirely so I can walk around without pushing the pole of fluids with me, which is nice too. It could be a little rough over the next two weeks, I’ll probably need some transfusions as my blood and platelets die off temporarily, though it shouldn’t really be anything I haven’t already seen in the past.
I have a lot to work on, and plenty of distractions. I should make more of an effort to try out some things, and I also have to delete photos to make room on my computer and my phone. That’s all for now!
So somewhat bad news, they called me back yesterday because the cytogenetic analysis of my bone marrow indicates the leukemia is still there, so Monday I’ll be readmitted at Dartmouth Hitchcock for another round of induction chemotherpy — it’ll be a lot like the first two rounds I went through, but not the exact same since whenever something survives one treatment they try to come at it from a different angle. I don’t know the details exactly but my guess is it’ll be about a week, and after that they’ll try to go right into the transplant process, so I’ll be moved down to Mass General.
It’s scary, which I’m sure is natural. Though I feel somewhat prepared, since the original cytogenetic analysis indicated it was likely to come back anyway, and also because I figure the next step was to knock out my immune system entirely to prepare it for the donated immune cells, so it seems like another round of induction fits in well with the planned process anyway. That’s just speculation though, I’ll ask the doctor Monday and get a better idea of what I’m facing, and try to keep this up to date.
So I’m back up at Dartmouth Hitchcock for a third round of consolidation chemotherapy. It started yesterday afternoon and if all goes to plan I should be heading home Monday evening after the last dose. The last two went well so I don’t expect this to be too different, they let me walk a lot and that allows me avoid these painful shots in my stomach that they usually give daily to most patients to help prevent blood from pooling or clotting in the legs. The shot is usually painful, first with the pinch of the needle, and then with the stuff they inject, so the nurses don’t like giving them either, so it’s a win-win. Plus, walking is probably my best bet at keeping my health up for the next step, the bone marrow transplant, which is apparently going to be a much harsher and longer process than these consolidation chemotherapies (which really havent’t been too bad, the complications in the weeks following have actually been worse, the nosebleed and the fever, but even they were relatively tolerable).
I got to see Allison a few times before coming back in, which was just great, hanging out with her really helped take my mind off things some. Not that I completely forgot whats going on and what lies ahead, but it stopped occupying my attention so much, which had started to happen for a while I think.
I forgot my phone cord so my phone is about to die, but I have my laptop and cord, so email or facebook are reasonable ways to contact me, or leaving a comment here (though my cousin said she couldn’t? I haven’t been able to figure out any problem with the commenting yet).
My plan was to go back to programming some, but without being able to test it on the phone it’ll be hard to go to far. Stefan also left me with plenty of reading material, and I still have a book Jared lent me that I haven’t finished, so I guess I should spend more time with paper and less time with liquid crystal displays.
Guess that about sums it up for now!