T+3 Conjoined twins

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	6.9	13-17	v
Platelets	59	140-375	v
ANC	MIA	1800-8300	v

Did you ever have a conjoined twin? No, I don't suppose you did, but then again I don't know that for sure. I am definitely at or approaching the nadir, or bottom of the barrel, as far as blood counts are concerned. This is expected about now. Check out the Box Score for today. My platelets are still hanging in there. Above 50 I consider to be acceptable. If I were home I would be on blood thinners at this level. Still there is a risk of bleeding, bruising, petechiae (tiny red spots on my skin), and other fun things. When they go below 10, I will need to have them replaced by transfusion. 

Ah, funny you should mention transfusion. With my hemoglobin at 6.9, I got a bag of Red Ryders, otherwise known as red blood cells (RBCs). They certainly helped with my shortness of breath. And that brings me back to the question of conjoined twins. At 6:00 am I was conjoined with my old buddy Olive Oyl (see Unpronounceable Medicines and Olive Oyl), aka IV stand. Now, I can take her with me many places, but like a conjoined twin, I can never be free of her. 

After a couple hours of receiving RBCs, another infusion was started with an IV antifungal medicine. You see, I don't have a functional immune system yet. So, I have to be protected by medicines from things like bacteria, viruses, and fungi. So, that was another hour with Olive Oyl. Following the funginex, I received a medicine called Mesna. It makes you really smart. Oh, no, wait. I think that would be Mensa. Mesna is given to protect my bladder from damage caused by crystal formation in my urine. (Eww, TMI) But why would I need protections from crystals, you ask? 

That's because the next thing I got from Olive Oyl was an infusion of Cyclophosphamide, which I received before the transplant to help kill off any stray leukemia cells and my faulty marrow cells. And Cyclophosphamide can cause crystals to form in the urine and damage the bladder. If you have been following this saga, you may remember that after the transplant, I was given a couple of days off from chemotherapy. The purpose of that rest period was to allow the new cells to begin attacking those stray leukemia and marrow cells. 

But left to their own devices, those new immune cells might just think, "Hmmm. That was a nice snack. I wonder if these liver cells and heart cells might make a good meal." So, I will receive Cyclophosphamide for two days to keep them in check. 

Now, if you are able to count to two, you will recognize that I have one more day to go with the chemo. Did I mention that along with the Cyclophosphamide  I receive liter after liter of saline (salt water) while Olive and I are doing our thing? In part that is to help me produce plenty of urine, which I am ordered to expel at least once every 1-2 hours. Part of the whole crystal conspiracy. The saline drip will go on through the night, and then we will start over in the morning. Depending on my blood counts as of midnight tonight, that could include RBCs and/or platelets. All the rest of the stuff will be repeated tomorrow. 

So, if you've never had a conjoined twin, but you would like to know what that might be like, get yourself an IV pole and several bags of saline, and have a licensed professional start an IV in your arm for attaching the saline bags, and give it a whirl. 

Who knows, you might like it. Just remember to put on your favorite shirt before you start, because you can't change your shirt when you have a conjoined twin like my Olive Oyl.

 A man of many companions may come to ruin, but there is a friend who sticks closer than a brother. (Psalm 18:24)