Friday Afternoon Happy Hour: Two-for-One Chemo Cocktails

It has been a great day today. I wish I could bottle it up and just sail thru chemo feeling like this each day. I was finally moved from the 10th floor of the North Hospital to the 2nd floor of the Critical Care Hospital. There was some sort of issue going on between the two groups but Brant finally just put his foot down and said I needed to be where my medical team of doctors was located. I was very impressed with how quickly and professionally they handled the situation after that. The new digs are pretty awesome. Huge room with a big window, fold out sofa, exercise room on the floor (hey - maybe I will have time to hit the gym, lol). Brant could not believe what he had been missing out on the last two days. But it was time for him to head up to Blacksburg, so my mom will get to enjoy it instead. Mom & Dad arrived around noon and we had the "hand-off". I will miss Brant and really enjoyed our two days together to get this process started. I didn't think he could improve on how well he did last time I was sick, but he kicked up his game a few more notches!!

I also had my first visitors today - two VDOT-ers. They brought some encouraging notes from all my co-workers - thanks so much!! They also brought a beautiful VDOT-orange flower plant.  But due to infection prevention he was banished to the window ledge out in the hallway.  I think he will be happy with a few other plants that have been quarantined there as well.  And he has a great view of the I-95 merge operation to keep him busy.  The staff isn't too crazy about living things around this place, but I will try to keep an eye on him as I walk around the floor and hope he will be with me in a month when it is time to go home.

I got a steroid and a unit of packed red blood cells today I am feeling good and have nowhere to go...  so I am going to make this a long post for anyone interested in the medical side of things and how the heck I wound back up in chemo!! You have been warned.

My blood counts have been slowly dropping -who knows for how long? I noticed it when out of the blue I was very fatigued about two weeks ago. I couldn't bounce up the stairs like normal at work and the hills on the walk Brant and I usually take suddenly wiped me out of breath. I thought maybe it was from a stomach bug I had gotten a few days earlier, but after a few more days of getting steadily more tired, I suspected otherwise. I went to the dr. for a check-up and asked for blood work to be done. From that appt I wound up in the ER on Wed and again on Thurs last week with low blood counts. With no obvious (ER type stuff) causing the low counts, they sent me home with a referral the next day with the local oncologist (I no longer had one of those....and my old one was back in Norfolk). The oncologist did the bone marrow biopsy last Friday, called Monday with preliminary results to say it didn't loook good, and then said I needed to pick my cancer treatment center. I said VCU sounded good and was pretty close to both home in Blacksburg and family in Hampton Roads, so that is how I got here...

The diagnosis they have given me is Acute Myeloid Leukemia (AML).  There are many different variations and subtypes of AML.  Once they have all of the cytogenetic testing done on my bone marrow, they will be able to tell more specifically what my disease is all about.  But basically my leukemia means that defective cells called Blasts are growing in my bone marrow and crowding out the healthy cells that make hematopoietic (meaning blood related) stem cells. Those good stem cells are released into the blood stream and grow into red cells (needed to carry oxygen to your muscles, low RBCs = fatigue), white cells (fight infection, low WBCs = high risk of infection), and platelets (needed for clotting, low Plats = bruising or bleeding). Did you know that a healthy person makes billions of new blood cells EVERY DAY??!! Talk about a serious production... The more the bad blast cells that grow, the less the healthy cells can get made.   I have probably been trending down for some period of time, but hit the point where I started to notice.  And I have been trending even further down in the last two weeks. 

So the standard treatment plan is first to go thru Induction Chemotherapy.  This is a week long regimen targeted at killing all of the blast cells in your bone marrow.  As usual with chemo, it is an equal opportunity killer and takes out lots of good stuff in the process.  It damages but doesn't kill off the good marrow cells and you spend the next three to four weeks in the hospital coaxing those guys to come back out and start working.  Of course, you gets lots of RBC and platlet transfusions to keep you going until your bone marrow kicks back in.

Assuming I have a good response to Induction Chemo, they would recommend I move to a stem cell transplant from a matched donor.  That is another whole process and I'm not even going there yet because I am focused on step one!!  But it is very similar to the procedure I did six years ago except that time I used my own stem cells.

So there you have it.  They say I got leukemia because of all the cancer treatments I received 5-7 years ago beating my Hodgkins.  So the game plan is to give me a lot more chemo?!?!  Makes perfect sense, right?  Well, as absurd as it may sound, I am praying this regimen will work.  We were considering entering into a clinical trial testing out a new drug therapy (FLAM) against the standard protocol (named 7+3).  But we found out today that we would have to wait until Monday for more pathology results to see if I could enter the study.  Given how fast my counts have been dropping, we decided to just get started with 7+3.  It is a randomized trial, so I would have had a 50% chance that I would have been placed in the standard treatment group of the trial anyway.  Didn't seem like good odds..... So as of 4:50 this afternoon they pushed my first of three daily doses of idarubicin, and then started my 7 day drip of cytarabine.  Not exactly the Friday afternoon cocktail I would like to be enjoying, but I am so happy to get started and just pray that these drugs will get in there and do what they are supposed to do!

I'm not sleepy but better get to bed....