An Intricate Game

Today looks very different than I expected it to look. Just over a week ago I expected to be getting a transfusion of Walt’s stem cells today: instead I am at the clinic getting a transfusion of platelets.

Walt and I came to the clinic for the consent meeting on Friday, Jan 16th. Dr. Ganguly was our host for the meeting, with my transplant coordinator, Beth. Ganguly was reluctant to move quite as fast on the transplant as planned because my liver was still inflamed from the gall bladder surgery. He first said let’s wait a week, then a day, then a week. It’s a delicate balance between the risk of leukemic cells returning and giving the body time to heal. He noted that the blast percentage in my bone marrow at the last biopsy was 4% and they could not proceed with a transplant unless it was less than 5%. So he ordered another biopsy to have more information.

The biopsy returned a blast number of 16% which changed everything. I went back into the hospital the very next morning for a round of induction chemo to get rid of the extra blasts. This chemo was more intense than the original induction chemo, but administered in 6 separate doses, rather than continuously as the first time. I had to sign my name before each new dose because changes in one’s signature can indicate the cerebellum is affected and they would have to delay starting the chemo. My signature made it through, though I don’t remember writing it all 6 times. I guess memory doesn’t count, except the physical.

My belly is only swollen at the wound sites and they are healing. I am amazed what this body can do. I don’t have enough platelets, but wounds heal anyway. I need a lot of sleep and a lot of calories. My weight is dropping a couple pounds a day, so I haven’t eaten enough yet. Which is a statement I might frame and refer to in the future when it seems like I only have to read a menu to gain a couple of pounds in a day.

My spirits are good. I am excited after marching through a chemo regimen relatively unscathed. I am pleased to be moving in what feels like a forward direction again.

Today Dr. A took me off the IV antibiotic because the team is confident I am past the risk of fever or infection. I got platelets to boost the counts because by design, the chemo damaged my marrow so it isn’t making enough of them right now. The goal of the chemo is to beat up the disease factory in my bone marrow so that the healthy factory can take over.

It’s kind of like the conference table in my head. Different people want different things and the stupid ones have to be ordered into submission somehow. (Wouldn’t it be handy if we could chemo the irregular people from our lives? Or at least their irregular impact on our minds?)

So when my marrow starts working again, it will be making good platelets, cells that mature as they should (rather than staying blasts for too long.) Dr. McGuirk says he wants to see my counts recover but he isn’t going to wait for it. I believe the current plan is to have a biopsy next week and then decide the next move.