Yesterday was a tough day. I got to admit having a date with destiny regarding my next bone marrow biopsy results made me a depressed. I never left my room. On the other hand, I never physically feel good after receiving a blood infusion. My temp went from averaging just below 98 to 99.5 and I just sort of felt lousy. So the worry and IV sort of teamed up. I feel much better this morning after another really good night's sleep and ready to hear the verdict, probably end of June.
My weight dropped to 173.1; down 18 pounds over 17 days. During the XC I lost fat and gained muscle. Now, I'm losing muscle and gaining fat. The plan is to trade fitness to fight leukemia.
I'll get a bag of platelets today. Chemo is still working because they have to regularly replace red blood cells and platelets.
A few days before I was admitted to the hospital, I saw my family doctor because I had a sinus infection. He gave me a shot of steroids in the hip and scheduled a follow-up visit. Someone from his office called two days ago to remind me of the appointment. I told her I almost died, was diagnosed with acute leukemia, received chemo and was still in the hospital. After a pause, she said, "So, I'll note you won't keep the appointment." I guess she was just interested in her form.
I commented to one of my nurses that I was surprised to see personal commits in a previous oncologists report. It said something like 'Mr Ryan is friendly, easy-going man'. The nurse told me they do that all the time. When I asked her what a negative comment might be, she said something like, 'so and so is an anxious, irritable'. I then started making up outrageous statements, such as, 'Mr X is a complete pain in the #%^, if his cancer doesn't kill him, I will.' Obviously, I've spent far too much time in the hospital.
Dr Patel gave me some more information this morning. My ANC is still at zero and she expects it to stay there for another 5-7 days. Today starts the second week of chemo, which is much easier than the heavy duty first dose. I think may be hooked up to the IV pole for the next four days.
So what does a bad day-28 bone marrow biopsy prognosis mean? If they still find leukemia in my bone marrow, it means these cells are not chemo sensitive. The chance of going into remission are lower, even after changing the chemo to something different. The odds drop that they can achieve complete remission from 90% to about 40-50%. Because the chemo is not working, they would then hurry me along to transplant as soon as they get me into remission. If I have positive leukemia on the day-28 bone marrow, there is a good chance I will retain some minial residual disease (<1%) which would lower the success rate of the transplant. Dr Patel said if the day-28 biopsy shows 5-7% leukemia, it wasn't a big deal. She will proceed with the next next round Hyper CVAD chemo, which are different chemo drugs. I have to confess, I don't totally understand all this. Hopefully, the day-28 biopsy shows I am in complete remission, or that the leukemia, which previously registered at 90%, has been knocked down to 5-7%. Anything higher than that is bad news.
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