Round and round we go

Another three weeks, white blood cell count low again,  and another Neulasta injection-my keen powers of observation are sensing a pattern.  Oh, and I'll be back in a couple of weeks for a recheck-bet you didn't see that coming either.

A dear friend (who is also a revered Hematopathologist) was kind enough to review my bone marrow biopsy.  The paraphrased executive summary: 'Your bone marrow has kinda been kicked in the teeth, but will likely recover given time'.  The full version was much longer and erudite, but I'll spare you the details- he agrees that tincture of time, patience, and Neulasta nudging is likely all that is needed.  Very reassuring when you realize a bone marrow is a terrible thing to lose-maybe worse than your mind...

So I won't bother you with an update for at least a couple of weeks 

Warm wishes

I'm Odd

I know what you're thinking-and this is news???  


Turns out my Oncologist has never seen a patient (after chemotherapy/stem cell transplant) who has developed a profoundly low white blood cell count requiring therapy-proof (as if you needed it) that I am in fact, odd.

Now I suspect the next thing to cross your mind is: am I willing to stoop this low just for some attention?

The truth is: no, but seems I'll be getting Neulasta injections for the foreseeable future anyway.  In Oncology this qualifies as attention, and trust me when I say there are easier ways to get it.

Synopsis: onward with injections and the medical version of 'wait and see what happens' (known as expectant observation but I was too embarrassed to write that).

Best wishes to all and I very much value and appreciate your continued interest and support.

Interim post

Synopsis: white blood cell count again below normal and going for repeat Neulasta injection Friday; anemia a little worse despite taking iron 3X/day (and what a joy that is).

Kind of 2 small strikes, but still at bat per the umpire...

T

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