Where are we, and what direction are we going?

So first the good news: white blood cell count is back in the normal range.  Sounds good-and yes, you may well be tempted to stop reading right now.  There is however one pesky little detail-the count was brought up with a Neulasta injection (think: steroids to pump up white blood cell production in the bone marrow) and we don't know if it is stable or just on its way back down to the subnormal level prior to injection.  I think this would be a Rumsfeld 'known-unknown' in his infamous quad matrix.

Now you'll love this: the best Hematologist/Oncologist docs on the planet don't completely understand: (a) what causes us to produce white cells in the first place, and (b) if there is a 'feedback loop' (the proverbial thermostatic regulator) for white blood cell production. Kind of like the good news, bad news joke: Bad news is we're lost;  good news is we're making great time.

With your brilliant powers of intuition, logic, and reasoning, you've likely already arrived at the plan: check the count in a week, and if low, repeat Neulasta.  I should probably buy stock in Amgen soon...it also helps to maintain an inexhaustible sense of humor, although for that I'm still trying to locate a vendor.

Thanks for your many kind wishes, support, and encouragement.

T

Ahhhhh Hahhhhh!!!

So the bright idea of stopping meds, supplements, and having a Neulasta injection resulted in a dramatic increase in white blood count (to over double the upper end of the normal range).  Conclusion: apparently my bone marrow CAN produce white blood cells when appropriately coached and pharmacologically encouraged!  Yes!!!

So back to the Oncologist in a week and continued monitoring (what else is new?).  All kidding aside this was great news and allowed me to stay in Bend Oregon for a week of skiing and fun with both daughters, SIL (son-in-law), my better half, and last but far from least,  Vyx our resident canine. 

Many thanks again for your kind wishes, prayers, and encouragement and I look forward to connecting with you again soon.

Best wishes

T

Hmmmmmmm

So what is the famous Rodin sculpture puzzling over?  Hopefully a recent quandary in my treatment.  Much as I feel well overall and seem to be recovering nicely 3 months post stem cell transplant, a routine couple of white blood cell tests a week apart were below normal and my Oncologist isn't sure why.  (That's really him sitting and cogitating over this mystery in the Seattle February sun yesterday).  

All components of the blood originate in the bone marrow, and a useful test in understanding a hematological disorder is a bone marrow biopsy, the joys of which I experienced this morning.  A brief summary: After entering the back of the hip with a long hollow needle, the marrow is aspirated, placed on microscopic slides, and studied by a Hematopathologist to determine the cause of 'neutropenia' or a low white blood cell count.  Won't have any news until tomorrow evening at the earliest but will break the suspense as soon as we find out.  Suffice it to say there are many possible causes of white blood cell formation disturbance (both red cells and platelets are OK), but speculation isn't going to help-the bone marrow biopsy is the acid test.

I was reluctant to post this somewhat vague message, but I sense that family and friends want to be kept in the loop, and rest assured I'll keep you in suspense as little time as possible.

Thanks again for your continued and kind support and watch for an update soon!

*****UPDATE Friday 2/10/2012*****

Preliminary bone marrow biopsy shows white blood cells not being made in the bone marrow.  Oncologist thinks this might be due to some toxicity, as yet undefined. 

Treatment for now: Stop all medicines and supplements; Neulasta injection (that may boost white blood cell production) and followup 2/15 with Oncologist. 

Thanks for your wishes and prayers.

T

Holding Up

OK, it is pretty corny-the gag photo in Arches National Park, Moab, UT-holding up the arch-on a road trip with my better half and our deputy dog Vyx. Slowly returning to something approaching normal, whatever that is.  Many friends have talked about the 'new normal' to indicate some diminished status due to illness, injury, etc. Hopefully a return to an old normal will occur-guess we will all have to remain tuned to find out.

Anyway Happy New Year to you all and I wish you a fun and healthy 2012!

Warm wishes

T

Happiest Holiday Greetings!

The National Christmas Tree in Washington, DC 2010

As a brief footnote, visit to the Oncologist today showed steady progress with blood values returning to or already normal and no medical issues of concern.  Next visit 2/1/2012 with an interim CT scan as part of the standard oncology patrol.  Returning to regular exercise and easing back into condition slowly but surely.

NOW, my big wish: For all of you to have a wonderful holiday season, no matter your flavor of religion.  Enjoy your family, relish the spirit, and give thanks for all you have to be thankful for.

You have all helped our family incredibly with support, encouragement, and kindness that seems boundless and I know my recovery has been faster and better for it.

Have a tremendous holiday and I wish you much health and happiness in 2012.

Warmly

T

Report Card

Good report from Oncologist visit today-blood counts OK in general and recovery from stem cell transplant is progressing well.  There is some residual immune suppression related to medications used to 'condition' (read: annihilate) the bone marrow prior to the stem cell transplant.  This is normal and will recover over the coming weeks.  Advice is to stay close to home and away from virus carriers,  and unfortunately that can include almost anyone.

Much as I would like to see each and every one of you in person, clearly that would be foolish for now.  Rest assured that I am working hard at recovering and will look forward to connecting as soon as I'm given the medical 'thumbs up'.

Thanks again for your support and understanding, and warm wishes to all.

Snoozerama

Yup-that's what I look like half the day.  Seems my job presently is to nap and keep nausea at bay.  Definitely improving each day, but it does feel kinda slow.  Wonderful being home-in to see the Oncologist this Thursday 11/10 for follow-up and will post anything of interest at that time.

Just hanging out at home to avoid the nasty viruses that seem to spread like wildfire this time of year.  Much as I have an immune system, doesn't seem much point in putting it to the test for the time being.  It seems there is plenty on my plate already...

Don't feel any need to reply-just wanted you all to know I haven't forgotten about you, but in between taking anti-nausea meds and snoozing, there wasn't anything to report.

I appreciate all your support as always.