Saturday, April 18, 2009

Day + 9 -- counts up, cancer down!

I am beginning to feel the inevitable fatigue that comes from low red blood, and I'm getting the side-effects of the neupogen -- headache and back pain, most noticeably, and as soon as I brag about the resilience of my GI tract, there's backsliding there as well. But frankly, I weathered this pretty well so I'm not complaining -- really just making notes so I'll be able to prepare for the second transplant in a few weeks.

The second transplant will be important, because I definitely want complete remission and I'm not there yet...but the numbers thus far are promising. First, my white blood cells are up to 0.1...very low, but certainly higher than 0.02. Platelets were at 22 today, again very low but up from 16. Hemoglobin (the key marker for red blood) is down to 8.2 from 8.5 and 9.1 the day before, which explains my fatigue. They asked if I wanted blood, but I said not yet -- keeping the WHO warnings in the back of my mind, I figure why take more than I absolutely need. They will infuse if it falls below 8, though, which it probably will. Potassium was borderline so I had to promise to eat a baked potato today (a very good source) and we'll see tomorrow if I need an infuser of it. Lastly, CRP is about 20 now, and if that increases again (as it likely will) they will give me an IV antibiotic tomorrow as well.

So tomorrow I may be full of additives and that could make for a long day at the hospital. Oh well.

I asked for my most recent tumor markers as of last Thursday (it takes two days to process the results). These are from when I hit the floor with the white count of 0.02, so these likely represent (I am guessing, anyhow) as low as the numbers will get from this transplant. I could be mistaken but I'm trying to be conservative, so I'm sticking with the presumption that this is the new "plateau" until the next phase of treatment...assuming it doesn't come back:

* M spike is 1.3 now (grams per deciliter of blood). Down from 1.6 a few days earlier, from 4 at both diagnosis and pre-transplant, and from 8 at the peak.

* Lambda free light chains crept up from 0 to 1.8...still squarely normal but I am reminded now that the light chains rise as counts recover so I'm not going to focus on this metric any longer.

* IgG down to 1800 from 2100 a few days ago, 6000 pre transplant and as high as 11000 before treatment. Normal is 700 to 1400.

After the second transplant, I have to imagine IgG will be normal and the M spike will be next to nothing -- still not good enough as I want it to be zero...but things are moving in the right direction.

Thanks as always for your comments -- it's great to hear from you all!