Monday, June 30, 2008

What a day. Before the mystery berry barium made it into my room one of my favorite people from the bone marrow aspiration clinic popped in loaded for bear. Terry surprised me with the news that I'd be getting the BMB on the spot. It was a little more uncomfortable than usual, but I attribute that to the smallish stature of the woman performing the actual "punch". Terry was assisting on this one.

As soon as they left the room, my nurse delivered two canisters of frosty barium. At precisely the same moment, my food showed up. I had placed the order before any one had a firm time for the scan. Since you can't eat three hours before a CT scan, I had to stare longingly at my breakfast/lunch while I slurped on a gritty whitish slime. Did I mention that I'd been fasting all day and was starving?

The CT scan took forty minutes, which doesn't include time spent waiting. I made it back upstairs in one piece, only to be met by a phlebotomist who'd been waiting to get a few samples. If any one's counting, this was my third draw for the day. It all has to be taken from my left arm since the IV is in my right arm. It would appear that the two other draws didn't include EBV tests and that was the reason for lucky number three. Who knows when we'll get the results since the vials have to be sent to a lab in California for analysis. Add in the holiday weekend and I'm thinking there's going to be an increased wait time.

I should remain unmolested for the rest of the evening; save for the taking of vitals in four hour increments and IV changes. Can't get enough of that crazy saline. Actually, because of the quantity of iodine injected into me, it's a good thing I'm getting the extra fluid. My kidneys need all the help they can get.

Our friend Nancy called in the midst of all this to catch us up on what's going on with her. She's two years post BMT and she's been such an inspiration and friend to us. She's had a cough for a few weeks and some difficulty breathing and her local doctor has been treating her. Today she found out that she has pneumonia, so please send as many positive thoughts as you can to her. We're both in a bit of a pickle with our predicaments and I'm just hoping that we'll both resolve quickly with no complications.

We're anxiously awaiting preliminary results from the bone marrow biopsy. The whole of the test won't be back for a few weeks, but they should know blast counts, etc., in the next day or so.

We asked Dixie to move forward on the closing of the house for us, but there's been a snafu on the part of the lender. We've been hounding them mercilessly to be sure that they had everything that they needed in the hopes of avoiding this situation. Our title company still didn't have the loan packet as of this morning and when Chris called they informed him that a third party hadn't turned in some paperwork. They needed his last employer to verify employment and because the one guy still at the office sat on it for a week before sending it off, Chris's dad didn't receive it until today. In addition to all of this the lender wants a copy of some of my bank statements since I'll be handling closing costs. They knew that from the beginning and only thought to ask for it today. They also want a letter from Chris stating why he left his last job. This one's going to be a winner.

I know the credit market is scary these days and banks are only protecting their best interests, but give me a break. If they need to know my blood type, we're screwed because I still haven't fully transitioned over from A positive to B positive. The closing has been put off until next Monday and I'm afraid that we're still going to have to impose upon Dixie to handle the closing for us. I don't know what we'd do without her. First she has to handle the selling of our townhouse and now she has to facilitate the closing of the new house. She definitely gets the best mother of the year award.

So now you're caught up as far as I can remember. When I get some news, I'll post again. It'll probably be Tuesday afternoon or evening. I'll go ahead and confess now that I'm fighting a powerful urge to call Dr. Anderlini Dr. Anderweenie just to see if I can get away with it. This place must really be getting to me.
I've got a CT scan booked for 4:30 and the barium has just made it to the floor. My nurse is supposed to bring the first cup in a few minutes. Berry flavored--adventurous. A nice young man from the CT team just left my room after confirming that I'm in good shape and able to do this. Unfortunately, he had to break the news that I'd be getting IV iodine contrast in addition to the barium and--wait for it, rectal iodine.

That's just not cool.

I've done this before and it's not the most comfortable experience. That's all I'm going to say.

UPDATE

In light of the blast findings, the rituxan has been placed on hold in favor of a bone marrow biopsy. I still don't know anything other than it looks like I'll be here for a little bit longer.

Really

Day 4 of my captivity:

WBC: 19.1 K/UL (4.0-11.0)
RBC: 3.77 M/UL (4.00-5.50)
HMG: 11.7 G/DL (12.0-16.0)
PLT: 295 K/UL (140-440)


With numbers like these, what can I say? My white blood cell count is high and it's made quite a jump from yesterday. My red blood cell count and hemoglobin count are falling. I'm just stating the obvious.

Dr. Anderlini made an appearance today and judging by his behavior, I must have smelled like manure. He couldn't get out of my room fast enough which was puzzling. He told me that Dr. Kebriaie would be out of town until next week, but they were in constant communication with her about me. He also informed me that the reason for me being admitted to the hospital was so that I could get a dose of Rituxan while she was away. I'm taking this to mean that if she'd been in town, I would have just gone to see her in clinic, etc.

The CT scan that I've been fasting for all morning has been canceled. Dr. Anderlini informed me that I'd be doing it as an outpatient. He paused long enough to give Chris a chance to ask a question. Chris asked him if he thought this could be EBV to which he replied, "I don't know." He also said something to the effect that it wouldn't be worth running any other tests today and that Dr. Kebriaei felt that with my history of PTLD that it would be a good idea to start Rituxan before the EBV test comes back. It would seem that the guys in the ER didn't run that test, so we'll have to wait until sometime next week for the results from today's blood draw.

I've signed the consent forms and am just waiting for the Rituxan. I've concluded that the sooner I get it, the sooner I can break out of this joint. I don't know if they'll pre-medicate me or just let me have it straight. The first time I got a dose of it I ran a fever and had severe chills.

Chris just came in with a copy of my differential counts. I'm showing 14% blasts. We're waiting for the doctors to come back and talk to us.

Sunday, June 29, 2008

S.O.B.

WBC: 14.7 K/UL (4.0-11.0)
RBC: 3.93 M/UL (4.00-5.50)
HMG: 12.0 G/DL (12.0-16.0)
PLT: 264 K/UL (140-440)
ANC: 11.32 K/UL (1.70-7.30)

So my cunning plan to escape my beige and taupe prison has been thwarted.

As you can all see, my white blood cell count has increased over Friday. My red blood cell count and platelets are dropping. My absolute neutrophil count is astounding.

I actually saw Dr. Khouri today and he expressed some concern about my CBC. He's ordering a full work up for tomorrow, including a CT scan and bone marrow biopsy. In his words, "it's going to be a full day." So as it stands I'm keeping the mystery, so to speak. Dr. Khouri cautioned us that it still might be nothing, but it could be EBV, and it's not out of the question that it could be a relapse.

He advised us to post-pone closing on the house for at least a week. His feeling is that we'll know what we're dealing with in that time frame. I just hope the sellers are cooperative. If worse comes to worse, Dixie has power of attorney and can close for us tomorrow.

So there you have it.
No news yet. Just waiting to see the new rounding physician. It's Dr. Anderlini today.

Saturday, June 28, 2008

tacopenia

Day +395

I finally got admitted into the hospital somewhere around 3am and by that time Chris and I were just happy to be able to go to sleep. My night nurse was very accommodating and went through my paper work as quickly as he could. I managed to get 4 solid hours of sleep before someone came in to do my vitals. It was all down hill from there on the sleep front, so I'm a bit bleary eyed.

My rounding physician was Dr. Khouri. I haven't had any prior experience with him, but know other patients who are his regulars, and they all love him. I found him to have a good sense of humor, which I find is important in dealing with me on this level. He questioned the need to have me admitted, which I supported. I'm not having any sort of medical "crisis" and was complaining to Chris that I probably could have been seen in clinic next week. Now, considering that all of the parties involved were erring on the side of caution, I have to concede that everyone was acting in my best interest. My doctors were being aggressive in the face of a mystery illness, and I'm sure most patients in this situation can appreciate that.

Dr. Khouri suspects that I'll have a bone marrow aspiration in a few days just to rule some things out and get a clearer idea of what we may be dealing with. The node in my neck has virtually disappeared and the one in front of my ear feels a wee bit smaller. That could be my imagination, though.

I'm hooked up to an IV via the traditional route: there's a big needle cradled in the crook of my right elbow. It gets occluded every time I bend my right arm slightly and sets the IV pump's alarm off. I managed to knit with straight arms for about an hour before I gave up. Even that made the alarm go off every few minutes. I'm sure I shouldn't, but I turn the alarm off myself. I'm not medically trained, but after nearly a year of dealing with the beeping little monsters, I've learned how to program them on a very rudimentary level. Occlusion in the line is the only fix I'll attempt. I'll leave the rest of it up to the pros.

I'm receiving one very exclusive and designer drug via the IV. Even Chris was impressed when the nurse came in to hook it up. You may or may not have heard of it: Saline.

I made the argument last night that since no one thought that I'd be receiving any drugs intravenously that perhaps they could hold off in putting an extra hole in my arm. The ER doctor felt that I would probably get some sort of drug therapy, so I lost that round. After Dr. Khouri elected to treat me with a broad spectrum oral antibiotic, I tried the argument again on my assigned nurse. No dice. Where's Charles Bronson when you need him?

I'm being kept through the weekend for observation, although Dr. Khouri indicated that if we had been local, he would have discharged me since there's no real reason for me to be here. I'm not running a fever and haven't had one since my mystery illness at the beginning of the month. All of my regular bodily functions are normal and my appetite was excellent up until this afternoon. When I was confronted by "room service" food my appetite went into hiding. I still ate my cardboard sandwich and potato salad and even ordered something else an hour later. It was just as bad, but that didn't stop me from eating it.

I have noticed that a few changes have been made to the menu. Chris's favorite cookie has been banished to be replaced by almond cranberry crunch. The "beef medallions in brown sauce" have disappeared. Soft tacos are still available for order, but if I were you, I wouldn't. It occurred to me that hard tacos never make it into the rotation. When I informed Chris that the menu was sadly tacopenic, he snickered and told me to order a quesadilla.

So, to summarize this post: please don't worry. The doctors and nurses who have seen me in the last 24 hours aren't.

Friday, June 27, 2008

Back at MDA

Day +394

We are back at MDA in the Emergency Center, waiting for Ann to be admitted. For those of you doing a double take and thinking "Whoa! That was fast", it was so let me catch you up.

Ann had a follow up with her local hematologist this morning and at MDA's insistence he drew a more detailed set of labs. Mainly what Dr. Kebriaei was looking for was how high Ann's LDH was, because she suspected PTLD. Which if you look back to our October 2007 archives you will see was the cause of Ann's first set of enlarged nodes. As it turns out the LDH numbers aren't that high 164 IU/L, which is the bottom end of normal for an adult. Does that mean the PTLD has not come back? Unfortunately, No. PTLD does not always cause high LDH in it's opening stages.

So exactly why are we at MDA, instead of crossing all the "t"s and dotting the "i"s on our up coming house purchase Monday, and getting set to move? Doctor Bienvenu (the local Hematologist) is pretty thorough, and after a month of elevated WBC counts he did a peripherial blood smear (several actually) this morning. After looking through several samples--in his own words, "very hard" he discovered 3 unusual cells.

He said they did not appear to be lymphoid blast cells (read: product of Ann's original leukemia). At the same time, he is at a loss as to how to accurately describe them beyond "strange". All the other partners in his practice came to the same conclusion: those are weird looking, but we don't know what they are. So he called MDA and spoke to Doctor Kebriaei, who basically told us to drop everything and head to Houston pronto. Her plan is treat Ann inpatient, probably on the BMT floor of the hospital, for whatever is going on.

We asked Doctor Bienvenu if we should cancel our closing or abandon the sale. He said "No". So we only made one stop to our attorney's office to sign a power of attorney so that Dixie can close the sale for us.

Turns out with heavy traffic and construction you can make the trip from Baton Rouge to Houston in about 4 hours and 15 minutes...if you don't mind excessive speeding the entire way.

Between the elevated WBC count for a month, the two swollen nodes, and the 3 "weird" cells, something is clearly wrong. It could be PTLD, or a leukemia relapse, or a reaction by Ann's new immature immune system. Or it could be something else...right now we don't know much.
Day +394

A small bump appeared on the roof of my mouth--same side as the node, late last night. It's gone this morning, and I don't know if I should be troubled by that. I also found another node in my neck, also on the left side. My appointment with Dr. Bienvenu is at 9:45 and my lab work is scheduled for 9. I hate to say it, but I really miss the labs at MDA. They had ridiculously long hours and were able to test for so many more things on the spot.

I'll post more this afternoon when I get a break.

Thursday, June 26, 2008

Day +393

We spent 2 hours and 45 minutes at the doctor's office trying to coordinate information. My local doctor does rounds at a local hospital in the afternoons, so his nurse had to page him in order to find out what he wanted to do with me. Let me just say that I feel really well and I'm not displaying the symptoms that I did previously with leukemia and PTLD.

Here are my numbers:

WBC: 11.5 k/uL
RBC: 4.7 M/uL
PLT: 453 k/uL
HGB: 14.7 G/dL
ANC: 8.6 k/uL
LNC: 2.2 k/uL

While we were waiting to hear back from Dr. Bienvenu, Dr. Kebriaei called Chris on his cell to find out what was going on. Chris filled her in, then handed her over to my nurse for a quick consult. Without being able to see me in person, Dr. Kebriaei wasn't able to definitively say what was going on. She asked the nurse to perform a few more physical checks, but I didn't have any other outward symptoms, save for the small lymph node in front of my ear. GiGi did find that my throat was just slightly red, but that was probably due to the amazing amounts of post nasal drip that I've been having this week.

A differential chemistry hadn't been ordered and when Dr. Kebriaei asked that it be done, it was too late in the day. So, she asked that I be scheduled for an appointment with Dr. Bienvenu tomorrow and that a chemistry be pulled. She's most particularly interested in my LDH numbers since this was the first indicator of PTLD last time.

I almost forgot to mention that my weight is down from the beginning of the month. I started out at 150lbs and now weigh 144lbs even though I've been eating like a champ. My appetite is excellent and I've actually been eating more than I normally do.

For tonight, the diagnosis is unknown. I feel fine, for whatever it's worth. I predict a very busy day tomorrow since there are still utilities to be transferred and I need to make arrangements for an appliance to be delivered to the new place, etc. It's on days like this that I really miss coloring books and recess.
I've found a small swollen node in front of my left ear. I'll be seeing my local oncology nurse this afternoon for lab work and a general examination. My hematologist is going to be out of the office this afternoon. I'll post tonight after my results are in.

Wednesday, June 25, 2008

I'm supposed to be calling utility companies and getting services established, and since it's one of my least favorite things to do, I'll just blog instead.

I've been having a minor GvH flare up lately, which leads me to believe that the baby stemcells are done playing with strange viruses and bacteria and reverting to attacking my skin. This morning I discovered another rash on my chest to add to the rashes on the backs of both ankles and knees, the two on my abdomen, the ones on both upper arms, and the one on my right calf. I'm sure its mirror image will show up on my left calf in the next few days. At least the stemcells share my need for symmetry. It's just a minor nuisance and doesn't get in the way of my day to day living. Most of the shades are drawn just to be safe, since exposure to sunlight can sometimes make these things worse.

The ever present GvH on my fingers has ratcheted up on my right index finger. It looks like I've been gnawing on it. It's constantly red and there are small plaques of scabs across the top of the finger. The finger is also the latest victim of paronychea. Trust me, I know these are very small complaints in the big scheme of things.

Chris's sister is coming into town Friday and we're looking forward to visiting with her and the kids before they make the big move to Vancouver.

I've submitted an application for re-entry into LSU and am waiting with baited breath to hear something. I got a little warning that I'm not in compliance with their vaccination policies which gave me quite a chuckle. I'm hoping that they can overlook this considering my circumstances. I've asked my transplant doctor to write a letter on my behalf explaining the situation, so I'm just waiting on that. I'm a little anxious about having to really engage my brain again. I went from being the kid who really didn't need to study to needing everything repeated a thousand times. It should be interesting. At this point, I'd just be happy to graduate with the minimum grade point average required. I won't stress about it.

As for the house...Angela called Chris with a confirmation for the Monday closing. When it all happens, I'll post pictures, etc. I'm just loathe to tempt fate.

Monday, June 23, 2008

I can't be certain, but I suspect some little corner of hell involves buying real estate as a punishment.

My agent is spot-on amazing, the house we want needs very minimal work and is not in a flood zone. Chris is quite pleased with the lack of yard. I love that the house is close to three drugstores and two major grocery stores and interstate access isn't too far away. What more could we want? What could possibly go wrong?

That shrill cackling you might be hearing is me laughing my head off.

House drama.

Chris has been doing due diligence and talking to the mortgage lender every day just to be sure that things are moving in the direction that they need to be. He was assured that things were indeed headed in that direction. We're scheduled to close next Monday. We even picked up a few things that we'll need to do a few minor repairs.

Today, Chris was tied up in meetings at work, so I was in charge of talking to our lenders. A little voice told me to check in with the title company and the company writing our home owner's insurance policy. I felt organized and in charge. Almost like a real, live adult. The insurance company hadn't heard from the title company and needed a few things faxed over before the policy could be written. The title company couldn't fathom that the insurance company needed anything. The mortgage lender was waiting on the underwriter who couldn't move forward because they were missing key documents. I was on hold for 22 minutes listening to the most God awful ode to commercialism. This company actually commissioned a song heralding their merits and why they should be your lender and it was all set to a bluegrass tune. Each time it repeated, I started to feel less inclined to ever do business with them again. The hold music actually triggered some primitive mechanism in my brain and I started to get angry.

The long and the short of it is that I know that the key documents had been faxed/emailed to the pertinent parties involved over three weeks ago. I'm guessing some one has a messy desk and probably mislaid a few things.

I've been assured that we're still on schedule to close on time. I'm trying to psyche myself up so that I'm not disappointed if the closing is delayed.

On the bright side, I don't have any medical drama to report, and isn't that really what's important?

Tuesday, June 17, 2008

Baby Cells - 1 Bacteria - 0

Day +383

WBC 9.2 K/uL
RBC 4.14 M/uL
HGB 12.9 G/dL
PLT 723 K/uL (!!!)
ANC 7.2 K/uL

The little "Jet Li" cord (aka DUC 8676) has thoroughly and completely kicked the butt of the bacterial infection Ann picked up around the start of the month. Ann's cough, which was pretty rough a week or so ago, has all but completely disappeared. Color me relieved.

The prevailing theory that the baby stem cells overreacted to the infection seems to be supported by her platelet numbers. 723 K/uL is a huge amount of platelets considering the normal range is about 150 to 350. Even that fits with the "overreaction" theory, because you need lots of platelets to plug all the holes that activated neutrophils make when they leave the blood stream and enter tissue. Our local doctor thinks that her white count and platelets will continue to normalize as the baby stem cells "relax" from their first encounter with a bacterial infection.

Bottom line is we just saw Ann's new immune system react like it should. Albeit more vigourously than expected, but normally. So all in all good news.

We close on our new house at the end of the month, which is another huge step on the road to reclaiming our lives again. I can't begin to tell you how much we are looking forward to it. We even bought a fridge this weekend.

Monday, June 16, 2008

I still have a lingering cough that's aggravated by my constant post nasal drip. Thanks, crazy allergies. Other than this very minor complaint, I feel completely normal. I've got a doctor's appointment scheduled for tomorrow and I'm hopeful that the blood draw shows things getting back to normal.

I spent the weekend working on a super-secret project that I can reveal tomorrow night. Nothing amazing, so don't get your hopes up too high.

Thursday, June 12, 2008

My friend, Patricia, has a friend who is raising money to benefit the Leukemia and Lymphoma Society. She'll be participating in a 100 mile bike ride in Florida in October in honor of Patricia. If you'd like to help, please visit Karen's fundraising page here.

The Leukemia and Lymphoma Society is an invaluable resource for patients and caregivers alike. In fact, it's one of the first places we turned to when I was first diagnosed. They offer programs that help patients financially and emotionally as well as educational material. To this day, I still draw a lot of emotional support from the LLS boards and the many wonderful people who post there.

I wish I could write more eloquently on how the Leukemia and Lymphoma society has benefited me. Since I'm a bit off my game, please just pop over and have a look for yourself.

Wednesday, June 11, 2008

Day +377

I have been sitting on this little nugget of news for over a week and it has nearly killed me to keep quiet: My friend Nancy was on The Price is Right! The episode featuring her in all of her fabulousness aired on 6/10 and I believe for a limited time you can view it here. Just select the episode of the same date. I screamed when she let us in on the secret. Literally screamed. It's just one of those once in a lifetime opportunities and the show is so iconic. It couldn't have happened to a nicer, more deserving person and I'm so glad she got the chance to thank her bone marrow donor on national television.

Nancy did ask that we not post any incriminating pictures and I think I've managed to skirt the offence. Sorry Nancy, I'm just so thrilled for you! I had to share the fun.

Monday, June 9, 2008

The new theory making the rounds is that I might have RSV. Since it's been an eon since I was a baby and I have very little real experience with them, I couldn't say whether it is or isn't. I have been warned that I'll probably catch it and that I wouldn't like it. If that's what this is, then I can confirm that I haven't enjoyed it.

Now a personal favor: If one of my buddies could Tivo The Price is Right tomorrow, June 10, I'd be ever so grateful. I can not tell you why, so you must trust me. Nancy, you know I love you.

I've put a call in to my local nurse with a question about my elevated white blood cell counts and neutrophilia. I suspect I know the answer, but I just need confirmation.

Sunday, June 8, 2008

Day +374

Still here and still coughing.

I am feeling more like myself and the cough is mostly due to post nasal drip. It's most prominent in the morning and at night. In fact, I've been waking up a few times a night in the midst of a coughing fit.

Chris is upset that I can't take a really deep breath without having to cough. I keep trying to explain that a really deep breath tickles my throat, triggering a cough in response. It's not because my lungs hurt, or can't fill to capacity, it just feels like I've swallowed a bag full of hair clippings.

During times like these, the internet is not your friend. I actually wouldn't mind if it went down until this cough clears up. Maybe just the medical sites. I have been recited all of the different ailments that a non-productive wet cough could be. Hunta virus, anyone? How about bronchitis? Pneumonia? Here's my absolute favorite: the common cold. Not that! Anything but that.

Yes, I'm cranky. You would be too, if you felt like the lens of a microscope was only seconds away from swooping in on you. I'm sick of all the long faces. I know I'm not being fair, and that the people closest to me just want me to be well because they love me. I'm just one of those crazy solitary people who likes to be left alone while recuperating. I've always been like that. Being babied has always made me feel claustrophobic and I tend to lash out because of it. There, now you know my dark secret: I'm imperfect.

Chris talked to one of the nurses at my local office and the cultures that were taken at the hospital have all come up negative. We may never actually know what caused this little hiccup, but if it looks like a duck and it sounds like a duck, then it's probably a cold.

My temperatures are a little closer to normal and only fluctuate between 98.4-99.5. I don't know what this is, but I'm determined that it won't sideline me for very much longer.

Thursday, June 5, 2008


I'm laying low and trying to conserve all of my energy for fighting this crazy infection. I've decided to treat this illness with as much sleep as I can. I know it frustrates Chris because he equates my sleeping with being really ILL. I keep trying to explain to everyone that I don't feel like I'm fighting sleep off, but rather choosing to sleep in order to give my little cells a chance to do some maintenance.

I'm going to spend the rest of the day babysitting a large pot of blackbean soup and translating a knitting pattern into an excel spreadsheet. Don't fret, my trusty thermometer will be at my side.

Wednesday, June 4, 2008

Fish Sandwich Part II

Day +370

WBC 14.7 K/uL (!!!)
RBC 4.10 M/uL
HGB 12.9 G/dL
PLT 496 K/uL
ANC 12.4 K/uL (!!!)

(I'll skip explaining the Fish Sandwich reference. If you are interested check out the search box at the top of the page.)

So everything looked great yesterday - The levaquin was doing its job and Ann's fever was gone. We expected that her WBC would drop back down to normal levels as the immune response her body was having to whatever she was fighting started to pass. Nice and simple in theory...at least until last night.

Just before going to bed, Ann had a small coughing fit, so I asked her to take her temperature. A few moments later, her digital thermometer started sounding the "Trouble" alert indicating a temperature over 100F. Specifically 100.3F, which was close enough to the 101 F limit that MDA told us would trigger a trip to the ER. Ann looked crushed, but we dressed and headed off to the ER in Baton Rouge anyway.

When we got there it was pretty much the same drill as last time except for the large number of armed Louisiana State Troopers standing guard on two of the examination rooms. The ER nurses talked about the ER being in "lock-down", so I presume that the Troopers had brought someone(s) in custody that needed treatment. The Troopers didn't look friendly or happy so we didn't ask.

Just like last time Ann got sent to the front of the line. We were put in a private room and waited for our doctors and nurses to come in. I always feel a little sorry for new medical professionals who get to deal with us for the first time. They get overloaded as Ann and I rattle off her history, time lines, diagnosis, complications, current perscriptions, drug interactions, and recent CBC differential numbers. That's about 1 million times more thorough than they expect from most patients they see, I guess. The doctor we saw last night actually asked me where I studied medicine and what my specialty was...Crikey! I corrected him fast and I could see his astonishment when I told him I was a Mechanical Engineer.

So Ann had to endure the same battery of tests as last time. Chest x-ray, looking for pneumonia; result negative. Nasal swab, looking for influenza A or B; results negative. Urine cultures, looking for UTI; result pending. Blood cultures, looking for sepsis; result pending. CBC and smear results were the same as the day before-- lots of mature neutrophils, and no pre-cursor or blast cells in sight. So the conclusion seems to be the same: A bacterial infection of some sort.

Ann's baby stem cells are reacting to the invading bugs by "dog piling" them. Billions and billions of nuetrophils are being cranked out by her new marrow every couple of hours, and they are literally throwing themselves at the enemy looking for anyway they can to kill the germs off. Eventually one of the neutrophils will "figure it out" and pass it on to the rest of it's cohort.

After leaving the ER this morning we discovered that Ann has passed a milestone, too. Because she still had a fever this morning of 100.7F, we called to check with MDA and our local doctor on what to do. We were pretty surprised by the answer...nothing. As in "do nothing, unless it gets really bad".

Well OK, not nothing: MDA the bastion of cancer research and treatment, the place that has the most qualified professionals in the nation, the people I would trust implicitly with Ann's life has suggested...(Pause for Dramatic Effect)...Tylenol. Until they have evidence of something more serious in Ann's blood they are just gonna let this one ride and see how the baby stem cells cope.

Looks like the training wheels are off and the baby stem cells are cycling on their own now.

Tuesday, June 3, 2008

Day +369

The sore throat showed up late to the party this morning. I'm taking it as a sign that the infection is making one last grasp for control. The cough syrup makes me very sleepy, but it takes care of the cough which I'm sure Chris is grateful for. I cough like a machine gun in my sleep and it usually wakes everyone up. This, I inherited from my dad.

I had to run a few essential errands today and I tried to keep every one's exposure to me at a bare minimum. Every one I know always picks up a vicious infection whenever they're around kids for even a short period of time. I figured that I'd play it safe and assume that I was as deadly as a two year old.

Squeeze had her follow-up appointment at the vet school today and I'm happy to report that her blood cultures came back more or less normal. Her kidney levels were a little elevated, but they always come back that way. The vet said that she was as normal as could be expected considering her age. Poor guy had to handle her after she had a very explosive bout of diarrhea in her carrier on the way to the office. I was so flustered because of it and worried about her and worried that I wasn't supposed to be exposed to such things because of oocysts and other fun toxicities. I managed to dispose of her puppy pad without getting any bacterial delight on myself and Greg was kind enough to clean her up, as well as her carrier.

Unfortunately, the vets weren't able to get a urine specimen from her because as they said, her bladder is the size of a walnut and there was nothing in it. Of course, she made a bee line for the litter box when we got home to relieve her tiny bladder. I'll have to bring her back in next week so that they can try again. They just want to be sure that they took care of the bladder infection. There's a chance that the bacteria can get into her kidneys which would complicate a lot of things. Poor girl, I know how it feels. She's sleeping on the couch, immersed in tiny kitty dreams.

Aside from a nap, that was the extent of my day. I managed to finish knitting my gift and will put the finishing touches on it tomorrow. After that, Chris is in charge of logistics.

Tomorrow is our fourth wedding anniversary and I'm bummed that I've been sidelined by this yucky thing. However, I am eternally grateful that I got another year with the love of my life.

Monday, June 2, 2008

still Day +368

I developed a wicked case of the hiccups after dinner which was compounded by a fit of uncontrolable coughing. So, I broke down and took some of the cough syrup that my doctor prescribed me. I was completely caught off guard by the nose searing flavor of concentrated orange evil that spread across my tongue. It did the trick and stopped my cough and also exorcised the hiccups out of me.

I now feel like I've been darted and am off to find a cave to hibernate it.

It's not a party until someone throws up

Day +368

WBC 12.3 K/uL (!!!)
RBC 4.37 M/uL
HGB 13.9 G/dL
PLT 484 K/uL
ANC 8.4 K/uL (!!!)

It all started Saturday with a cough, which became a tickle in the throat, then a fever. I never honestly felt under the weather, but a cough is a cough and so I started monitoring my temperature. It went up steadily until Sunday, when it peaked at 100. I had a doctor paged at my local hematologist's office and he phoned in some levaquin to get the ball rolling. My doctor was kind enough to shoe horn me in today for a few tests including blood work and a chest x-ray.

My white blood cells were elevated and to put my mind at ease, Dr. Bienvenu ordered a slide so he could have a look at what was going on. The cells turned out to be mature neutrophils and not blasts which put Chris's mind at ease. My lungs were clear as far as the x-ray went.

As Dr. Bienvenu put it, I probably caught a kiddie bug. Kids must be the most resilient creatures on earth to keep bouncing back from these strange infections. I know I have the immune system of a one year old, but it's fighting to keep a 33 year old illness free. The body is a traitor as you wave good-bye to your twenties.

As a preventative measure, I have to take valtrex twice a day for the next week and as a salve to my irritated throat I get to take a prescription cough syrup. Hello narcolepsy.

I had a very lovely "birthday" replete with cards from friends and a surprise dinner with Chris. We had a nice dinner at the Maisonette Brandt followed by hot fudge Sundays at home. Honestly, the secret to my heart is a cake purchased from a grocery bakery. Yes, I know what the frosting is made of and yet my palate yearns for the overt sweetness layered over dry yellow cake. No, I would not eat shortening out of a can, but I might consider it if you mix in some icing sugar. I'm just saying. If there is communal cake and icing is missing, it's usually because of me.

I have another birthday coming up in October, so there's still another chance at cake. I know I can just buy myself one, but I'd feel weird about eating the entire thing.

I'm getting plenty of rest and filling up on fluids while I frantically try to finish a gift for some friends who just welcomed their new daughter over the weekend.

Such is life.