Monday, September 17, 2007

day +27

I was at Sloan with my dad and Clare this morning for my weekly check-up. Dr. Barker attended to me since Dr. Castro-Malaspina is performing his duty as the attending physician on the transplant service for two weeks.

The Adenovirus test is still pending, which surprised me because I was told by Ally that the results would be available by today. Nevertheless, another Adenovirus test was done today and I was told by Dr. Barker that these tests will be ongoing for at least the immediate future. The medical staff doesn't seem to be alarmed, however, because I don't have any of the symptoms, such as chills or fever, which would indicate that it has spread to my blood. It's their belief and hope that my donor's T-cells will contain the Adenovirus to my GI tract and destroy the virus there.

With regards to the persistent diarrhea (though I haven't gone today yet), again it could be the result of several things: the Adenovirus, the Magnesium supplements, the late-effects of the chemotherapy or some weird combo of all three. GVHD is a possible cause too, but because I'm not experiencing any of the other common symptoms of GVHD, such as a rashes, cramping, or stomach pain, they doubt it's GVHD. Dr. Barker asked me if the diarrhea had improved, remained the same, or worsened and I replied that it has remained the same. For now, she prefers to keep an eye on it, but if it worsens a colonoscopy may be in order, which is exactly what Dr. Mayer had said last Monday. I asked Dr. Barker for a script for Oxycodone, since I had used the only two pills that I was given at discharge. I have used the Oxycodone to alleviate the rectal irritation caused by the diarrhea. She complied gladly, but asked jokingly that I not profit from selling them.

At the appointment I was informed that the levels in my kidney function were within range, but on the high end which is a sign that I'm not drinking enough. Ally recommended I drink more water, which I've been drinking at brief moments only. So, I must drink more water. My Potassium level was too high, so I was given a prescription for 15 gm oral of Kayexalate which I got filled out at the hospital's pharmacy. Kayexalate is a very sweet, gritty, gray liquid that lowers the level of Potassium. No Gatorade too I was told though I haven't drank it recently. Gatorade is high in Potassium. Also my Absolute Neutrophil Count (ANC) dipped below 2.0, so I received a Neupogen injection but I was told that the fluctuations in my WBC are normal and therefore, not a concern.

I expected the worst part of today's visit was going to be the scheduled bone marrow aspiration, but it was canceled because too many aspirations had been scheduled. To my surprise, Dr. Barker divulged that there's a blood test which can ascertain the same information as the bone marrow aspiration. If I were her patient, she told me, she'd forgo the aspiration all together because every sign (as indicated from the CBCs) shows that my donor's cells have engrafted well. This special blood test, she said, is a fine alternative as it saves me the discomfort and anxiety that goes with a bone marrow aspiration. I was taken back by her admission, because I had never heard of such a test. She, however, must go over this with Dr. Castro-Malaspina. At the very least, I've been given a reprieve at least for this week.

I must return to the clinic on Thursday for my counts to be reviewed in light of today's low ANC. In addition to that, on Thursday I will use what was described to me as an inhaler that's given to help prevent Pneumocystis carinii pneumonia (PCP), a certain type of pneumonia, which is a potentially serious threat to transplant patients as well as AIDS patients. It's called an aerolized pentamidine and at Sloan at least, it's a common prophylactic post-transplant treatment for their patients. Dr. Barker said I'll receive this 20 minute treatment of 300 mg once a month at Sloan. On Thursday, I'll also receive Intravenous Immune Globlulin (IVIG), which is aimed to strengthen my immune system with added antibodies. Like the aerolized pentamidine, the IVIG is a standard treatment for post-transplant patients at Sloan.

Dr. Barker scheduled me for my first post-transplant PET scan for next Thursday even though last week Drs. Castro-Malaspina and Mayer told me that I wouldn't have it for about three months.

On a pleasant non-cancer note, today is Su's birthday. Late this afternoon after her massage at Ease Salon (my gift to her), she came by and together we celebrated her birthday with a cake, tea, and gifts before enjoying another episode of 24.


Comment Anonymous Anonymous said...

You made my morning by sharing the photos of Su on her birthday with the swirling hearts. What a cute and thoughtful thing to do.

So glad you two could celebrate together.

thanks for the update on your MSKCC visit.


8:00 AM  
Comment Blogger Duane said...

Thanks, Eileen!

10:07 AM  
Comment Anonymous soogle said...

Hello love! Thank you for your lovely birthday tribute in pictures and floating hearts and flowers - it's a lovely sort of flipbook/picture show of birthday wishes and gifts. What a nice surprise! And thanks also for a lovely birthday, for the luxurious massage with a clear view of the Chrysler Building, the cake and card and chocolates, but most particularly for your company in celebration.

Thanks also to Clare, Jerry and Virginia for the lovely scarf, woolen socks and stained glass sainted retriever, and to EFG for the thrice-looping leather bracelet with the magnet catch (on my left wrist in the pictures).

I'm afraid it's rather late to call tonight so I will speak to you in the morrow, which is to say later today. Love, your Su(boo)

1:05 AM  

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