T+28 Drugs and criminal investigation

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	9.9	13-17	^
Platelets	123	140-375	^
ANC	1340	1800-8300	^

I must be feeling better...or worse. I haven't posted in four days! Actually, I am feeling better and stronger day by day. At my last lab visit, my counts all went up, and that's a good thing. Now, you may be thinking, "But Tom, they are all low vis-a-vis the standard range." I'm sure, gentle reader, that you think in terms like "vis-a-vis," right? Well, never mind. I find these counts to be remarkable, in that they were all achieved with no marrow stimulants. This is my new marrow, doin' its thang! My hemoglobin hasn't been this high since back in February, and although ANC is pretty low, I haven't been "neutropenic" (neutrophils below 1000).  And ANC hasn't turned around spontaneously without marrow stimulant since late November. Color me pleased. 

On Day 0, the day I received my transplant, the nurse asked me if I had planned my life of crime yet. (see T+0 The Big Show) To refresh your memory, the transplant has given me a new (additional) DNA. If someone were to take a blood sample and test my DNA, it would give a different result than if someone were to take a tissue sample and test my DNA. Essentially I am a dual person now. No, not two faced. I just happen to have two distinct DNA profiles. I had known this would be the case since I first considered transplant, and honestly, it kind of freaked me out in the beginning. But now I have come to terms with it. 

And, yes, there have been cases where police authorities have been baffled by finding the DNA at a crime scene of a person (BMT donor) who was known to be thousands of miles away at the time a crime was committed. The perpetrator had apparently had a BMT. I don't know whether the perp turned to crime opportunistically because he had different DNA, or whether he was a rotter before his transplant. Either way, it's a dirty trick to play on one's donor. 

After that conversation with the transplant nurse, I mentioned the situation to our son Patrick via text message. We had a good time bandying the thought about, and since then, we have referred to my new DNA profile as "John Dillinger." I want to apologize here and now to my donor, whose identity I don't know. If you should ever read this blog, kind donor, the John Dillinger handle is no reflection on you. We're just having a little fun based on the peculiarity of a person carrying two DNA profiles. It is a little weird, given that, for a couple of decades, DNA evidence has been considered absolute proof that a person whose DNA is found at a crime scene had to have been physically present at the time of commission. 

So, if I may continue the theme, and if I may return to my point about my blood counts rebounding without the help of drugs or transfusions, the remarkable increase in my blood counts is all the work of John Dillinger!

Next week will involve a couple of important events. On Monday, I will have a Bone Marrow Biopsy (BMBx). I am not 100% certain of all Dr. Meyers will learn from this BMBx. I know the biggest concern post-transplant is that the leukemia could relapse. Whether she will also learn things about the success of the BMT or John Dillinger's immune system, I am not clear. 

The second procedure next week will be an infusion of a drug called Pentamadine. Pentamadine is an IV antibiotic that is used to reduce the possibility of a certain type of pneumonia that has been associated with Fludarabine chemotherapy. Fludarabine is one of the chemotherapeutic agents I received before the BMT. I also received Fludarabine in December, February and March, during my final chemo treatments at Kaiser. Pentamadine is given monthly for a stretch of time following Fludarabine therapy. 

Other than these procedures, we are settling into a routine of twice weekly visits to the infusion center for magnesium infusions. One of the anti-rejection meds I receive tends to interfere with blood electrolyte levels. My hope is that when I stop taking that medication (not sure when) my electrolytes will stabilize. In the meantime, I am tweaking my diet to include more magnesium rich foods. In spite of the inconvenience, I am forcing myself to eat more dark chocolate, nuts, avocado (all favorites) among other foods. I'm also taking an oral magnesium supplement.

So, that's where we are as of day T+28. I am feeling a little stronger day by day, and my GI tract is beginning to adapt to all of the drugs that are assaulting it multiple times daily. Jill and I are very pleased with my progress to date, and the medical team seems to agree. Yesterday, I shaved off the few straggling hairs on my head. My beard has thinned considerably, but I am confident it will return. Isn't it interesting how vanity never seems to go away, even in the face of advancing years and intense medical treatment? I hang my head. 

Moreover, I saw under the sun that in the place of justice, even there was wickedness, and in the place of righteousness, even there was wickedness...So I saw that there is nothing better than that a man should rejoice in his work, for that is his lot. Who can bring him to see what will be after him? (Ecclesiastes 3:16, 20)