Red Cells and White Cells and Platelets, Oh My!

Virtual church. It's just not the same as gathering with friends for worship. This morning we were actually able to attend our church online. The last couple of weeks that was not an option. Our church, which instituted streaming the services during the Covid19 shutdowns, was having problems with the technology and we were not able to receive the signal. We do feel blessed that, although Dallas Church now has in person services (in fact they resumed in July, 2020), we also are able to stream the services for those who, for whatever reason, are not able to attend in person (that would include the immuno-compromised, like me). Still it is not the same.  All of that being said, this morning, the technology was working, and one of the elders, Geoff, gave a sermon titled Mission Possible. That iconic reference, of course, is to the TV Series from the '60s and the later series of movies Mission Impossible. As a foundational Scripture reference, Geoff used Matthew 19:26, "But Jes...

Today was lab day. Always a mixed blessing. On  the one hand, I am anxious to see my progress, and on the other, especially with the Thursday labs, I am concerned that I may need a transfusion, there will be no appointments available at the medical office, and another trip to the ER will be called for.  In an effort to prevent further ER visits, I connected with oncology and told them my sad tale of Monday's experience . The staff was in agreement that spending nine hours in ER, with its attendant dangers, to get a one our job done is not a good idea. We came up with a plan to have more frequent testing when my platelet count reaches a certain level. That will give us more lead time to get an appointment for transfusion.  Today's labs were interesting to me for several reasons. First, my hemoglobin is low, which is not surprising, but this will be the first time since I was at the Club for the original round of induction chemotherapy that I have needed a red blood cell tr...

There are a couple of things you don't want to hear from your doctor. One would be, "Go the the ER, now!" But another and maybe more terrifying one is, "They are swamped right now!" I know that the people working in the ER have no control over who shows up or when, but really couldn't people be more orderly about having emergencies? Why must they show up in droves, when I need to go there?  Yesterday's blood draw showed a platelet level of 7. Now, just for some perspective, when my platelet level gets below 50, I have to stop taking the blood thinner I have been taking to prevent more blood clots in my leg. If I continue to take it, there is significant risk of a serious bleeding event, the most serious being a brain bleed.   I knew when I got up yesterday morning, that my platelets must be low. Telltale signs include bleeding from my nose, hematomas (blood blisters) in my mouth and little red spots (petechiae) on my skin. I had 'em all. As grandpa u...

Last night, I awoke once again in need of a trip to the bathroom. Between the chemo drugs and the huge amounts of water that I consume to help flush them out of my body, these awakenings happen multiple times every night. Sometimes, I have difficulty in getting back to sleep. That's where I found myself in the wee hours.  Often, my wakefulness is the result of my mind becoming focused on something about which I'm troubled or curious or something I think I need to take care of. In this case, I decided to have a little pity party. Surprisingly, I was not feeling sorry for myself because I have leukemia, but because I have to go through the chemotherapy treatments. I find the times between treatments tiresome, because, well, I'm tired all the time. I'm unsteady on my feet, and feel as if I'm prematurely aged. I am accustomed to robust health and being able to pursue the things I love to do with a good measure of energy.  Of course, the irony of all of this is that with...

"Let no grass grow under your feet," that's what I always say. I came home from Club Sunnyside on Monday. Yesterday (Thursday) I had my first blood draw for stat labs since I was discharged, and before the results were posted, I got emails indicating I am already scheduled for my next visit to the Club. I have appointments for all my blood work and a pre-admission consultation with the oncology nurse practitioner. I also got an email directing me to schedule a Covid screening test. I haven't made that appointment yet, simply because the options for scheduling require me to go to another medical office. Since I will be having blood drawn at the Skyline Medical office on the very day that I am directed to have the Covid test, I will request to have them done at the same visit.  It's odd how experience shapes perception. I have had a harder time with the aftermath of the chemo this round. It's not that I feel ill, I am just weaker and have experienced more light-...

Every day a new adventure awaits. "Weeping may tarry for the night, but joy comes with the morning" (Psalm 30:5) No weeping tarried for me last night, but a lot of trips to the bathroom did, as my body clears out the aftermath of my latest chemotherapy. I lost three pounds since yesterday morning; all fluid I'm sure. Please don't think this is a miracle diet. It's a hard way to lose weight.  Jill has been concerned about the weight loss I experienced during the induction chemotherapy and the first round of consolidation. She's been feeding my like a prize steer in the Chicago stock yards. I bottomed out at 183 pounds, but I am back up to my usual 195 as of today. The medical staff has told me this is no time to concern myself with weight control or calorie counting, so I haven't. Now my concern, as a compulsive eater, is whether I will be able to curb my intake, when the time is right. Mmmm, ice cream every evening... Today, I am feeling the effects of the...

Stepping from the car, after a pleasant ride home from Club Sunnyside, Tom was excited to see the new look of the front of the house, where four overgrown plants were removed in his absence. He took a few steps out of the garage, and in the midst of acknowledging a "Welcome Home!" from the neighbor across the street, he promptly found himself in a pile in the bark dust.  My knees just collapsed! Went to jelly. It is the oddest sensation when a body part just stops working as expected. There was absolutely nothing I could do, except to accept my fate. This was not the homecoming I had planned or hoped for. It was awkward and a bit sobering.  Thank God it was also short-lived. I got up and dusted myself off, thankful that I didn't go over backward and bash my brains out on the pavement. I got my cane from the house and we proceeded to take our daily walk around the neighborhood without further incident.  The day was pleasant after that. My ANC, is currently high, and on the...

Dose six of six for this round of consolidation chemotherapy is underway, and I am scheduled to go home again this morning. I told Jill yesterday that the last day is the hardest...you know, "so close and yet so far away!"  This round has been a good one. My plans for more things to occupy our time here at the Club have worked out splendidly. We finished our novel yesterday. It was full of twists and turns that we didn't expect, as all good mysteries are,  and we thoroughly enjoyed it.  I have watched some old, old movies that I really enjoy but that aren't among Jill's favorites. It fills my time after she leaves me for the day.  We have been able to walk daily around the campus, because the weather has been perfect and my blood counts have been in the range where I have a fair amount of energy. Yesterday, we walked 1.8 miles; not bad for an ailing septuagenarian!  And so today I am homeward bound. While I was gone we had a tree service come in and trim trees a...

September 11, 2021. It is twenty years since we all were assaulted by the horror of airliners full of people crashing into buildings full of people. Briefly the greatest nation the world has ever seen was brought to its knees. And then the first responders arrived, rushing into the fray as everyone else fled the death and destruction. Over 3, 000 lives were lost that terrible day. The families of those 3,000 still live with the terror and senseless loss of that tragic day. In the aftermath, people did what people always do, when the world they knew is turned upside down. We ask, "Why?" And then we go to church and say a few prayers for a few weeks, and then we begin to forget. So, now we have a generation of college students who only know about "9-11" from history books. It kind of takes the punch out of the terror we all felt that day. I wasn't around for the Pearl Harbor attack in 1941, but after 9-11, I felt I could understand more what our nation must have b...

It is day two of my current stay at Club Sunnyside. Doses one and two of HiDAC* chemotherapy have been administered. That went well. The condo where Jill stayed last time has not been available, because our dear, generous friends who lent it to us have been staying there this week. In truth, they invited Jill to stay in one of the guest rooms with them, but they had extended family there with them, and it seemed like we would be intruding, in spite of their protestations to the contrary.  Because we chose not to stay in the condo the night before my hospital admission, scheduled for 7:45AM yesterday, we had to leave home around 6:15AM, (good thing we are early risers by nature), which caused a departure from our usual routine of a leisurely cup of coffee and catching up on email, but it was not a difficult change. We arrived in plenty of time and were admitted at 7:45.  Unfortunately, because the hospital is experiencing high occupancy right now, due to a surge in Covid19 case...

After a rather tumultuous run-up to the big event, we are definitely scheduled for admission to Club Sunnyside tomorrow at 7:45AM.  My most current labs are pending, but given that they looked great on Sunday, we are confident there will be no surprises.  A few things we have learned during previous vacations at the Club. First, during consolidation chemotherapy rounds, there is a lot of unoccupied time. Chemotherapy happens on day one about 5PM, that's so the second dose can be given at 5AM the next morning. This arrangement is good for the patient, in that I won't be awakened at, say, 1AM for the second dose, which would be the case if they started therapy at 1PM. It also works out well for the staff. They can get the chemotherapy administration, which takes around two hours, completed before the shift changes at 7:30.  So, if we do the math, Check-in is at 7:45AM and Chemo starts around 5:00PM. That's about nine hours of unstructured time. Some of it will be occupied b...

Sometimes things just don't go as we planned or thought they would. As Jill and I approach our next visit to Club Sunnyside, everything has been falling neatly into place. I had blood work on Thursday. We had a pre-admission consultation with an oncology nurse practitioner on Friday. All of my labs looked good; well, my ANC was at zero, but there was time for it to rebound. I have made an appointment for a pre-admission Covid19 test for Monday, and I have an appointment for more blood work on Tuesday. Wednesday is D-Day: check-in day at the Club.  But, last night I went to bed after taking my evening meds; all five of them. I woke up around 10PM (yes, I was already in bed asleep by 10) and found that when I would take a deep breath, I had some kind of tension or pressure in my upper chest and lower neck. Now, this wasn't the classic "elephant sitting on my chest" that people describe associated with an acute myocardial infarction. For one thing, it was not constant; i...

 In our entryway hangs a painting by Sam Toft. Sam is one of our favorite artists because of her whimsy and her unique style. We have several of her works (well, prints, actually). The painting I refer to is one of a set of four depicting the seasons of the year. The one currently on display is Spring. I was supposed to change it out for the Summer painting on the summer solstice, June 20, 2021. We have a dear friend who says he counts on our season painting to keep him straight on which season we are currently in.  I didn't change the Spring painting to the Summer, because by June 20th I was feeling pretty rotten and didn't know why. I just couldn't muster the strength or the desire to make the change. Five days later I landed in the hospital with a diagnosis of Acute Myeloid Leukemia. (It just occurred to me the irony that I didn't put up the summer painting, and I didn't really have a summer, at least not like the ones I have known.) This morning Jill and I had a...

 Last week was kind of difficult, or at least complicated. By the time it was over, we had made four visits to the medical clinic. That's a thirty four mile round trip. Two of the visits were for blood draws. They were on Monday and Thursday. The other two, on Tuesday and Friday, were for platelet transfusions. I am approaching the point where my blood counts are at their lowest following my last round of chemotherapy.  When I am in this phase of the treatment, I get light-headed, fatigued and prone to bleeding. I was fortunate to get the Friday transfusion, because if I had not, and if I subsequently had a bleed, it would have meant a visit to the ER. That in turn would have meant mingling with lots of people. Now I like people, but with the current rise in Covid cases, I would just as soon not be exposed to them. Thank the Lord for Friday platelets!  Our son Patrick had a lot of fun teasing me about whether platelets were tiny little plates. As he put it, platelets <...

Time is a precious thing. When we run low on time or waste it, we can't go out and get a job to earn more time, as we can when money runs low. (Yes, I know, sometimes getting a job is not as easy as saying, "I think I'll get a job," and poof, you have a job, but that's not my point here.) Time is like water you scoop up with your hand. It runs through between your fingers and before you know it, it's gone.  This past several days has been a little like that for me. The days go by, and although I want to be doing something "productive," I find that before I know it it is evening. I am tired and I want to sleep.  If you read my previous couple of posts, you know that I have had some symptoms that were confusing to me. As a result, I learned that it is not only my level of hemoglobin that determines how I am feeling and functioning, but other parts of my miraculous blood. Yesterday, I got an infusion of platelets. My platelet level had been plummeting f...

 If you haven't read my last, previous post, please be kind, and just skip over it.  The older I get the more it seems I only open my mouth to insert a foot! After all the complications involved with getting my blood drawn yesterday, and with all my bragging about how I just knew my hemoglobin was plummeting and that I would undoubtedly be the recipient of at least a red blood cell transfusion today, well I was just wrong. Wrong, wrong, wrong!  When the lab results came back, not only has my hemoglobin NOT  plummeted, it actually increased very slightly. Now, in my defense, it is still below the normal range, but nevertheless, I read my symptoms incorrectly. My platelet count is rapidly tanking, but RBCs, not so much.  After I got this news, I became a bit alarmed, because based on my rudimentary knowledge of blood tests, I could not see anything in the lab results to explain my symptoms of light-headedness, ataxia and general feeling of weakness. This is the po...

 Learning to read is a big task. I suppose that's why it is best to do it while one is young and has a bright young mind to absorb the details and the nuances involved in turning ink blotches on a page into coherent thoughts to be transferred to the brain. It's kind of like digitizing old photos. You need a sensory device (camera) to record the ink blotches (letters, photos) and a powerful processor to convert the images into strings of impulses that can later be sorted by processing them in reverse to extract their meaning and reconstruct the image.  Now what is that all about? It occurred to me that part of this experience of living with a new paradigm is like learning a new language and how to read it. Today, I have an appointment for a blood draw. The purpose of the blood draw is to tell my medical team how my body is responding to the recent chemotherapy I had. In the meantime, though, I have discovered that my body can tell me a lot about what is going on without doing l...

Home again! Consolidation chemotherapy session number one is in the history books. It went well. I feel great, and (did I mention this?) I'm home. I convinced Jill that I don't want her to become my full time caretaker. I want her for my wife. So, we hired a housecleaning agency. While we were at the Club, they came in and did a thorough, deep cleaning of the house. So, we came home to that. Not quite as dramatic as the new floors, but also not as intrusive. Shine and Sparkle will be back every other week to help Jill keep the house, while she attends to a lot of other things that I normally would do.  As we were on our way home yesterday, we were passing a field, or maybe it was a truck, but something had a strong odor of onion. We started talking about all kinds of things it could be: onion, garlic, leek, scallion, and then we could not think of the other "s" bulb.  We both wracked our brains for the word. For years, I have maintained that failing memory in the elde...

 "Rounding the club house turn." Isn't that what they call it just before the horses head down the stretch to the finish line? Well, whatever that means, I think I am there for this round at Club Sunnyside. I have had four of my six doses of chemotherapy, and I feel like the horse on the stretch, riding the rail.  Hemoglobin and ANC are starting to fade, Low Immunity is beginning to make his move on the outside. Lethargy is also beginning to plan his advance in the pack. Confidence remains steady and Spirit is near the head of the pack. Although this race is only 5 furlongs, it feels good to be leading the pack and anticipating a win by at least a half a length. Then I will be put out to pasture for about three weeks prior to the next race.  Those of you in the stands, keep on cheering, please. I need all the encouragement I can get.  1 Corinthians 9:24 Do you not know that in a race all the runners run, but only one receives the prize? So run that you may obtain i...

I mentioned yesterday my concerns about returning to the hospital, when I am feeling so good. Well, just let me suggest that you not go to the "dark place," as I call it when Jill or I over-react to unknown future events.  I have had two of six doses of the consolidation chemotherapy that I will receive during this visit, and I feel great. My appetite is good and my energy is good, too. I expected to feel pretty awful by now. Nope! Now, when I get home on Monday, my immune system will begin to tank, and my hemoglobin will drop, leaving me lethargic again, but I am not going to imagine how that will be, because I don't want to go to that "dark place."  Although I have not actually inquired about the term, the staff keeps referring to this consolidation chemotherapy as "high dose Cytarabine." Here is what I have concluded. I am actually receiving a higher concentration of the same medication I had before, while I am plugged into Olive Oyl for my infusion...

Did you ever have one of those situations where you feel uneasy, but you can't figure out exactly why? That's how my morning began. Eventually, I figured out what was going on.  I am back at Club Sunnyside for round one of consolidation chemotherapy. It hit me as we were walking from the admitting desk to the Oncology department on level 4A. The last time I checked in here, I felt lousy and arrived on an ambulance gurney, and although I had to stay a month, when I left I felt good. This time I came in feeling great and arrived under my own power. After the chemotherapy, I know I will feel less than great for a while.  In the night, when I woke up with this uneasiness, I was reminded of the story of Jesus in the Garden of Gethsemane on the night he was arrested. He knew He was going to go through a very difficult and painful time, and worst of all, He would be separated from His Father. He even prayed, “Father, if you are willing, remove this cup from me. Nevertheless, not my w...