Chimerism (ki-mer-ism)

Another Monday clinic visit. I spent 5 hours at the clinic yesterday and all that happened is they drew blood and gave me a Neupogen shot. Sometimes it's like that. There seemed to be a serious staff shortage yesterday. No doctors at all, one nurse and one nurse practitioner. Every tech was there however. I asked where everyone was and got a short, frustrated answer, "OUT!"

Mary Burkhardt, NP, reported the chimerism (ratio of donor cells in the bone marrow) is 56% donor and 44% recipient. This is from the bone marrow rather than the blood which I reported a few weeks ago. Everyone would like that number to be 100% at this stage of the game. A likely next step is a booster of lymphocytes (T-cells) from Walt's original donation. (Remember they froze enough stem cells for a second transplant.) This 56/44 ratio is the likely reason that the WBC persist in remaining low.

I have broken with my practice of not researching and looked up some of this stuff. Neutrophils are the portion of white blood cells that are actually capable of fighting infections. Thus the emphasis on the ANC or absolute neutrophil count. No matter what the WBC count is, the ANC must be more than 5% to be non-neutropenic. Mine is currently 3%.

The booster of T-cells is a not uncommon event in this process and often leads to a full donor chimerism in the bone marrow.

Personally, I feel good. I am chafing more every day at the restrictions. I want to start living like a well person. I am considering breaking some of the rules, while still not exposing myself to any risks. Sometimes when I ask about more freedom the answer is "no" but nobody has any real reasons for the restrictions. "Just because" is soothing me about like it soothes a 3 yr old who has been denied an afternoon cookie.

Hayward is on his way to Oklahoma City for a few weeks. He is recovering nicely. He had an infection that dogs get from the urine of wild animals, e.g. the raccoon that occasionally haunts my back yard. Fortunately it responds to antibiotics and is relatively easy to cure.

Daisy, my more independent dog, will be living with Mark in Manhattan for those weeks. Daisy thinks having a raccoon in the back yard is great fun. She can spend hours under a tree traumatizing the creature. If there is no raccoon, a squirrel makes good prey. I had my roof replaced a couple of years ago and the dogs were kennelled for the duration. The neighbors remarked on the return of the squirrels to their yards when Daisy was absent. I am very grateful she ran off the chipmunks wreaking havoc on the step from the house to the deck where they lived. I hope they don't return while she is on vacation.

I return to the clinic on Thursday. Hopefully I will see a doctor and we can establish a plan. However, staffing is on Mondays and it's very possible they will not have pow-wowed to decide the next steps for patient Cathi Maynard.