Wednesday, October 24, 2007

Crazy, Sexy, Nuts

D +148

Today's CBC results:

WBC 4.7 K/uL
RBC 3.04 M/uL
HGB 9.9 G/DL
PLT 469 K/uL
ANC 3.49 K/uL
LDH 559 IU/L

OK so the numbers look good. True to form Ann's baby stem cells seem seem to have a fixation on making platelets. I guess they have a talent for it so I'm not going to discourage them.

Apart from the daily CBC results we also got feed back on two other important tests. The first was the final results from the pathologist for the bone marrow biopsy of a couple of days ago. Turns out Ann's marrow has 1% blasts and they are all normal cells. There is also no evidence that the PTLD managed to infiltrate her bone marrow. Since the CT from last week showed the kidneys, liver and spleen where unaffected, that means the problem is isolated to the lymph nodes in her neck, abdomen and the large colon.

Also in the good news category we got the follow up test for the EBV viral load in Ann's blood. I know we didn't post it last week but the initial test showed (+-) 172,000 viral copies/uL of blood. After the 1st does of Rituxan the amount of virus in her blood has dropped to (+-) 3,200 copies/uL. As I understand it healthy people who have had Mono usually show up with about (+-) 200 copies/uL. I've been cautioned that you can't just treat a viral population as a static quantity, but a 53 fold decrease has got to mean something is working like it should. Combine that with the increase in RBCs and HGB over the last couple of days and I am cautiously optimistic.

The attending physician mentioned today that it was possible that Ann might be released from the hospital as soon as tomorrow afternoon. That depends on the results of the CT scans (we have one more tomorrow). If the Rituxan is working like it looks like it is then the lymphoid tumors and edema should show improvement on the scans. How much Rituxan she has to have after that or if there is some other treatment required (Chemo, CTL, Radiation) isn't clear right now.

After almost three weeks in the hospital Ann is starting to show some fine cracks around the edges. I think its the cumulative stress of dealing with not knowing what was wrong with her at first, expecting just some antibiotics and then being cooped up for a longer than we imagined. When she heard that we might be released tomorrow she got excited. That is until she thought it through and realized that we would have to wait here in Houston for the test results and procedure planning Monday.

So unfortunately it looks like Ann is going to have to spend her birthday in the Hospital this year. It makes me sad to see this small thing taken away from her, but I'm determined to make it the best I possibly can. Being sick sucks... not just for the big things you miss out on, but the small ones too.

We spent the night watching the documentary Crazy, Sexy, Cancer on TLC. After watching it Ann and me sat down and talked about it and came to the conclusion that the show really avoided the subject of cancer all together. Instead it concentrated on macrobiotic diets, crazy theories, and quackery.

I suppose that was because the subject of the documentary had been diagnosed with incurable cancer, which as it turns out later is stable and not progressing. People in that condition will do almost anything to try to save themselves, and when science and medicine fail what else do they have to turn to but hucksters and self help books? I admire the spirit of the film, but there are loads of things like listening to your doctor, aggressive treatment or clinical trials that can be done before turning your piece of mind over to wheat grass enemas administered at strange clinics and eating sprouts every day for the rest of your life.


Carilou said...

I knew it was going to end up to be an annoying glitch and nothing super dangerous.
I also know tomorrow is your birthday. HAPPY BURPDAY!! As usual, you should not expect a card from me. Maybe in 2008 I'll be better with these things.

Nancy said...

Hey Ann, Happy Birthday Girl!!! Great Blood Counts, as usual! We've come to expect great counts from you... but we never take them for granted! We're also happy about the BMB results and that the PTLD is somewhat isolated. Keep up the good work... relax and recooperate! love, Nance