Wednesday, June 17, 2009

Since the last post's euphoria, there's been neither much excitement nor cause for alarm. For the past month, the doc and I have been observing my blood counts like some watch share prices. Whereas devaluations are normal after any chemo, the Led Zevalin is really applying this stock market simile in proportions akin to the current recession.

For a while there, I was in the clinic just about every day for blood tests. At first, my doc had wanted to avoid ordering transfusions or booster shots so as not to artificially pump up the market. But meanwhile, my bailout package has come in the form of five transfusions, two weeks of white-cell booster shots and even a dose of the very steroids that have ruined many an athlete's reputation.

Pardon my delay in posting but these have been pretty slothful weeks. My hard-earned red-blood cell count (pre-Zevalin, riding just shy of 14, nearly-normal) has been volleying between 8 and 10, making minimal efforts require maximum exertion. (But I have taken comic relief in the little things, like trudging up the stairs, one by one, to the tune of Lili Von Shtupp's "I'm Tired.") Last week's transfusion has now done the trick, and my body and brain welcome the oxygen kick wholeheartedly. Immune cell count (i.e. virus/germ defences) are up, too, after riding so low. (How low were they?) Well, so low the doc imposed house arrest and said I shouldn't even take out the trash (about which Anke wondered, "Why would I start now?").

While waiting for the values to improve, we've been weighing the options. Deal was, we would see what the 2nd post-Zev PET CT scan showed and if we saw the boat still shrinking and getter ever less active, I might even be able to get back to work again once the blood count is stable. Then wait&watch Zev's effect until it goes into full swing in two years. Otherwise, we go ahead now with the transplant - and this time, I DON'T wait weeks and months for a damn bed.

Today got the results of said 2nd PET CT scan. On the bright side, no new boats. But no major differences to the scan a month and a half ago; same activity levels, with parts of the boat smaller, some bigger. Essentially, the window of opportunity for transplant is still open -- but it would appear that it ain't opening any wider any time soon. So, next week - bed TBD - I go in for my month's stay.

Strange thing is that they've got to wait until the blood counts are up and stable before they start the transplant process. Then, the first step therein is to thoroughly obliterate the blood count with high-dose chemo. Tabula rasa with the bone marrow. For starters, I get four days of "BEAM" chemo. Each letter stands for an unpronounceable and most likely very uncool substance name. Then a day's break, then a dose of my biggest, strongest blood stem cells. It only takes one day for them to "graft," i.e., to make themselves cozy back at home in the bone marrow. Then it takes around three weeks until blood counts pick up again, you have an immune system again, and are freed from quarantine.

While I'm not thrilled with the PET results, I'm relieved that we're finally moving forward. Let's just get this crap over with and I can be easing back into business sometime late July / early August.

On with the rock.