Thursday, April 9, 2009

April 8, 2009 Mayo Clinic

Boring Alert-----If you are looking for brilliant comedy or tear jerking commentary, it’s not happening today. This is a technical (at least as technical as I can get) and long discussion of where I am and where we will be going in the next two months.

Julia and I met with Dr. Mikhael for the second time today and he was as informative as he was the first time we met. He went over the lab work that took place last week, including the infamous 24 hour urine study. Obviously, this was a group of tests that I didn’t have to study for as it appears that I aced them. Both my blood and urine have improved significantly since my first set of tests on February 24.

Between February 24 and April 3, the change in my bodily functions was significant. I’m going to give some raw data that doesn’t mean a great deal other than the fact that there was a huge change in that five week time span. All of these are important markers, but don’t ask me what they mean:

Hemoglobin improved from 10.6 to 12.8 where 13.2 is the low end of normal.
Red blood cells improved from 3.00 to 3.89 where 4.21 is the low end of normal.
White blood cells went from 2.3 to 3.4 where 4.2 is the low end of normal.
Sodium, potassium, calcium and total protein are all in the normal range.
Creatinine seems stuck at 2.3 but that is still an improvement over the 2.9 of February 24. This signifies that my kidneys are improved but still less than 50%. This may never improve.
The total protein in my urine was down from 522 to 121 with the high end of normal at 102.
The M-spike showed a drop of 361 to 61. This should be 0.
Lambda free light chain was down from 65.8 to 12.8 with the high end of normal at 2.63.

If you just look at the numbers, they don’t mean a whole lot. The fact that there were such huge drops especially in the last three, which shows that the cancer has been reduced, signifies that the chemotherapy is working. Not only is it working, it is working at an accelerated rate.

What this all means is that I will undergo one more session of chemo and probably be ready for the stem cell transplant. Good news all around.

Assuming that we can get UnitedHealthcare to approve the out of network procedure at Mayo (which is certainly not a given) this is the approximate schedule going forward:

Week of May 4—a series of tests that will hopefully show that my heart, lungs and kidneys are all in good enough shape to handle the chemo.
Week of May 11—a series of injections that will stimulate the growth of stem cells in my body
Week of May 18—If all goes well with the tests, I will then have anywhere from one to three four-hour sessions where I will be hooked up to a machine that will take blood out of one arm, send it through a filter and then shoot it back into the other arm. This is the stem cell harvest. When complete, they will be frozen.
Week of June 2—I will enter the hospital and undergo a rather aggressive round of chemotherapy. This will be a completely different drug than I have taken thus far. It is designed to completely wipe out my immune system. These treatments, in addition to killing cancer cells, also destroy the blood-producing cells in the bone marrow, hence the need for the stem cell transplant. This little vacation will include mouth sores, nausea, loss of appetite, an even more advanced state of baldness than I currently enjoy, vomiting, diarrhea and skin rash. I think I can get a two for one coupon if anyone would like to join me.

A couple of days later, I will receive my stem cells back in similar fashion to a blood transfusion. The cells will then begin their job of producing new red and white blood cells.

I will be in the hospital for two to three weeks and then be sent home. It appears that Julia and I will then be lining up a divorce attorney as I will have to work from home for the next three months. The only way she can put up with me now is because she has an eight hour escape from me everyday. If I don’t go nuts during that period of time, I’m not sure I ever will. I tried to go back to work the day I left the hospital the first time, before my boss threw me out.

If everything works as planned and I go into remission, I will become a cancer survivor. I plan on staying that way a long time despite the normal remission time of only 18-24 months. My plan is to (oh God, I can’t believe I am saying this) eat healthier and do whatever I can to be cancer free.

The next few months will be interesting, stay tuned for further developments.

1 comment:

  1. John, it sounds like quite a challenging few months. However, it also sounds quite encouraging that you have responded so well to the treatments to this point. I've been following your posts since we last talked. Stay strong and positive and I have every confidence that you will continue to beat this!

    Stan

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