Friday, June 8, 2012

Is it really that time again?

Time for another MDA update.  I schlepped all the way to Houston on Wednesday for my 3 month check-up. My borrowed immune system is still up and roaring, and presently doing what immune systems are supposed to do, except for the whole attacking my lungs thing. It still thinks my lungs are the enemy.

Here are the counts, including normal ranges in parentheses:

WBC: 10.6 k/ul (4.0-11.0)

RBC 4.27 m/ul (4.00-5.50) Woo-hoo! I'm finally making enough red blood cells and it's only taken 5.5 years.

Hemoglobin: 13.2 g/dl (12.0-16.0)

Platelets: 396 k/ul (140-440)

ANC: 7.75 k/ul (1.70-7.30) This has been running high since the car wreck.

My thyroid was acting up the last time I was at MDA, so my endocrinologist doubled the dose of my thyroid meds. It seems to have done the trick since my T4 level was normal this go around.

I had a visit with the pulmonary clinic and was told what I already know. Once infiltrates get in your lungs, they're impossible to get rid of. On really humid or hot days it feels like my chest is being crushed and breathing seems next to impossible. I'll probably be dealing with this feeling for the rest of my life. In three months, I'll have another pulmonary function test to see if I've had any improvements. I'll continue to take inhaled steroids every day.

Dr. K. wants to discuss trying to tapering the tacrolimus again in 3 months. The last time she tried, my GvHD manifested as an angry rash on my arms and chest after being off of the immunosuppressant for 2 whole days. My wacky immune system.

On the weird news front, I'm unhappy to report that what I unhappily thought was GvHD of my toenail--yes, it does exist, is actually a fungal infection. Yay! I haven't been on a systemic anti-fungal for ages, so I really should be surprised that it didn't happen sooner. I get to treat it with an over-the-counter medication and if that doesn't work, then Dr. K. and I will discuss bringing in the big guns. She doesn't want to start a systemic treatment right now because it's so toxic to the liver and I have that whole liver GvHD thing that likes to flare up and interrupt my life.

Dr. K. also revisited the topic of secondary cancers after treatment. Long term use of immunosuppressants increases the chance of developing a squamous cell carcinoma particularly in the head and neck regions. She warned me to wear lots of sunscreen every day. I watched my dad deal with skin cancer. I will wear sunscreen.

No surprises, unless you count the nail mushrooms, and no complaints. All is well in my little corner of the world.

Thank you to all who left congratulations on graduation! I still can't believe I managed to do it.


Nancy said...

OMG. You got a job already!!! Awesome girl. Congratulations and nobody deserves it more than you. You can run circles around the average student. You managed the same curriculum and beat cancer (twice) in the last few years. You rock girl and I know you'll be an extremely valuable asset to any company!!! You Go Girl!!! love ya, n

Nancy said...

Great Counts, too!!! I'm so proud of you... Keep it up Ann. You are an inspiration to so many...

lisa adams said...

So happy for every uneventful checkup and for your big job news. I can't wait to see you soar as you start this next chapter.

PJ said...

Great check-up. Mmm mushroom toenail. I'm sure I'll develop it soon since I too don't take anti-fungals.

Ronni Gordon said...

Toenail fungus. Oy. I had that ages ago before cancer and took the systemic drug, which made it go away. Of course with so many other things in the picture, I guess you have to use it as a last resort. Now that you mention it, I remember having my liver tested before, during and after. I was so oblivious I didn't think a thing about it.

Betsy said...

Belated congratulations Ann on your graduation....that's so awesome and I'm so proud for you!!!! I know it wasn't easy and took a ton of determination. You're such an inspiration to so many, including me & Dean! Congrats on the job too...that's wonderful news! glad you had a good report at MDA. Maybe we'll get to run into you & Chris again one day...for check-ups of course!!!! Dean & I send best wishes to you as you begin your new career and this next chapter in your life!!!!