Red Cells and White Cells and Platelets, Oh My!

Yesterday marked one month since my last blood draw, so it was time for another. I had no concerns about this one, except for curiosity. You see, I have been feeling so well that it seemed apparent I am in good health. Since a blood draw means a visit to one of the three Kaiser Permanente medical offices in Salem (about a 20-30 minute drive), we like to combine them with other errands.  As it turns out, we had a couple of other stops we wanted to make. I have been doing a little remodeling in my home brew pub. One project that was long overdue was to install a light over the sink. For that I needed an electrical junction box. Our local hardware store was out of the one I needed, so we added a stop at Lowe's to our Salem junket. We also needed a few things that we normally get at Costco, and this seemed the perfect opportunity to see the brand new store that opened a week or two ago.  So, we hopped in the Ford and headed for "town." Lowe's was first on the list, since ...

On Tuesday I had an appointment with my ophthalmologist. I have been waiting for this, because one of the side effects of chemo therapy has been that my eyesight has changed significantly. Shortly before my diagnosis, I got new glasses. Now I can barely see through them. Interestingly, I found that an old pair of glasses from my past work better, so I have been wearing those.  Before I go to the optometrist to get new glasses, it seems like a good idea to have an ophthalmologist check my eyes to make sure they are organically healthy. As it turns out, there is a problem. Dr. Osterholzer, whom we know affectionately as "Dr. O," said my corneas are "a little wonky." Jill loved that. She said, "Now that's a medical term I can understand!"  By "a little wonky," Dr. O explained she meant that the corneas of my eyes are kind of wrinkled around the edges. She also mentioned that my left cornea has a nodule along one edge. In addition, my eyes seemed...

Did you ever get the feeling someone is preventing you from doing what you want to do? Well, of course, we have all been prevented in one way or another from pursuing something we desired. But this is kind of strangely specific.  In my last post, I mentioned that "my number had come up" in the lottery to receive a treatment of EvuSheld . As I mentioned, I was scheduled for the injections on Tuesday, and sure enough I received them. The advantage of this regimen is that I could get more or less instantaneous antibody protection against Covid19 before exposure. This is important for us immunocompromised patients, because our bodies may not create enough antibodies, even though I have had three doses of vaccine. EvuSheld provides antibodies directly into my system to help prevent a Covid infection. This treatment is distinct from other monoclonal antibody treatments which have been given to vulnerable patients AFTER they contracted Covid.  Having this new level of protection has...

You've heard of Wacky Wednesday and Taco Tuesday, right? Well, today is Marvelous Monday. This is the first Monday since August 2, 2021 that I have been both of the following simultaneously: 1) not in the hospital AND 2) not required to go to the clinic for a blood draw! We almost didn't know what to do with ourselves. I won't have another blood draw until March 21st!  But wait, there's more! (Didn't I hear that on TV somewhere?) As you know, if you follow the blog, we have been struggling with understanding how careful we need to be as we come out of quarantine. Part of the problem is that we couldn't seem to get clear information about whether I am actually immunocompromised, and if so, to what degree. A couple of emails to my oncologist have yielded some vague information, most of which comes from the CDC guidelines about Covid precautions. Today we got something we can sink our teeth into. About two weeks ago, the Nurse who did my blood draw said that there ...

After forgetting to post my good news last Monday, I decided to be Johnny-on-the-spot today. I had my first blood draw in the new era of APL (After PICC Line). This was a mixed blessing. Whereas I had to be poked in the arm (no big deal), I also didn't have to make an appointment (just show up at the lab), then again there was a bit of waiting without an appointments. I didn't realize how many people show up first thing on Monday morning for lab tests!! Jill also needed to have a blood draw today, and by the time we were both finished and got to our next stop, which was Walmart half a mile down the street from the clinic (for our grocery pickup), only about 35 minutes elapsed. Acceptable in my book!  And now for the news you have all been waiting for. My lab results!!  PARAMETER VALUE NORMAL RANGE RBC count 4.4 4.0-5.5 Hemoglobin 14.1 ...

Do you ever get so excited you forget to do something important? That's what happened to me this week. If you read my last post, you know that I was OKed by my oncologist to have my PICC line removed. And so, on Monday my old friend was removed from my arm and with no problems. The last time I had one removed there was some bleeding afterward that was not serious, but it was annoying. Francisco, the RN at the Nurse Treatment Center who removed this one just stood by my side and held finger pressure on the exit wound while we chatted about different things. After, perhaps, ten minutes, he put a pressure dressing on the wound, told us he was going to miss seeing us (since I will now have to have my blood draws done by a phlebotomist in the lab), and bid us adieu.  I was like a kid at Christmas. As much as I appreciated having the PICC line when I needed it for frequent blood draws and transfusions and chemotherapy infusions, it was a bit bothersome having to be sure I kept it dry whe...

We had a consultation with Dr. Waugh, our oncologist, yesterday. Bottom line: I'm officially in remission. Praise the Lord! My latest bone marrow biopsy (BMB) showed no sign of disease in my marrow and the KIT16 mutation that was associated with my Systemic Mastocytosis is gone. In fact all of the mutated genetic markers that were previously found are gone. There is one genetic factor that is of mild concern, but whether it actually causes leukemia is unknown, and it sometimes shows up after chemotherapy and in people who never develop any disease. Dr. Waugh will consult with Dr. Cook at Oregon Health Sciences University (OHSU) to get her opinion in the matter, but for now no further treatment is currently recommended, except for monitoring my blood counts.  Even the blood draws will be reduced to once a month, providing they continue to be good by the end of this month. That really boils down to how my labs come out on February 21st, my last scheduled draw this month. Less freque...

You know what it's like when Christmas morning finally arrives, after you have waited for it for weeks or months? You know what's better? When you've waited months and it finally happens that  your hemoglobin level climbs back into the normal range. Today is the day!! I think I'll call it Hemoglobinmas Day.  Today was the day for my biweekly blood draw, and I was hoping for some improvement in my hemoglobin level, which is all related to my Red Blood Cell (RBC) count. Two weeks ago my hemoglobin had slipped from 12.4 to 12.3 (normal is 13-17). I was so happy two weeks ago when Dr. Waugh said I only need blood draws every other week, instead of weekly, and now this news: my RBCs are at 4.19 (normal is 4-5.5) and my hemoglobin is at 13.4 (normal is 13-17). The hemoglobin jumped 1.1 in two weeks, and that's huge.  Once again, I am amazed by and grateful for the amazing body that God designed for me and gave me 75 years ago. It has bounced back yet again. Can't help...

I got a preliminary report on my bone marrow biopsy. It reads in part,  “- No morphologic or immunologic evidence of previously diagnosed acute myeloid leukemia.  - Molecular analysis: genomic microarray and NGS pending."  The pending studies, from what I can learn on the web, are used to study genes or parts of genes. I'm not sure what they may be looking for with those studies, but everything in the report I received indicates that none of the cells they looked at are abnormal. I suppose these gene sequence studies are meant to take the search that much deeper. I give my medical team high ratings for their thoroughness. I have an appointment for a consultation with my oncologist scheduled for a week from tomorrow. I expect the pending studies will be complete by then, and Dr. Waugh can interpret all of this stuff for me. Praise the Lord; it all looks good from here! This report is very encouraging to me and especially so to Jill. Still, we choose to live one day at a ti...

Today is the anniversary of the eradication of my cancer. No, unfortunately, my leukemia has not been declared to have been eradicated. I'm referring here to my colo-rectal cancer, which was treated surgically 26 years ago today. Some days after the surgery, I was seen by an oncologist who told me that the surgery was apparently successful, since no sign of the cancer was found in the many lymph nodes that were removed during surgery. When I asked him whether I would need radiation therapy or chemotherapy, he said, "Well, I could do either or both, if you like, but I have no reason to believe that would be of any benefit." That was good enough for me. I told him I would just as soon not have either, if there was no benefit.  So, here I am 26 years and countless colonoscopies later, free of colo-rectal cancer. Now if I were a big league baseball player, I would say that batting .500 would be good enough, but in real life, my goal is to be batting a thousand, where it comes...

No, you are not on the wrong blog! I changed the picture in the header. The other one was kind of drab and depressing. Maybe that's how I was feeling when I started this blog. I think this one is cheerier and kind of fits the subject matter. Let me know what you think.

It's funny how anxiety can sneak up on you. Today was Bone Marrow Biopsy (BMBx) day. This is the third time I have had this procedure done. The procedure itself is what I would call a non-event. They use a bit of lidocaine to numb the skin over the crest of the pelvic bone. Once that is done they go back in with more lidocaine and kind of soak the surface of the bone. The biopsy itself amounts to drilling a hole through the bony cortex and into the marrow space. This procedure is done with a specially designed instrument.  The instrument consists of a tube with a cutting edge on one end and a handle on the other end, allowing the operator to twist the blade through the cortical bone. Once the tube has been inserted to the proper depth, a central rod is  removed from the instrument, leaving a hollow canula, through which a sample of marrow tissue is withdrawn with a syringe. Michelle, the NP who did my biopsy today, said the sample looks like rich red blood, although she didn'...

Sometimes, you just have to wait. I last met with Dr. Waugh, my oncologist, on November 8, 2021. That was the day I checked out of Club Sunnyside for the final time after completing all of my HiDAC chemotherapy rounds. On December 4th, I had a consultation with Dr. Cook, the oncologist who specializes in bone marrow transplants (BMT) at OHSU. At that appointment, we learned that a suitable donor for BMT was not found in the worldwide database. Dr. Cook told us that day that she would consult with Dr. Waugh about where to go next with my treatment.  Well, today was the day we had a consultation with Dr. Waugh to discuss the way forward. Unfortunately, due to current Covid19 protocols, Jill was not able to accompany me into the meeting, be she was able to be part of the festivities via phone. Dr. Waugh had some good news and some other news. Whether or not the other news turns out to be good, bad or indifferent will have to wait until after I have another bone marrow biopsy (BMBx). T...

Oh, my! How the time goes by. I hadn't realized how long it has been since my last post. We had a call this morning from our financial advisor to go over some planning for the coming year. He asked how I am doing, to which I replied, "I'm doing great; and you?" Well, he wasn't buying it. He said, he is doing well, but he questioned the veracity of my claim to be doing "great." Wayne was one of three people who came to the hospital to pray with and for us when I was first diagnosed. The other two were our pastor and a dear friend from dental school days, who is also the owner of the condo where Jill stayed for most of the days that I was hospitalized for consolidation chemotherapy.  But really, at the moment, I am doing great. My last lab report showed all my blood counts "within normal limits" (WNL), except for my red blood cells and hemoglobin, which are essentially the same issue. Even my hemoglobin was at 95% of the low end of being WNL. I f...

Timing is everything. I posted on Monday that we had had a lovely drive in the country on Sunday. What I didn't mention is that we took the pickup. Now "Black Beauty" has not had much driving in the past seven months. We have taken her out for a couple of drives over the past 4-5 months with Jill at the wheel, but mostly she has sat in the garage. I sometimes imagine her weeping quietly, since she hasn't had an opportunity to pull the trailer or haul a load of bark dust.  So, when we boarded her for our Sunday drive, I put the key in the ignition and gave it a twist. There was some kind of chattering noise, but no activity from the starter. I was surprised, because I have had a battery charger hooked up for some time. Fortunately, we have a portable battery jumper for just such occasions. It did the trick, but not without some difficulty. Once the engine was going, ol' Black drove like a champ.  When we got home, I reattached the battery charger. Now, during the i...

Today is lab test day, and the results are good today. All of my blood counts are in the normal range, except for red blood cells. So, today is a good day.  In fact, this past week or more has been like a new leash on life. I have been doing some projects around the house. I have been driving here and there. In fact yesterday we went for a drive around the countryside. It was a gorgeous day with a cloudless sky and the temperature was around fifty degrees.  We headed north from Dallas toward Perrydale, a very small village that serves many in the farming community, primarily by means of a school system that is highly regarded. People put their names on a waiting list in hopes of securing a place for their children in Perrydale schools. Other than the school buildings and a few homes and a small church building, there is not much to Perrydale. All of these buildings are clustered together near the intersection of the two roads that cross in the village, Perrydale Rd. and Bethel...

 Just  a quick update. If you read my previous post titled Life's Little Mysteries , you may recall that I was disappointed in my labs from last Monday. In particular, my absolute neutrophil count (ANC) was very discouraging, because it had plummeted over the course of the previous three blood tests from 2690 to 1160 (normal range is 1800-8300). In fact, it was nearing the level where I would need to resume taking anti-biotics, which carry risk of allergic reaction, and anti-fungals, which are hard on the liver. To be precise, one week ago today, my ANC was 1160. At 1000, I go back on the meds.  So, I was keenly interested in today's result. I am proud to announce that my ANC today is 2940!! My hemoglobin has also increased to 11.9 (92% of low normal). Hemoglobin, which is present in red blood cells (RBC), as you will no doubt recall, is the protein that carries oxygen to the body's tissues. Pretty important. RBCs are the slowest to regenerate of the blood elements, so it...

Life must be hard! Every year at this time, I hear myriad people giving thanks that last year is over and that we get a "new start." And I am one of them. Last year was hard in many ways. We started the year still being bombarded by the fallout from a pandemic that had begun a year earlier. Millions were unemployed, thousands were suffering from the Covid virus. There was political upheaval as a new president attempted to undo on his first day in office everything that his predecessor had done in the previous four years. Half way through the year, I was diagnosed with acute myeloid leukemia (AML). And the remainder of the year, for me, involved fighting for my life against an enemy I can't even see. Five rounds of chemotherapy later, I am here. I am recovering. I am feeling better, although I am currently back in quarantine as my immune system is once again flagging. The oncology team assures me that this current set back is all part of the game, but it is getting harder ...

If only I could remember things from one day to the next. In my previous post, I shared that my ANC has been plummeting over the course of the last three weeks. This is a great concern to me, because just as we were beginning to emerge from quarantine, I learned that my immunity is dropping again. The fact that I couldn't seem to connect with the oncology office didn't help to allay my anxiety.  Yesterday, I was finally able to make contact with the oncology office. I spoke with one of the nurses about my concerns, and what she had to say was, well, helpful if not comforting. She reminded me that recovery from chemotherapy takes a long time...several months to a year. One of the things that happens as my body seeks the point of equilibrium between my bone marrow being beaten down by the chemo and returning to its normal function of making new blood cells is that there are periods when new cell production goes kind of wild and may overshoot the target.  There are also times whe...

Life is full of little surprises and little mysteries. For example, white Christmases are somewhat unusual in Dallas, OR. And although the snow didn't start falling in earnest until Christmas evening, we did have an accumulation of maybe an inch of the white stuff by the time we went to bed. The next day we awoke to about 4" on the ground, and the storm brought us another three or four inches during the day. And then, yesterday, we awoke to about three additional inches of snow.  Mondays I have a standing appointment for my blood draws and PIIC line dressing change. We debated about pursuing the 23 mile drive to the clinic in Salem and back, given the road conditions. Then it occurred to me that to miss my appointment would mean having to go later in the week. Since the forecast doesn't sound encouraging for the weather conditions to improve before the weekend, "later in the week" would effectively mean next Monday. In other words, I would go two weeks without la...