MDA Recap

I've been trying to write this post since last Thursday, but life and a mild case of writer's block have been conspiring against me. My most recent visit to MD Anderson involved a routine checkup with my transplant doctor and a bone marrow aspiration to be sure that there's no evidence of residual disease. 6 months has elapsed since my marrow has been checked for any lurking leukemia cells and so I was due.

The procedure went off without a hitch, my blood work was normal, and my transplant doctor was happy to send me on my way. As a special treat, I was able to meet with 2 of my twitter friends for lunch. Jody and Jennifer deserve a commendation for infinite patience. My clinic was running 2 hours behind and they had to wait on me for lunch. After a comedy of errors in which I kept pushing the schedule back via text messages, and poor Jody lost her keys, and sweet Jennifer was stuck at the restaurant holding the table during lunch time rush hour all by herself.

I'm afraid I'll have to recap the adventure in another post since my brain is shutting down and this seems to be as good as it's going to get. Before I completely forget, I managed a 3.0 for the semester. I don't know how it happened, but I'm happy to have it.

Here are the numbers for my blood work:

RBC: 4.01 M/UL  (4.0-5.50)

WBC: 7.5 K/UL  (4.0-11.0)

Hemoglobin: 12.3 G/DL  (12.0-16.0)

Platelets: 387 K/UL  (140-440)

Absolute neutrophil count: 4.94 K/UL  (1.70-7.30)

My liver enzymes are absolutely middle of the road normal

Shuffling along

I took my last final of the semester this past Thursday and have spent the last 3 days blissfully doing nothing more intellectual than reading some pulp fiction for a book club I've recently joined. The club was started by a friend from high school and its members all live in different states. We communicate via the internet and I must admit that I've been enjoying their pithiness immensely.

Aside from continued pain from the car accident, my health is good.  I have a checkup in Houston on Wednesday which will include another bone marrow biopsy.  It's routine, so no worries.  Monday, I'm going to see my internist about the issues that I continue to have as a result of the car accident.

After a week of radio silence from the claims adjustor, I started leaving messages for him.  After 2 weeks of staring at my smashed SUV taking up space in the driveway, I vented about the insurance company in question on twitter. Their twitter representative responded with a phone number and a request that I call. I'm glad I did. She worked some magic and my claims adjustor called me the next day. My car went in for repairs 24 hours later. I'm still waiting for reimbursement from them for the cost of having my car towed from the site of the accident back to my house. It's been almost a month and still nothing.

I'll post the results of the MDA visit Thursday or Friday.

DNA wins

After a weekend of dealing with constant discomfort and pain, I decided to give my new internal medicine doctor a call.  There is a grinding sensation in my spine and neck.  I've had a low level headache since Thursday, the day after the wreck.  I've been taking things easy and popping muscle relaxers as directed.  Things are not improving.

I was able to get in to see Dr. C.'s nurse practitioner after classes Monday.  It just so happens that they've been trying to reach me since Friday.  The woman working the front desk didn't update my personal info the last time I was there and so they've been calling my old number.  

My cholesterol levels are ridiculously high.  I eat well and am moderately active.  I have a relatively healthy lifestyle all things considered, and yet my cholesterol level weighed in at 263 mg/dL.  The normal range is between 140-200 mg/dL.  My near-vegetarian mother has struggled with her cholesterol since I was a child.  I come by the problem honestly, and so I can't really complain.  Dr. C. has started me on a prescription in the hope that my wayward lipid level can be brought back into line.  Just as an aside, my good cholesterol measured at 58 mg/dL, which is higher than average and a saving grace.  

As for my spine and neck, Dr. C. prescribed an anti-inflammatory drug in addition to the muscle relaxer.  If things haven't improved after two weeks, I have to go back to be reassessed.  The headache is a constant bother and makes concentrating in class a terrible chore.  I'm hopeful that it resolves soon.

Applied physics

On Wednesday, November 16, I was in a 2 car wreck.  The other driver was making a left turn into oncoming traffic without the right of way.  My SUV smashed into his front passenger side door.  He was at fault and admitted as much.

My car is inoperable.  I am in near constant pain.  I've seen a doctor who prescribed muscle relaxers.  I prefer to avoid painkillers since they're either toxic to my liver or cause me to vomit, which makes everything worse.  I can't get into more detail since the case is far from being resolved.

I'll write more about the accident when I'm free to do so.

In the meantime, I hope you all have a very wonderful Thanksgiving.  May there be too much of everything that is pleasurable.

A little GvHD to go with my chemo brain

It's been five and a half weeks since I last saw my transplant doctor and the rest of the team of specialists who work so hard to ensure I maintain a reasonable quality of life.  I've been off of bactrim, valtrex, and v-fend since that last visit and I can feel the difference.  These three drugs were taken as a precautionary measure against pneumonia, viruses, and fungal infections.  I've managed to avoid catching anything so far, and when you consider the fact that I spend a large part of my day sitting amongst a menagerie of college students, most of whom are just barely out of their teens, that is quite a feat in itself.

The real reason for brining this up is related to another drug that I still take.  Tacrolimus is an immunosuppressant drug that keeps my transplanted immune system in line.  The anti-fungal I was taking also helped boost my ability to metabolize the tacrolimus, which meant that 1mg was enough to keep my immune system under control, and thus GvHD was a very minor nuisance.  I still only take 1mg of tacrolimus and my immune system has started acting like a petulant baby left with a sitter.

The GvHD affecting my skin, mouth, scalp, and eyes has flared up ever so slightly.  My skin feels like sandpaper and no amount of moisturizer really helps.  I get small rashes, mostly on the lower part of my face.  They're easily controlled with cortisone cream and are more annoying than threatening.  I've had one mouth sore to date and that went away after a few applications of a steroid mouth rinse.  My eyes are a little drier than usual, but honestly, they've been dry since transplant number one.  I continue to use restasis drops and that keeps the problem under control.

As for my scalp, well, it's just gross.  I constantly look like I'm smuggling artificial snow in my dark locks.  My scalp itches sporadically and ferociously.  I use a dandruff shampoo that smells like burning tar as well as a prescription topical steroid solution that I'm only supposed to apply every two to three days.  I think the new normal for me includes an abundance of flakes of dead skin peppering my dark hair.  It definitely beats having cancer, but really?

I've also been taking the new hormone replacement therapy for five and a half weeks.  I do not love it.  I was taking Prempro, which left me feeling even keeled and emotionally stable, before the whole fertility mystery.  Now I'm taking Seasonale and I constantly feel like I have PMS.  Poor Chris has been a trooper while I've subjected him to hormonal whiplash.  I'm starting to get a handle on it, so I'll stick it out for another month or two in the hope that the compulsive bitchiness disappears.  If it doesn't resolve, I'll ask to be put on something else.

There's a month left to my current semester of school and to put things bluntly, my scholastic performance to date has not been stellar.  I'm stumbling badly in an estimating class and the very best I can hope for is a C.  Truth be told, I will probably repeat the class next semester.  As for the other two classes I'm taking, I have Bs in both.  I'm a bit of a freak about my grades, so you'll have to excuse my neurosis if a C sounds like a good deal to you.  I spend more time than most working on the material and trying to understand the subjects.  Chemo brain makes life difficult and so I have to work ten times as hard to do half as well as most people.  I no longer do tests well and time constraints only make things worse.  In real world applications, I can bore you to tears with what I've learned.  Give me a list of questions and an hour to answer them all and I am suddenly struck dumb.

I'll get through it.  My professors are great and have been very understanding.  One professor who knew me from classes taken before the transplant has been especially fantastic about everything.  He makes an extra effort to be sure that I understand how to work things out during class.  I've spent quite a few mornings in this professor's office getting extra help on the subject. Chris has been helping me nearly every day with the subject outside of class.  You'd think I'd have an A given the amount of effort I've been putting in on top of the extra help I've been getting.  It's the class in which I am doing the worst.

37

36 has come and gone and with 37's arrival Wednesday I realized that things are getting easier.  I don't mean that I've unlocked the secret to mastering new things, but that the simple act of being now fits better than it ever did in years past.

I'm also learning that the middle-aged body is a mercilessly unforgiving thing.  I gave myself a free pass from the diet yesterday and ate those things that I normally eschew.  I managed to get as far as a lunch of nothing but those tiny powdered donuts that come in the glossy white bag.  I had 6 of them and started to feel sick like I'd had too much of a good thing.  After dinner, I had a piece of cake purchased from my local super market.  You know the variety, the sheet cake covered in the kind of icing that never seems to go bad because it's made of entirely synthetic food-stuffs.  Truth be known, it's one of my most favorite things.  I rarely have it because I have no self control.  After finishing a single slice, I asked Chris if he wouldn't mind bringing the rest of the cake to work just to get it out of the house.

Today, I just want to eat oatmeal and salad.

Biopsy results

The biopsy results from my last visit to the dermatologist at MD Anderson have come in and it was nothing to be concerned about.  Just a little cyst.  Nothing predatory or cancer-like.

I am swamped with midterms, so things will be quiet on the blog until after 10/20.