Day +27

There is not a lot new to report from our little homestead here in Richmond.  Unfortunately my white blood cell count drifted down to around 2.0 and has fallen further to 1.7.  My platelets are hanging in there at 115 and my Hemoglobin floats around the 8.5 mark.  But it was 8.1 this morning so I am guessing I will have a transfusion tomorrow if it drifts any lower because they like to keep you above 8.0.  My white blood cell count when I left the hospital was a bit higher but that was because I had been given a growth factor that artificially bumps up WBC production.  I have been feeling worried about my lagging blood counts, but I saw Dr. Chung today and he is happy with where I am at and can see that there are a lot of precursor cells in the pipeline.  I have a bone marrow biopsy on Thursday and that will allow the doctors to see even better what is going on.  I also had a follow-up with the cardiologist today and he thinks I am doing well.

We head to clinic every morning.  I have not had a day off since I left the hospital, so it is nice we are close.  We walk most days now to get a little exercise.  My electrolyte levels seems to be improving, but they are working to get my cyclosporine levels correct.  Apparently this will be an ongoing process.  Cyclosporine is the immunosuppressant drug that keeps the donor marrow "under control" for a while as it gets settled into my system.  Too much of the drug is hard on my kidneys and keeps the donor from "setting up shop".  Too little of the drug and the donor system can go crazy and start attacking me - GVHD.  I think we are getting close to having it at a good level so maybe I will get a day off soon.

They do keep a really close eye on you here.  I get daily labs as well as weekly chest x-rays and blood cultures to watch for anything that might be brewing.  The nurses are on top of any symptoms you tell them about.  You see a Dr. or Nurse Practitioner at least weekly.  And the pharmacist meets with you frequently as well.  By all accounts I am doing well at this point.  My stomach is still not a friend to me, but I eat because I know that is necessary for recovery.  Mom does a great job of trying to find things I will like and that are good for me.....and that meet the ridiculously strict dietary restrictions they give you post-transplant.

The kids and Brant try to make it up most weekends which is great.  Last Sunday Katie was dropped off by some of our Blacksburg friends heading home and I had almost the whole day with her.  That was a lot of fun.  I am looking forward to this weekend and a nice visit from Brant and the kids.  I am bummed that I will be missing the first day of school, but Brant has promised to take pictures for me.

Hope everyone is enjoying their end of summer - or is looking forward to spring for my Australian family!!