Counts for 08 January:
Hemeglobin 8.9
WBC 0.1
Platelets 34
Counts for 09 January:
Hemeglobin 8.9
WBC 0.1
Platelets 29
Creatinine 1.25
Yet another uneventful day. Headaches continue. My vision seemed to be improved this morning but has since returned to about where it has been.
My MRI revealed no abnormalities and my CSF is clear. The cultures of my CSF are still pending but so far things look good.
No plan yet for the next round of chemo. Dr. Oran has been out of the country and should be returning Monday or Tuesday. I think we're waiting for her opinion before making a decision.
Tomorrow should be another boring day.
09 January 2010
Day 16 & 17
Counts from 07 January:
Hemeglobin 9.6
WBC 0.1
Platelets 26
Last night I received the biopsy results. The leukemia has been diminished from 75% to about 12%, so more chemotherapy is necessary. My doctors are going to consider the options over the next few days before making a recommendation. So it looks like I'll start the next round early next week.
Over the past several days I've been having headaches. The doctors have three possible explanations at this point: a drug side effect, a bleed in my brain, or the leukemia has moved into my central nervous system. Last night I had a CT scan which came back normal, but CTs don't have a high resolution. So today I had an brain MRI which will make any bleeding that's occurring clearly visible. I also had a lumbar puncture this afternoon to check the cerebral-spinal fluid for blasts. I should have the results by tomorrow or Sunday.
The painkillers I've been getting for the headaches have made me constipated again. Other than that I've been feeling pretty good. The vision in my left eye has been improving as well.
Hemeglobin 9.6
WBC 0.1
Platelets 26
Last night I received the biopsy results. The leukemia has been diminished from 75% to about 12%, so more chemotherapy is necessary. My doctors are going to consider the options over the next few days before making a recommendation. So it looks like I'll start the next round early next week.
Over the past several days I've been having headaches. The doctors have three possible explanations at this point: a drug side effect, a bleed in my brain, or the leukemia has moved into my central nervous system. Last night I had a CT scan which came back normal, but CTs don't have a high resolution. So today I had an brain MRI which will make any bleeding that's occurring clearly visible. I also had a lumbar puncture this afternoon to check the cerebral-spinal fluid for blasts. I should have the results by tomorrow or Sunday.
The painkillers I've been getting for the headaches have made me constipated again. Other than that I've been feeling pretty good. The vision in my left eye has been improving as well.
06 January 2010
Day 15
Hemeglobin 7.8
WBC 0.1
Platelets 28
My biopsy this morning went well. When they're done inpatient the doctors are able to administer any kind of pain killer (whereas outpatient they only offer less powerful drugs). So the biopsy, which can be excruciating, was only slightly uncomfortable. I then spent most of the day sleeping off the drugs. I also received two units of blood and platelets.
Little else to report. No fevers. No improvement in my left eye. Things are still going well.
WBC 0.1
Platelets 28
My biopsy this morning went well. When they're done inpatient the doctors are able to administer any kind of pain killer (whereas outpatient they only offer less powerful drugs). So the biopsy, which can be excruciating, was only slightly uncomfortable. I then spent most of the day sleeping off the drugs. I also received two units of blood and platelets.
Little else to report. No fevers. No improvement in my left eye. Things are still going well.
05 January 2010
Day 14
Hemeglobin 8.4
WBC 0.1
Platelets 40
Creatinine 1.22
Another good day today. Lots of visitors: my parents, Dietz, Melanie, Zu-Yi, and I got to spend lots of quality time with IRael :)
I have my bone marrow biopsy scheduled for tomorrow morning at 0830, which means we'll hopefully have the results by Friday. This will be the first look at how effective chemotherapy was. If I'm back in remission the marrow will be <5% blasts (I was at about 75% blasts before starting chemotherapy). However, this biopsy is just sort of a preliminary indicator. Since my counts have yet to begin to recover, even if this biopsy shows remission it would still be possible for the cancer to appear when the counts return. An additional biopsy around day 28 would be needed to confirm remission. I think if this biopsy indicates the leukemia is still present I will begin additional chemotherapy even before my counts return. If it's clear I'll begin transplant preparations again, pending another clear biopsy around day 28.
Day 13
Hemeglobin 8.3
WBC 0.1
Platelets 28
Creatinine 1.22
Another uneventful day. No fevers, no vision changes, no other developments. I received platelets once this morning and again tonight and was put back on my pump.
Tomorrow is day `4 so it might be time for a bone marrow biopsy. Oncology hasn't said anything about it recently, so they might end up waiting until my counts begin to return.
WBC 0.1
Platelets 28
Creatinine 1.22
Another uneventful day. No fevers, no vision changes, no other developments. I received platelets once this morning and again tonight and was put back on my pump.
Tomorrow is day `4 so it might be time for a bone marrow biopsy. Oncology hasn't said anything about it recently, so they might end up waiting until my counts begin to return.
04 January 2010
Day 12
Hemeglobin: 7.5
WBC 0.1
Platelets 10
Creatinine 1.34
Today was better than yesterday. I was able to get a decent night's sleep before receiving two packets of platelets and two packets of delicious blood. Dietz and I watched the Vikings win, then IRael came over, we ordered pizza and played cards (I lost terribly). I haven't spiked a fever since last night and it seems I've started pooping regularly again.
Ophthalmology came and examined my eyes this afternoon. This fall I was diagnosed with retinopathy, a condition affecting blood supply to the retina. Blood vessels provide the oxygen and nutrients necessary for cells found in the retina to survive. These vessels are very tiny and thus very delicate. If they become damaged from disease (diabetes) or drugs (chemotherapy), the blood supplying the retina is interrupted and cells receiving no nourishment begin to die. The damaged places on the retina therefore send no visual information to the brain and a dark spot is perceived. The damage to the vessels occurs as small tears which then bleed. It is this bleeding that is causing most of my vision problems now. When my platelets dropped so low it caused the vessels in my left eye (where the retinopathy is worse) to bleed. This blood found its way into the space between the retina and lens, causing a "floater" to appear. The good news is that this is not damaging the retina, there is simply blood blocking the image seen by the lens. It should improve on its own once my system begins to stabilize, and there are procedures to remove blockages like this if needed. The bad news is that it got worse again tonight. The blurry area now has a red tint to it (makes sense) and has grown larger. I am relieved to hear it should not be permanent.
In an effort to reduce the risk of further damage from bleeding my doctors have decided to up my threshold for platelet infusions. Instead of waiting until my platelets fall below 10, now they'll infuse if they fall below 30.
WBC 0.1
Platelets 10
Creatinine 1.34
Today was better than yesterday. I was able to get a decent night's sleep before receiving two packets of platelets and two packets of delicious blood. Dietz and I watched the Vikings win, then IRael came over, we ordered pizza and played cards (I lost terribly). I haven't spiked a fever since last night and it seems I've started pooping regularly again.
Ophthalmology came and examined my eyes this afternoon. This fall I was diagnosed with retinopathy, a condition affecting blood supply to the retina. Blood vessels provide the oxygen and nutrients necessary for cells found in the retina to survive. These vessels are very tiny and thus very delicate. If they become damaged from disease (diabetes) or drugs (chemotherapy), the blood supplying the retina is interrupted and cells receiving no nourishment begin to die. The damaged places on the retina therefore send no visual information to the brain and a dark spot is perceived. The damage to the vessels occurs as small tears which then bleed. It is this bleeding that is causing most of my vision problems now. When my platelets dropped so low it caused the vessels in my left eye (where the retinopathy is worse) to bleed. This blood found its way into the space between the retina and lens, causing a "floater" to appear. The good news is that this is not damaging the retina, there is simply blood blocking the image seen by the lens. It should improve on its own once my system begins to stabilize, and there are procedures to remove blockages like this if needed. The bad news is that it got worse again tonight. The blurry area now has a red tint to it (makes sense) and has grown larger. I am relieved to hear it should not be permanent.
In an effort to reduce the risk of further damage from bleeding my doctors have decided to up my threshold for platelet infusions. Instead of waiting until my platelets fall below 10, now they'll infuse if they fall below 30.
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