Hemoglobin 9.4
WBC 13.9!!
Platelets 154!!
|Neutrophils| 13.9
Creatinine 1.30
Yesterday ended better than it started. Once my glucose came down I was able to eat and I felt a lot better.
Today I'm still waiting to have a chest CT done. No headache yet. No nausea. No appetite. Vision remains poor but my glucose has been in good control.
15 January 2010
14 January 2010
Day 23
Hemoglobin 10.1
WBC 6.5!!!
Platelets 120!!!
|Neutrophils| 6.5
Creatinine 1.40
I didn't feel well today. Sick to my stomach, headache, and high blood sugar.. My doctors wanted to get my eyes checked again so I spent a couple hours at the eye clinic this afternoon. My vision has become blurry again in both eyes. The ophthalmologist said things look better than before, my vision changes are probably due to the cytarabine and how quickly my counts have been changing. I should just give it time.
WBC 6.5!!!
Platelets 120!!!
|Neutrophils| 6.5
Creatinine 1.40
I didn't feel well today. Sick to my stomach, headache, and high blood sugar.. My doctors wanted to get my eyes checked again so I spent a couple hours at the eye clinic this afternoon. My vision has become blurry again in both eyes. The ophthalmologist said things look better than before, my vision changes are probably due to the cytarabine and how quickly my counts have been changing. I should just give it time.
Day 22...
...or should I say Day 1??? First the counts:
Hemoglobin 9.3
WBC 0.8
Platelets 77
|Neutrophils| 0.1
Creatinine 1.40
I'm currently receiving my first dose of my fourth round of chemotherapy. Dr. Oran met with me today and we decided to go with FLAG again. My primary concern was that a second dose would not be aggressive enough, leaving me out of remission and out of transplant again. Dr. Oran believes that since the first round was so effective there's a good chance another is still my best option, especially since I have such little ground to cover. She also explained that with ALL a bone marrow biopsy needs to be performed once the counts have returned in order to obtain an accurate measurement of surviving blasts within the marrow. Complete destruction of ALL marrow blasts require an immune system to clean up dying blasts. With AML you can biopsy at day 14 for an accurate blast count. Eg: This summer I was sent home after a biopsy revealed approximately 9% blasts. About a month later the biopsy was completely clear. This remaining 9% were dying ALL-like blasts that my immune system was able to whack.
With FLAG comes Decadron, the dreaded but useful steroid I was receiving before, and (you guessed it) the insulin drip. Boo hourly glucose checks...
I will also have a chest CT this week to check on that sneaky fungus. Although I remain asymptomatic we should know what it is up to.
I hope this is strong enough to put me into remission. No two rounds of chemo are the same, even if pharmacologically identical. We'll see how FLAG treats me in the rematch.
Hemoglobin 9.3
WBC 0.8
Platelets 77
|Neutrophils| 0.1
Creatinine 1.40
I'm currently receiving my first dose of my fourth round of chemotherapy. Dr. Oran met with me today and we decided to go with FLAG again. My primary concern was that a second dose would not be aggressive enough, leaving me out of remission and out of transplant again. Dr. Oran believes that since the first round was so effective there's a good chance another is still my best option, especially since I have such little ground to cover. She also explained that with ALL a bone marrow biopsy needs to be performed once the counts have returned in order to obtain an accurate measurement of surviving blasts within the marrow. Complete destruction of ALL marrow blasts require an immune system to clean up dying blasts. With AML you can biopsy at day 14 for an accurate blast count. Eg: This summer I was sent home after a biopsy revealed approximately 9% blasts. About a month later the biopsy was completely clear. This remaining 9% were dying ALL-like blasts that my immune system was able to whack.
With FLAG comes Decadron, the dreaded but useful steroid I was receiving before, and (you guessed it) the insulin drip. Boo hourly glucose checks...
I will also have a chest CT this week to check on that sneaky fungus. Although I remain asymptomatic we should know what it is up to.
I hope this is strong enough to put me into remission. No two rounds of chemo are the same, even if pharmacologically identical. We'll see how FLAG treats me in the rematch.
12 January 2010
Day 21
Hemoglobin 10.1
WBC 0.8
Platelets 65
|Neutrophils| 0.2
Creatinine 1.28
When the white cell count is below 0.5 (500 cells per microliter of blood) the technicians don't bother counting the different types of white blood cells - the sample cell population is so small the results are statistically insignificant. Once the total white cell count is higher than 0.5 a differential is performed - the cells are separated by type and counted. This is why my absolute neutrophil count is back.
End of the third week, sixteen days since chemo ended. My counts are up on their own again and I can feel the difference. Today I've felt good but my doctors are still working on getting my blood pressure under tighter control. My doctors and I suspect that is what is causing my headaches and have been adjusting my medication dosing. It's moving in the right direction but just takes time.
Tomorrow Dr. Oran will be back on service so we're waiting for her opinion before deciding a chemotherapy regiment. An additional day or two is insignificant at this point so I'm comfortable waiting in order to receive Dr. Oran's opinion.
WBC 0.8
Platelets 65
|Neutrophils| 0.2
Creatinine 1.28
When the white cell count is below 0.5 (500 cells per microliter of blood) the technicians don't bother counting the different types of white blood cells - the sample cell population is so small the results are statistically insignificant. Once the total white cell count is higher than 0.5 a differential is performed - the cells are separated by type and counted. This is why my absolute neutrophil count is back.
End of the third week, sixteen days since chemo ended. My counts are up on their own again and I can feel the difference. Today I've felt good but my doctors are still working on getting my blood pressure under tighter control. My doctors and I suspect that is what is causing my headaches and have been adjusting my medication dosing. It's moving in the right direction but just takes time.
Tomorrow Dr. Oran will be back on service so we're waiting for her opinion before deciding a chemotherapy regiment. An additional day or two is insignificant at this point so I'm comfortable waiting in order to receive Dr. Oran's opinion.
11 January 2010
Day 20
Hemoglobin 7.4
WBC 0.3
Platelets 46
Creatinine 1.32
Yet another unremarkable day. My hemoglobin was low and I spent most of it sleeping. My platelets went up on their own (finally). No word yet from Dr. Oran, perhaps tomorrow.
WBC 0.3
Platelets 46
Creatinine 1.32
Yet another unremarkable day. My hemoglobin was low and I spent most of it sleeping. My platelets went up on their own (finally). No word yet from Dr. Oran, perhaps tomorrow.
Day 19
Hemeglobin 8.3
WBC 0.3
Platelets 45
Creatinine 1.25
My counts began their slow return today - my white blood count is up and both my hemeglobin and platelets stayed constant without any infusions. It doesn't really make much difference whether they come back or not before the next round of chemo, I guess it's just nice to know they are.
Today my doctors switched the medication I'm receiving for the headaches, the new one seems to manage the pain much better. It's longer lasting and doesn't seem to make me as sleepy. They also tweaked my blood pressure medications around, hoping to provide better control. They say high blood pressure could be causing the headaches, so hopefully it'll make a difference.
The hematology office expects Dr. Oran to return either Monday or Tuesday. Hopefully she'll stop by and give me her opinion on what treatment I should have next. If we haven't heard from her by Tuesday, the fellow on service, Dr. Zilla, will seek opinions from his colleagues and make a recommendation for treatment. Either way I should begin the next round on Wednesday. Until then it should be a quiet week.
WBC 0.3
Platelets 45
Creatinine 1.25
My counts began their slow return today - my white blood count is up and both my hemeglobin and platelets stayed constant without any infusions. It doesn't really make much difference whether they come back or not before the next round of chemo, I guess it's just nice to know they are.
Today my doctors switched the medication I'm receiving for the headaches, the new one seems to manage the pain much better. It's longer lasting and doesn't seem to make me as sleepy. They also tweaked my blood pressure medications around, hoping to provide better control. They say high blood pressure could be causing the headaches, so hopefully it'll make a difference.
The hematology office expects Dr. Oran to return either Monday or Tuesday. Hopefully she'll stop by and give me her opinion on what treatment I should have next. If we haven't heard from her by Tuesday, the fellow on service, Dr. Zilla, will seek opinions from his colleagues and make a recommendation for treatment. Either way I should begin the next round on Wednesday. Until then it should be a quiet week.
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