Wednesday, February 22, 2006

my first follow-up

I had my first follow-up appointment this morning since my discharge from the hospital on Friday. Since Dr. Schuster is on vacation, I met with Joanne, his assistant. In past meetings with her, Joanne came off as aloof or even cold but she was quite affable today. I didn't feel uncomfortable around her as I have before.

She asked me how I was doing and I told her that I become fatigued more easily and during the past few days, I have experienced a bit of constipation for which she gave me a prescription for a stool softener. I told her about the rash in my groin, which is improving and also about that heavy feeling of pressure that I had felt in my chest several days although thankfully, I haven't felt it again since then. Otherwise, I'm feeling pretty good I said to her. Considering everything that I had just undergone, I'm doing well she told me. I just need to take it easy and listen to my body.

My platelets went up to 148, which she said is normal. Therefore, I can floss now which I'm happy about because plaque can build so easily without flossing. Brushing alone isn't enough. My WBC dropped to 4.7, but that's okay too. A count of 4.7 still places my WBC within the normal range. White blood cell counts fluctuate anyway, so it's not a thing to worry about. The bottom line is that my WBC has risen since my transplant and that now it is within a normal range, so this means that my bone marrow is engraftening properly. My red blood cell count was 10.6. Since my blood counts have normalized, I can forgo the the neutropenic diet. I can eat salads and fruits with a thin skin, dried nuts and cold cuts for example. I can eat out again, which is great to know. Sushi, however, should be avoided for a few more weeks but I'm not in a great rush to eat it right now. I can wait. Common sense, I think, is the key. If I choose to eat out, it should be at a reputable place.

My next appointment will be next Thursday afternoon and this time it will be with Dr. Schuster, my BMT doctor. Joanne said I'll have a weekly appointment at the clinic for the next several weeks and then, thereafter once every two weeks before it changes to once a month. In about six to eighth weeks from my appointment next week, I'll go for a PET-CT imaging scan and that will be repeated every three months thereafter for two years. After those two years, the scans will take place about every four months instead. In five years, she said, if the cancer doesn't return than I can be declared cured. Honestly, a part of me was a little annoyed by her five year comment but I do understand fully that indeed according to their research and experience, five years is the benchmark and that's what they must go by. That's perfectly rational. They go by data and numbers. But as the patient who had just undergone this wrenching treatment, I felt a bit snubbed. Was she implying that I had go through all of this for naught? Of course, she wasn't but that's how I interpreted in part. Five years is the all-important mark for the doctors, but I'm going to declare it now and not worry myself about their formula. I'll be 31 in five years. Amazing.

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