T+59 July the HOT!

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	11.3	13-17	v
Platelets	151	140-375	^
ANC	2810	1800-8300	v

A number of years (or decades; I can never keep those straight) ago the famous comedian and host of the Muscular Dystrophy Association's annual telethon, Jerry Lewis, did a TV skit about a guy who couldn't stand hot weather. In the skit it's July; it's Jerry's birthday and it's unbearably hot. His dear wife scrimps and saves so she can surprise him on his birthday with the most powerful air conditioning unit available. While Jerry is at work, she has it installed in their living room, hidden behind a drape. 

When Jerry arrives home from his job, she greets him with a kiss and says, "Do you know what day this is?" He replies, "July the HOT." She says, "No Dear, I mean it's your birthday! And I got you a present. It's behind the drape." He is not interested in birthday celebration all he can think of is the heat. If I recall correctly, he begins taking off clothes and looking for cold things to drink. 

His wife pulls back the drape to expose the AC unit and tells him it is his birthday present. He asks what it is, and she tells him, "It's the most powerful air conditioner available." He looks at her like she is crazy and asks why she hasn't turned it on. So, she turns on the unit, but it isn't cooling things off fast enough to suit Jerry, and he turns the temperature setting to the lowest possible temperature. (You know where this is going, I'm sure.) 

Soon, the temperature drops, and Jerry is happy. But then it starts getting too cold. When he tries to adjust the temperature, the control knob is frozen in place. Next thing you know, snow flakes start coming out of the unit and then a full on blizzard. He then, of course, is scrambling to find his ski suit and parka.*

I tried to find a video of the skit online, but failed. The point of my relating this tale (with apology to Jerry Lewis if I got the details wrong) is that since I saw that skit, in my mind any excessively hot day has been July the HOT. And now it's here again; July the HOT times 3 or 4 or 5, depending on which weather forecast you read. That's the number of days predicted to be over 100º in the next week. 

Jill and I don't have the world's most powerful AC unit in our apartment. We have a fan. It is a nice fan. It has several speeds. It oscillates or holds still. It is about two feet in diameter. It is quiet. It is not an AC unit. But don't pity us. We chose this place, and we are stuck with it. Also, because it is a basement apartment with only one wall of about 10 feet by 7 feet that ever possibly gets sun on it, and that is only in the early morning, the temperature varies very little day to night, hot days to cold days. And besides, if it ever gets too hot in here, our landlord who lives next door, has a portable AC he has offered to install for us. We'll see if we need it. 

In other good news, we had a meeting with Dr. Meyers on Friday. My blood counts are stable, my magnesium count, which is the only thing I get by IV infusion these days, is rising, so I need less and less at each infusion. And I have had some very minor rashes on my head and upper back. 

Wait, what? How are rashes good news? Well, one of the signs that the bone marrow transplant (BMT) is working is when a little graft versus host disease (GVHD) occurs, and these rashes show that GVHD is happening. And that means my new immune system is working! The rashes are very minor and are quickly controlled by a little cortisone creme. Dr. Meyers suggested that I use the creme daily, even without a rash, because one of the things it does is to increase the number of lymphocytes in my system. Lymphocytes are immune cells that like to eat cancer cells! So, bring on the Hydrocortisone creme! (This is a much more powerful version than you can buy over the counter. Consult a physician before using corticosteroids.)

I think Jill and I agree that the best news we got on Friday was when Dr. Meyers said, "I am so excited, because your bone marrow biopsy (BMBx) showed that 100% of your immune cells are donor cells." She went on to explain that a 30 day post transplant BMBx rarely shows 100% conversion. She has a theory about why mine is one of those rare cases. 

In essence one of the chemo drugs (Fludarabine) that I was given prior to the transplant is used to kind of prime the pump by making the target cells more vulnerable to the second chemo drug (Cytoxin). The idea is like putting red flags on the unwanted cells with Fludarabine so the Cytoxin can more readily find and kill them. In my case, and this is where Dr. Meyers' theory comes in, I also had Fludarabine on three occasions within a few months prior to being admitted for transplant. So, Dr. Meyers was not only excited that my treatment is going well, but also because she thinks she knows why! Fludarabine! 

So, I will readily put up with a little GVHD and the inconvenience of having to use cortisone cremes, for a better than usual result in my transplant history! Maybe in some little way, I have advanced BMT science by being in the right place at the right time. And you thought God didn't have a purpose for letting me go through these three years of battling leukemia. 

Call to me and I will answer you, and will tell you great and hidden things that you have not known. (Jeremiah 33:3)

 

* My dad had a little poem posted in his home office that went like this: 

As a rule, a man's a fool. 

When it's hot, he wants it cool. 

When it's cool, he wants it hot,

Always wanting what is not!