Back in the Saddle

Back to the same ol'...bi-weekly blood checks that always turn into blood transfusions.  At least I know the drill now! Not only that, I'm becoming quite familiar with the nurses and receptionists at the clinic and they with me.  It's nice to at least not feel like a number.  I'm also becoming familiar with my friend Tim who helps me with admitting at the hospital (I have to go to GW for the transfusions...it's just a block from the cancer clinic).  He's helped me every time.  I asked him this last time if there's a rewards system I can take advantage of.

So, I was good on Monday the 15th, just a few days after ending my last does of chemo.  As expected.  Friday morning (the 19th), I noticed bruises and little red dots popping up on my legs.  Bummer.  I knew that meant I'd at least need platelets after my appointment that afternoon.  Sure enough, all my counts had dropped.  I was officially neutropenic again, meaning I'm prone to infection with no immune system to speak of.  And, I did require platelets.  Over to the hospital it was for the inevitable wait it is to get a transfusion.  I finished up about 9:45 that night.  The next morning I woke up with this crazy low back pain.  Actually, it was so low it wasn't really my back; more like my sacrum.  I was told to contact my doctor with low back pain after a transfusion, and I kept debating if I should.  I decided to at least email him.  Within a few minutes of sending the email, he called me and wanted me to go to the ER for a CAT scan to make sure it wasn't an abscess (that can happen, though rarely, in leukemia patients).  After 4 hours at the ER, the CAT scan came back clear and I went home...though still in a lot of pain.  Sometimes it would shoot up into my sternum.  I realized it might be due to a shot I'd had that Monday to boost my white blood cell count.  One of the side effects was bone pain as your bone marrow kicks into high gear to produce more white blood cells.  I couldn't have this shot after the first round of chemo because the tumor, which originated outside the bone marrow, was composed of white blood cells.  This round, since the tumor was gone, I could have it.  This was a good thing because it would prevent me from being neutropenic for so long.

Sure enough, this past Monday (the 22nd) at my blood check my white blood cell count had shot up from the Friday check (at which point it was basically non-existent).  Hoorah!  The shot worked, and it was indeed the cause of the pain.  This meant I could eat fresh foods again, stop taking all my anti's (antibiotic, antifungal, antiviral), and I had an immune system.  I did require a blood transfusion and spent the rest of the day and evening at the hospital taking care of that.

As of today, Saturday the 27th, my numbers (platelets, hemoglobin, white blood) are recovering and I am done with transfusions.  After about 42 hours of chemo, 3 MRI's, 2 PET scans, several CT scans, and 6 blood transfusions, I get to have my PICC line pulled next week!  As for the next month or so, I'll meet with the radiation oncologist to make a plan for my radiation treatments (which I'll schedule for the end of May/first of June), as well as with a doctor at Johns Hopkins to discuss the possible role of a bone marrow transplant.  Again, this is still not certain.  This doctor is my oncologist's mentor and, as such, Dr. El-
Shami thinks it beneficial to meet with him.  Dr. El-Shami himself doesn't feel, at this point for my case, that the benefits of a bone marrow transplant outweigh the risks.  But, he does respect the opinion of his mentors at Johns Hopkins and wants us to have all the information for all parties to make the best decision.