Red Cells and White Cells and Platelets, Oh My!

Just over a year ago,  July 26, 2021 to be exact, I came home from Club Sunnyside after spending 30 days in the oncology unit. I was feeling good physically, and very grateful to be back home. As I got out of the car, I felt a little funny. We had had some yard work done while I was gone, and I wanted to inspect it. As I walked out of the garage, my knees buckled and I went down. A rather inelegant version of the conquering hero returning home.  Since that time, I have been wary of getting out of the car. This syndrome has not been evident, except for exiting the car. There has not been a repeat of the crumpled knees, but I always feel quite unsteady, and I generally have to hang onto the car for a minute or two before I feel ready to walk. Mind you, now, this was not happening after I fully recovered from the chemotherapy that ended in November.  Well, now it's back. As I have contemplated the cause of this phenomenon, I realized that this is vertigo. So, I started payin...

Life is a whirlwind of activities, challenges and surprises. I haven't posted in several days, but I haven't been idle.  Last week I had two chemotherapy sessions (injections), three blood draws, three transfusions, and a telephone consultation with Dr. Cook. Since I already had a transfusion scheduled for Monday at 8:30am this week, we moved my Monday blood draw up to Sunday morning. Then, on Tuesday, we had a day off! Whew!! Wednesday morning is when the miracle happened.  I had a blood draw at 7:15am on Wednesday (yesterday), and my platelets had increased... significantly. My hemoglobin also increased marginally, and my neutrophils tanked. The chemotherapy is doing its job. Because my platelets were up, not only did I not have another transfusion today, but we got another day off. Tomorrow brings another blood draw at 7:15am, but that also means we can do our curbside pickup of groceries at the Walmart down the street from the clinic.  If you are a praying person, ple...

There is a paradox called something like the "approach-avoidance" paradox. Have you ever been there?  It goes something like this: There is something that terrifies you, but you can't resist the urge to find out about it. Jill and I have just passed through such a situation. When we received the diagnosis telling us that my AML has relapsed, Dr. Waugh suggested that, along with beginning the current regimen of treatment I am on, we make an appointment with Dr. Cook at OHSU for another consultation. We assumed the purpose of the meeting was to reexamine the possibility of bone marrow transplant (BMT).  If you have been following this blog, you may recall how I agonized over the decision about whether to proceed with BMT and how the Lord intervened and made the decision for me. (Please see my December 7, 2021 post,  The Big Day ) Today we had a new consultation with Dr. Cook. To our relief, it was about more than BMT. Dr. Cook asked a few pertinent questions and then explai...

One year ago today, I was ensconced in Kaiser Permanente Sunnyside Hospital. I had received my induction phase chemotherapy with Cytarabine, and I was in the recovery phase, during which the oncology team closely monitored  my blood work as well as my metabolic labs. I was probably at my nadir in terms of energy and immunity; I don't recall for certain. Today, I am at home and just about to finish round one of outpatient chemotherapy with Azacitidine. Why do I make this comparison today? It's my birthday. My birthday present is that, after today, I will have three weeks with no injections into my belly of what is essentially poison.  The effects of the medications (I am also on an oral chemotherapeutic agent called Venetoclax. Who comes up with these names?*) so far has been pretty negligible, although my belly is red and a bit bruised where I have received three injections daily of the Azacitidine. Jill and I continue to walk our two mile route around the neighborhood daily, ...

The first "week" of my new treatment regimen is complete. I put the week in quotations because it was a Monday to Friday week and not the seven day kind. Today's activities included a 7:15AM blood draw and a 3:30PM transfusion of platelets, coupled with my fifth day of chemo injections. My platelets had dropped to 15, whereas the threshold for transfusion is 30. I am so grateful for my oncology team who anticipated this situation and arranged an appointment for me "in case." One of my favorite guys is Justin Case!! Getting a load of platelets late Friday afternoon is a virtual guarantee that I will not wind up in the ER this weekend.  Suzanne called this morning and said my numbers looked very good, except for the platelets. She was very upbeat. When I mentioned I was a little concerned that my neutrophils are inching their way up, she said, "You're only 4 days into this, so there's no cause for concern. You're doing great." Now, that's...

As opposed to previous days this week, today feels like a new paradigm. We only need to make one trip to a clinic today. At 4:30, I am scheduled for my next chemo injections. I don't even need to get lab work done today. We feel almost lost about what to do with the extra time.  So, here's the story. Tuesday morning we went to the lab to check on my uric  acid level. The venetoclax medication has a tendency to elevate uric acid counts in the blood. This is a problem because too much uric acid tends to crystalize, and among other things, like gout, it can cause kidney problems if crystals form in that delicate organ.  We also had an appointment at 4:30pm for injections, but Monday's labs showed my platelets had dropped again. So, my 4:30pm appointment for Tuesday was rescheduled to 7:30AM, so that I could receive a platelet transfusion as well as the chemo injections. That same day, my dose of venetoclax was doubled, which of course means more uric acid worries. So, it was...

We got an early start today. First stop was the North Lancaster Laboratory at 7:15am for a blood draw. (As it turned out, that was not a necessary stop.) Next we headed for the Skyline Medical Office on the other side of town. Skyline is the location of the Infusion Center, but there is also a pharmacy there, and we needed to pick up my oral chemotherapeutic agent (Venetaclax), which I needed to start taking this morning.  Downstairs we went: from the pharmacy to the Infusion Center, arriving in plenty of time for my 8:30am appointment.  We didn't know what to expect, except that I would get an injection of the second chemotherapeutic agent . When I was called into the room, Jill stayed in the waiting area for a bit and then headed for the car.  There was some confusion about the procedure between the pharmacy and the Infusion Center. First, the medication had not yet been delivered. Second, there was a note from the pharmacy saying that I should receive 1.5 liters of nor...

The countdown has begun toward a new treatment regimen, beginning on Monday. It is curious how life unfolds. On Thursday morning, I told Jill I believe that we should be embracing life to the fullest extent we are able. By that I mean that where we can enjoy life experience, and especially when we can connect with loved ones, we ought to be doing that.  As a result of that conversation, we arranged to connect with two young couples who are dear to us. Then we got the news that I will be undergoing more treatment, beginning on Monday. My latest (yesterday) blood work shows that things are still wonky, but my ANC (a measure of immunity) is still in the "safe" zone. It will undoubtedly decline during the coming treatments, but for now it is as good as it can be. So, we are proceeding to make the most of this weekend by entertaining these lovely friends; one couple this evening, and the other tomorrow afternoon.  In the meantime, I am remotely advising another young friend who is...

As we sat on the patio last evening, processing all that had gone on during the day and determined to salvage a special day out of our wedding anniversary, my phone rang. It was Suzanne, Dr. Waugh's nurse. She is always a delight on the phone, and she began by saying that she had called to cancel our beach trip. We had told Dr. Waugh that we were scheduled to go to Newport for a couple of days next week to celebrate our anniversary, and she apparently passed that information on to Suzanne.  It is ironic that this is the fourth trip to Newport that we have planned and then had to cancel. The previous three were on account of freezing weather that made driving treacherous. Surely, we thought, a trip to the beach in July is safe.  Suzanne disabused us of that notion by telling us that I am scheduled to begin out-patient chemotherapy on Monday. She had called Jill, the RN in charge of the infusion center. We know Jill from past transfusions. According to Suzanne, when Jill heard i...

Today is our wedding anniversary. Jill has survived 21 years with me. Our marriage is old enough to drink!! In many ways, it seems like only a couple of years since our wedding day, and in other ways it seems as if we have always been us. This, I believe, is what is referred to in the fairy tales as "wedded bliss." Only, in our case, it isn't a fairy tale at all. It's just, well...wedded bliss. How I love that girl! A year ago today, I finished my induction chemotherapy at Club Sunnyside. Jill picked up German food at Gustav's, which is across the street from the hospital campus. She also picked up Bundt cakes from "Nothing Bundt Cake;" a little one for us and a big one for the oncology staff. It was as fine a celebration as we could muster under the circumstances, and one we will never forget.  Today we had a morning clinic visit. This time for Jill's blood pressure, which with the help of a new medication added to her regimen, is perfect, thank you...

Independence Day is past. It was a pleasant, quiet affair...until bedtime, when neighbors started setting off fireworks. The weather was mild, and everyone else was busy somewhere else. Jill and I had smash burgers and corn on the cob for dinner. All things considered, it was a happy holiday.  Today is July 5th, the day of my bone marrow biopsy. I downed my pre-meds, and we were off to the clinic. There was some rain on our way in to Salem, and skies were gray. This is not the July 5th that I always laughingly refer to as "the first day of summer." Last summer, while I was chilling (literally) in a climate controlled oncology clinic at Club Sunnyside, the temperature was 90º F, but it had been 117º F on June 28th, just a week earlier.  So, today, while quite pleasant, was not "the very model of a modern Major Summer Day." (with apologies to Gilbert and Sullivan). I'm not sure the temperature reached 70º F today. Works for me. I'm not a heat guy.  The biopsy ...