Sleepy nugget times

Star's grandma Valerie made the hit of the year with her present: A big, fluffy cat bed! We weren't sure star would want to use it, but amazingly she has been jumping right in nearly every night. The bed is atop a TV stand/dresser we have in our bedroom closet. She likes to be up high, and I think she likes to be high in our closet specifically because she can keep an eye on us. Isn't she quite the fearsome guardcat?

Forget rolaids! I spell relief G-e-l-c-l-a-i-r

One of the more "fun" parts of chemo is its ability to make you miserable in ways you never before thought possible. So it is the case with this new chemo I have been getting: Erwinia. Within a few hours of getting the first shot, I started to feel funny. My face swelled up, my cheeks were flushed, and in general I just didn't feel right. As I have gotten subsequent doses, the situation has deteriorated. I shaved several days ago (I think it was sunday) and had some razor burn. I still have the razor burn. It just doesn't want to heal.
Chemo has a devastating effect on the body, even at its most targeted. The chemo I take is aimed at killing cancerous white blood cells. At the same time, however, it kills good healthy white blood cells, and it also kills any of the body's "fast growing" cells, particularly those in the Mucous membranes.
The worst part of the killing spree has manifested itself in my mouth. I'm not sure if you can tell by this picture, but my tongue has swollen to about double its normal size and has these nasty lesions on the sides of it. The lesions are VERY painful. I had beern taking Oxycodon to manage the pain, but for some reason the Oxycodon was making me super agitated, even wired, and on edge all the time. I couldn't have been much fun to be around.
Because of my hyperactivity and loopiness, I stopped taking the Oxy after getting barely any sleep for the past few days. Last night I was able to sleep more or less all night long without tossing and turning. But when I woke up, it was there waiting for me: Shooting, stabbing, bone-pulverizing pain.
When I was in the hospital this summer there my mouth got a little bit sore, but nothing like it is now. Then I could just use the Peridex mouthwash and a mycelex troche(kind of like a lozenge) and my mouth would immediately feel better. That hasn't worked for this new problem. On Tuesday I was at Roswell for an Erwinia shot, and told Linda the nurse practitioner about the pain I was having. She gave me a box full of Gelclair samples to try. Gelclair is a gelatinous medicine that, when swished around in one's mouth, creates a protective coating over the sores so the exposed nerves don't light up like a painful Christmas Tree. It also is supposed to help the sores heal. I had tried the Gelclair in the clinic, and it worked great. Unfortunately that was the day I had my super low platelet count of less than 5000. After three bags of platelets and at least 4 hours of getting them, I was in a HURRY to get on the road and get home. Predictably, I left the samples on my tray in the clinic.
In even more pain on Wednesday, I called Roswell and asked Linda for a prescription for the Gelclair. , which she quickly ordered from Upstate Pharmacy. When the Gelclair didn't show up on thursday, I called upstate. THEY HAD NEVER SENT IT. Apparently the size or dosage or something wasn't available in its complete form, so instead of sending what they had, they sent nothing at all. Worst part was they didn't even tell me or the NP, so neither of us could pursue the medicine elsewhere. If I had known, I would have had the Vestal Target Pharmacy order the stuff, and would have had it by Thursday. When I called upstate on Thursday wondering where my stuff was. the lady on the phone said, "Well, when we send fedexes, we want to make sure we've got everything." What that means to me is she was worried more about the $20 Fedex package than relieving my several days of agonizing pain!
This may be the last prescription I ever fill from Upstate Pharmacy . I just can't tolerate an organization with that little of a clue.
Anyhow, it all turned out OK in the end. Di and I drove up to Roswell today for another Erwinia shot and the Vincristine, and a whole case of the Gelclair, probably 100 doses, was waiting for me at the nurses' station. I just used some before writing this blog entry, and I've got to tell you the stuff is sweet, sweet relief. Finally!

And God blessed us, every one

A very full belly and lots of laughs later, I've got to say this is really one of the best Christmases I can remember.
I know it will probably sound corny, but there were many days this year where I wondered if I'd even be around for Christmas. To my great relief and enjoyment, I was really more than around. From dinner all day yesterday with Di, Mom and Dad, to the feast at Phil's house in candor, to goofing around with the kids and their toys at Kathy and Mike's Owego home, everthing sparkled a bit more, everything seemed to mean more this year, because honestly I thought most of it would not include me.
So I ate a lot of food and talked a lot of talk and was probably way too hyper way too many times, but I don't really regret any of it. We had such a damn fine time and I think I really know what it is like to be grateful for the time with all of my family, in a different and very wonderful way from what I've had in the past.
You couldn't ask for a happier man than me at this point. Even though I'm on chemo and my mouth is sore and I'm tired, I am also completely satisfied. Without getting into too much hyperbole, this Christmas was just about as perfect as anyone can expect. Gives me a real charge going into the new year, this perspective that I hope will continue giving throughout the difficult days and weeks that I know are coming down the line.
Merry Christmas everyone! I hope your day was a fifth as special as the way I treasured mine.

Looks like I made it

Well today was a long day, but worth it. I picked dad up in vestal at about 5:55 today and we headed to buffalo. After the four hour drive there, the waiting in Roswell Park and the evaluation from my Nurse Practitioner, the famed Erwinia was given to me and I seem to be doing ok. Keep our fingers crossed though!
However this chemo has been much harder on me; my White Blood Cells are quite depressed (down from approx 10 k/ul monday to 1.47 today, and I am left with 57 platelets per n. That means I will probably skip the beebe gift exchange tomorrow, and not go to church on monday. I know the counts aren't very likely to increase, even though I am taking the neupogen white-blood cell shots every day. Will save myself for sunday dinner at mom and dad's, Phil's and Kathy and Mike's on Monday.

Very tired now. Going to watch TV and relax a bit. I am pooped!

MattK

Erwinia Erwinia....Er win with Erwinia

OK, sorry for the goofy title.
Barb Anderson (research nurse and generally good doo-bee) came to see me today at Roswell to sign a consent form for this fancy Erwinia drug. As it turns out, there has been some difficulty with getting it. Not so much a difficulty as someone used old numbers and did not expect the cost to go up by about 40%.
Ahh. Drug companies. Don't we love them? I think I should buy stock.
Anyhow, Roswell had to hold up on ordering it and get the new amount approved by blue cross, who promptly approved the discrepancy. Gee. They were nice about that, weren't they? I mean, in my work life if I quote somebody a price and then submit a price for billing that's $20 higher they will raise holy hell. But thousands? They might laugh me off the phone. Sure am glad BCBS had such a good attitude about it.
The long and the short: I probably won't have my dose scheduled for Tuesday, and maybe not friday, though I have offered to stay another day if necessary to get the shot. Barb is going to petition the study chair to allow me to have these pricey injections that I am missing at the end of this current round of treatment. Otherwise, the stuff will just go to waste, as no other cancer patients in the entire hospital --or according to the FDA, the country -- need this stuff.
Otherwise all is very well. I seem to be tolerating today's chemo just fine. The cytoxan (ominous, clear fluid) made my brain all funny and gave me a pain in the nose like you'd get if sniffing horseradish. The discomfort was quickly eased, however, by the daunarubicin, a chemo drug that has the color and consistency of red cool-aid.
Lots more fun for my week up here in Buffalo. Stay tuned..I'm here all week. Really, I am!

One Clingy Nugget

Star has just been all over me lately.
I'm not sure what it is. Maybe it's the cold weather, maybe its the fact that I'm around a lot. Maybe its because she's just a nugget, but for whatever reason, this cat is around all the time.
---
Anyway, I'm doing well. After a weekend filled with social gathering (IE Ron and Dawn's STYP fiesta for the Christmas Holiday gift swap) I had my blood test today and, goody, it looks like my blood is finally doing what it is supposed to. I'll be heading up to Roswell Park for some good, old-fashioned FUN chemotherapy. It'll be a bit wierd, as I haven't been there in a while, but I'm sure I'll warm up to it soon 'nuf.

Othewise I've been spending an inordinate amount of time playing with my model trains and, oddly, cooking. On the trains bit (see how inordinate this is??) I've been using the excuse of Meg and Nate. On The cooking bit, well, I just like to cook. Plus, diane is back to work this week--we had a fun week together, so now as long as I am home I am helping with the cooking and the cleaning and the making of her lunches.

So, as promised at the beginning of this post, Star STILL won't leave me alone. She's sitting on my lap now, enjoying it while I write and staying up with me past my bedtime, despite of course the fact that I no longer really have a bedtime. . .

Birthdays with the Kenseys...

In the Kensey Household, we celebrate birthdays the old fashioned way: All at the same time!
Yesterday was my Birthday, Dec. 2. Today is Diane's Birhday, Dec. 3rd. I will reveal that yesterday i turned 28, but due to contractual obligations and the fact that I value my right eye tooth, I will not reveal Diane's age.
We had a nice time on my birthday. Spent most of it just hanging around, but got out of the house in the afternoon to visit Tom's on Main Street. See, a certain printer and lettershop has been bestowed with the honor of printing and mailing the sacred Tom's birthday cards and other such coupons. As loyal Tom's customers, Diane and I receive their regular mailings and the latest one caught our attention. Free coffee always catches our attention!
A full pound of Italian Espresso later -- we wouldn't just take the half pound, I mean, that would be silly and kind of cheap-looking, right? -- we were out of Toms and headed to Manley's to pick up some wingys. Later on that night, we ate a wonderful meal at Sabaidee, a Thai restaurant in Endwell, with my Mom and Dad. Though the service was a bit spotty and the bathrooms were somewhat less than perfectly desireable, we had a nice time. And what was with the fake crabmeat? I mean, does anyone who's actually ever had crabmeat really believe that the fake stuff is even close to the genuine article?

I had some pretty incredible news this week. First the good: Remember L-asparaginase, that chemo drug that gave me hives the size of Volkswagen Beetles? After that episode the Docs decided I wouldn't get that particular drug anymore, for fear of anaphylactic shock. Trouble is, the next round of chemo I am scheduled for requires this drug be given several times. Now, chemo has taken a whole new importance to me, as bone marrow biopsy has been tabled. I remembered someone mentioning this very expensive drug that comes from europe that is an alternative for difficult (you know, petulant or allergic) cases like me. Called Erwinia, the drug wasn't available before, but having a bit of time, I asked the good folks at Roswell to seek approval from my insurance company for the replacement chemo, which I was told costs about $30,000.
The long and she short of it? After several days of waiting and consternation, the Erwinia was approved! I'll be starting it as soon as it is made up and shipped to Buffalo. I was shocked. The people at roswell was shocked. One person there was so sure It would be denied that she bet me her paycheck it wouldn't come through. I forgave the debt for the sake of her two beautiful children and her desire to buy them christmas presents.

From the wierd an annoying department: So, Diane and I trekked up to Roswell Thursday for the startup of the new chemotherapy routine. Much like the old routine (the one I had in the hospital) the new module required a blood test at the outset. They kept me sitting in the chemo clinic a good two hours before a nurse practitioner, Linda, told me that my Absolute Neutrophil Count (ANC) had dropped to about .75, which is too low to start treatment. ANC is a formula based on the White Blood Cell count as well as some other factors. It was really wierd as my blood levels have been fairly stable for several weeks. Anyway, I was told to go to Broome Oncology Wednesday for bloodwork, and if my WBC levels rise and restore my ANC to a good enough baseline, I would probably start chemo friday the 8th. We'll see.

That's all for now folks...

Happy thanksgiving!

Today was thanksgiving and at 124 Earl Rd it was turkey, turkey and more turkey!
After years of trekking to 3 different homes on thanksgiving day, Diane and I last year decided we'd have turkey day at our house. Despite cancer and lots of travel and other issues, we made it happen. And there were only one or two screwups!
The guests showed up (some of them a bit early, but that was OK too.) The usually suspects: Mom, Dad, Kathy, Mike, Phil B., Shawn, Bill, Fedo, Uncle Dean, Pam, Meg and Nate dogg. DI had stayed up most of the night as she is wont to do, arranging the tables and generally fussing, but it all looked good and such, as her fussing always makes her projects look in the end.
I'd gotten the turkey in and it looked GREAT when I took it out of the oven at about 12:30. It was nice and brown and cooked evenly according to Pam's thermometer. (Someday pam, we will actually return your candy/meat thermometer.) The trick, however, was getting it out of the pan and onto a platter. I made several attempts with forks and tongs and praying and squeezing, and nothing seemed to want to coax the 22 pounds of scrumptious, dead birdmeat out of Kathy's black roasting pan.
Finally I grabbed ahold of the turkeys back legs and promptly lifted them and the entire turkey out of the pan. The resulting plop of the big heavy breast piece back into the pan slopped drippings all over the recently cleaned stovetop and left me holding the intact "dark meat" section (legs, thighs, wings and other pieces in my hands...
ANYWAY The turkey turned out OK in the end and we had a heckuva nice time with all the families together. After the last guest left at 5 pm diane and I plopped on the red barber's couch by the front door and didn't move for a half-hour. We have resolved, however to make this a tradition and host the thanksgiving meal next year....that is if everyone wants to come back!

Anyone want to flip a coin?

I'm sorry I haven't written much lately, folks. I guess I was just waiting for a chance to tell you about something significant. I'll get to that, but I'll fill you in on what's been happening in the meantime. Basically, chemo chemo and more chemo. I've been coming to Roswell every other week for three weeks, getting methotrexate in my spine and big bags of yellow-green fluid in my bloodstream. There have been delays and general annoyances, but things generally have been going according to plan.
Over the last few weeks, though, I have become somewhat bothered by the prospect of bone marrow transplant. I did a lot of reasearch, much of which reccomended that my particular type of leukemia responds well to chemotherapy, and that because of the pretty severe risks of bone marrow transplant it is usually reserved until if or when the leukemia relapses. After some effort, I finally got to meet with Dr. Baer today to discuss the matter.
Now, doctors being doctors, Dr. Baer would not tell me what to do. As I understood it, I have T-cell ALL, which is the kind of the disease that response best to chemotherapy. As it turns out, though I am T-cell positive, there is a slight anomaly with my genetics that raises my risks of relapse somewhat(or might not risk it at all, or might mean good things, as the doctors don't really know-it's that rare.). She also said that no one can tell the future, but either way--continue chemo or have the bone marrow transplant-- the choice of either treatment is perfectly reasonable.
More or less I could just about flip a coin!
So after meeting with Dr. Baer, Diane made a list of the pros and cons (she says thank you Tillie Tompson) we had discovered about each treatment. Though I have made my decision, I wonder what all of you might do if faced with this dilemna:

Bone Marrow Transplant.
Pros:
lower chances of relapse
RPCI good at preventing infection and Graft-Vs. Host Disease (nasty side effect of transplant)
A patient with young age, and in good health.
Two donors who are already typed and match
A patient who is already adjusted to chemo and lifestyle of sickeness.

Cons: Graft-vs. Host Disease and other infections
30+ days inpatient at Roswell
100+ days in recovery with a caregiver 24/7.
high risk of complications.
risk of DEATH (even a small risk is a big deal)
Uncertain what next step is if treatment doesn't take: second BMT more risky than first.

Continuing chemotherapy through two-year maintenance- no BMT.
Pro:
A patient who is responding well to treatment
Classified as T-cell ALL, which according to research is the "best" kind to have as far as treatment goes.
Intensive treatment ends February/March.
Easier on patient, less immediate risk for patient.
Dr. Baer: for chemotherapy "The only risk is relapse". And death was NOT mentioned.
Roswell uses cutting edge chemo treatments that research studies suggest.
Good chance of finding other donors later on if need be.
Leaves option for BMT open for later date should a relapse occur.
Typed donors can be contacted again later on if needed for transplant.

Cons:
Abnormality in 9 and 10 chromosomes and smallish number of T-cell genetic indicators play uncertain role in remission rate. Not necessarily a bad thing, not necessarily a good thing. No research exists for this specific abnormality- I'm just that weird.
2nd induction chemo can be resistant, but usually the cells can be "beaten down" enough to start transplant, according to Dr. Baer.
Increased age increases risk of difficulty.
typed donors may have moved or died or gone to Iraq or whatever, meaning more tests and time to find new donors.
Potential for relapse more likely with chemo only (as opposed to with BMT as treatment).

So, uh, notice anything about these lists? They're all about the same length. So, there's pretty good support for doing either thing. I've decided to stick with the chemo now and bet my money on the disease not going into remission. The way I look at it, either treatment I choose has plusses and minuses, but at least if I save transplant for a later date, I have it in my back pocket should a remission occur. I haven't told the doctors yet, but I plan to do so later in the week.

I never liked being a gambler. What would you do if you were dealt my hand?

Matt

Chemo update week one

Hello everyone!

Well last week's chemo was the worst outpatient one yet. Worst in the sense of that it was busy with lots of side effects. On monday 16 november I arrived at the chemo clinic bright and early, as I had a lot to accomplish that day. After meeting the (literally) blood-sucking phlebotomists at 7:30, I was quickly whisked into the chemo clinic and they started hydrating me for the chemo. Before they could start however, I met with Trish the Nurse Practitioner, who looked me over and then ordered the chemo for me. Meanwhile, I was carted upstairs for my intrathecal, or lumbar puncture with chemo. For those unaccustomed, this means they numb up my back really well with lydocaine, then find the proper place in my spinal cord with a floroscope (fancy x-ray machine). They then puncture my spinal column with a large needle in the appropriate place, suck out some of my spinal fluid and inject chemotherapy. This time, it was a bright green substance known as methotrexate. After returning downstairs to the chemo clinic, where Iwas hooked up to a bag of what seriously looked like bright green antifreeze. This was more methotrexate. About 1 p.m. I was ready to go.
That night and the next day I had to take methotrexate pills 19 at a time at a very specific time of day (10:30, 1:30, 4:30am etc). The next day they started me on Leukovorin IV and ultimately Leukovorin pills (more 4:30 wakeup calls for drugs. Yay..) Also, I started another drug to be taken daily through OCtober. This chemo, Mercaptopurine, is more chemo and has the added benefit of making me quite tired and nauseous. FUN.
I had last wednsday off and was scheduled for a short blood test last thursday to investigate how much Methotrexate was left in my system. Unfortunately, that blood test showed my levels weren't low enough (they were at .10 K/ul and needed to be .05 k/ul. Apparently that test wasn't available in broome county (I found out later it was available, just not on the same day it would have been drawn. So I was stuck for an extra day in buffalo, which had me quite surly, as I was ready to scram thursday morning.
Good news is my levels were fine Friday morning and Trish the NP sent me home. It's been nice being home. Star is quite pleased to have some all-day-long company. There's been quite a lot of political chatter going on at all ready, and I helped dad deal with that.
Otherwise not much new. Had a blood test at Dr. Khan's today (tuesday 24 october) and all my levels were quite good...no blood required. I wonder when they will start to drop. Hopefully never! He hee.

OH other big news. Supposedly today my bone marrow donor is scheduled to have his or her blood taken and shipped to roswell by tomorrow for some genetic testing. If the tests confirm her genes, I'll have a donor. Yay! Though this may mess up our thanksgiving plans, it would be really great to start the BMT process before 2006 ends.

-Matt

Light up the Night walk Oct. 12 2006

Pam Travis organized a team of walkers for this benefit to the Leukemia and Lymphoma Society. Thanks to everyone on "Kensey's Krew" who walked:

Pam Travis, Kathy Malloy, Shawna Lindsay, Louise Lattin, Tammy Howe,
Tina Daddona, Heather Greeno, Krystle Silvestri, Ernie Kensey, Valerie
Kensey, Matt Kensey, Diane Kensey, Amy Ingraham, Peggy Woosman, Sharon & Dave Majka



Dad was in a hurry to get going!



Everyone's waiting




Matt, Kathy and Di staying warm and walking fast



Tina's walking for Matt, and Pam is really enjoying walking for Matt!



Hey,Di, Can I borrow your cool corduroy hat?

lost....and found!

Thanks to help from a variety of sources, Diane, Mom and I found the Nugget today!
Star emerged from underneath the shed in my parents' back yard as Diane and I had about given up searching.
Star seems to be in good health, though I will have a vet check her out later in the week. She's been quite clingy ever since we found her, and I think she is still a little agitated from being outside for so long. When she eats, she looks up every 10 seconds or so, listening to every little noise. But she's like her old self otherwise, and seems quite happy to be home!
We had help from many different directions, the last one being a couple on Benita Boulevard who called saying they had seen our kitty, they were pretty sure, in the woods behind thier house. There is a small forest that separates the two subdivisions and they said Star had run into that woods. That was encouragement enough to get Mom, Diane and myself out there looking, to no avail after almost two hours of looking.
We had about given up and I suggested we go over by my parents' house for one last look. I wanted to check the live trap I had put out earlier in the day. The trap was suggested by a nice lady at the Animal Care Council in endicott. In any case, when I walked by the tunafish-baited trap on my way to get some treats from inside the house, there was no sign of the cat. But as Diane, Myself and my Mom stood in the backyard jabbering about not finding her, Diane said, "Oh my god there she is!" and sure enough, star had emerged from underneath the shed, gracefully stretching out her back legs one by one!
We are quite happy to have found her. What a relief.
Thank you to everyone who helped post signs and look for the cat, and for several suggestions all of which I think helped in getting Star home.
The Kenseys are very happy tonight!

The Good, The bad, and the curmudgeonly

It's been an eventful few days.

Monday:
Went to Broome Oncology to have blood tested. After my appointment, I popped upstairs to the cardiology clinic to make sure everything was all set for my appointment set for thursday and the wolf parkinson white surgery. It was important to have the surgery done this week, as I am REALLY healthy right now--we'll talk about that later--and I start chemo at roswell again next week. So I Talked to the head cardiology nurse. Sbe said there was "no way," as the doctor had to see me first and, anyhow, the surgery generally took a about four hours and the doc's time had to be scheduled ahead of time. I asked if maybe I could get the appointment moved up. The head nurse said she would page the doctor.
Five minutes later, they called me out of the waiting room, and started an EKG. Dr. Rehman, my cardiac Doc, weas across the street at wilson and would be right over. Within fifteen minutes he was knocking at the door. Two minutes later, he asked. "So, do you have any objection to having the surgery today," and I said no. Apparently Monday was a good day for him to do the ablation. After explaining this to me, he called up the catheterization lab, where the surgery is done, and asked if they had time for a WPW operation. Surprise! A window! He told me I would be staying overnight, and told me to hurry over to Wilson, as they would be waiting for me.
A chest X-Ray, a new IV, two Xanax, two Benadryl and about an hour later I was gowned up and on a gurney at wilson, in transit to the catheterization lab. Though I was awake for the entire surgery, they had drugged me in what they called "Conscious Sedation," so I wasn't totally lucid. But this is how the surgery went, according to the docs: a wire was inserted into each one of my groins. The wires were fished through a vein (left groin) and and artery (right groin) until they reached the inside of my heart. An electrical map of my heart had meanwhile been made from the extensive electrodes attached to my chest and back. When they figured out which nerve was the extra one, the doctor used the wires to cauterize, or ablate, the bad never in my heart with what he called microwaves.
I don't remember all of the surgery, but I rember Diane, my Mom and Dad being in my room in the hospital after the surgery at some point. I unfortunately remember my curmudgeonly roommate , who is an entire additional tale but who enjoyed heating the room to 80 degrees and was loudly debating the effects with the night nurse of a certain new medicine on his bowel movements.
I was quite glad to be discharged by 10:30 Tuesday.

Tuesday:
Dr. Rehman visited me about 8:15 while I was munching on my omlette. He told me I could go home any time I wanted. So, I started looking for my clothes and paged the nurse to take off all the heart monitor stuff. Well, she said, there would be a delay, as the Dr hadn't signed off on all my prescriptions....many of which turned out to be scripts written in buffalo that had nothing to do whatever with the heart treatment. ARGH! Because of that, I had to tolerate my cranky roomate, his crankier adult son --who yelled so loudly at staff that I could hear him in my room all the way from the nurses station, and who filed a formal complaint that completely embarrassed his dad. I also had to tolerate waiting for more than two hours for no good reason. On any other day, that wouldn't have been such a big deal.

Missing Cat!

So, I found out tuesday just before my operation that my cat was missing. (FYI: Star was staying at my parents house due to worries that Cat germs might not be so good for the Cancer Patient). The timing wasn't my mom's fault. I called her as soon as I left the cardiology office, but before I could tell her about the ablation she told me that Star had gotten out late sunday night as dad was letting Jake (their 1-year old dog) back in the house after a walk. The cat hadn't returned, and extensive attempts to locate her without luck. She and dad felt terrible, of course. Frankly, (and I told her this at the time) I just couldn't deal with it right then. But tuesday I was itching to get out of the Hospital to look for the cat, and I went right over as soon as I was discharged.

Though she's gotten outside before, Star's never been away this long, and I think she might be afraid to go back to the clover drive house by now. Nonetheless dad printed up hundreds of fliers and climbed up pierce hill looking for her, and Mom called around to all the animal care shelters and veterinarians and asked if anyone had turned in a rather unusual-looking calico. Kathy Malloy and Pam Travis (my Mother- and Sister-in Laws)helped me flier mailboxes in two whole separate neighborhoods. I placed an ad on Petfinder.com and my mom put an add in the Press and Sun classifieds, so we'll see.

It would be so easy for someone to find Star and just want to keep her, she's that nice of a cat. I really hope that doesn't happen.

Some Good News:
Looks like the latest Bone Marrow biopsy has shown some progress. Dr. Wang, who performed the procedure --with great skill and very little pain on my end, to my great surprise I might add -- called on Friday to report that my Biopsy showed "no signs of disease. According to Barbara, my research nurse:
"In our world, saying "there was no evidence of disease" essentially means that you are in a complete remission... The chemo is working, and you should continue with the current treatment plan."
Sounds like good news to me, what do you think? However it won't prevent the three intratecal (into the spine) chemo treatments I am looking forward to in October. But at least treatment hasn't been a waste of time....

Anyhow, that's what's been happening.

Bone marrow update

Well, it looks like the first of three theoretically "perfect matches," for bone marrow donors has backed out. I got a call from Karen Duvell at Roswell yesterday, saying that repepeated attempts to contact the person have failed, and they have moved on to request contact with a second donor. See, what happens is people get their blood tested and sign up for the marrow list and fully intend to give. Years later, their situations may have changed, and for whatever reason they back out. Karen said you'll usually find out for certain at this point, when the transplant hospital requests another blood sample so they can confirm the test. Kind of a bummer, but at least there are two other optimal matches.
Otherwise I am feeling great. I head back to Roswell Wednesday for an L-asparaginase treatment on Monday and Saturday, and I have another apointment with the cardiologist on thursday to get a different medication for my wierd heart problem. The last meds had me breaking out in itchy hives. A little reasearch last night into the L-asparaginase proved interesting. Apparently, normal white blood cells produce this essential protein (don't ask me why it's essential, I don't know. The cancerous lymphoblasts (bad white blood cells) are unable to produce asparagine, and are forced to forage for extra protien floating through the bloodstream L-aspariginase divides these extra proteins into their baser elements and deprives and eventually kills the lymphoblasts, who can't make the protiens they need. Healthy white blood cells are generally unaffected, as they can make their own asparagine. This is a very elegant way of attacking the disease, I think.
Hope all of you are well.

Home again

Harumph. After a long day yesterday packing up groceries and clothes enough to last a month, DI and I made it back to Vestal last night. Actually we would have been home sooner, but we stopped for a late lunch at the Cortland Friendlys. A cup of broccoli and cheese soup and a quesadilla later, we decided to take the long way home down rte 13, over hill and dale and eventually to Maine, where we found 26 and made it back to Vestal.
After all this, it's OK in the end that they're letting me go home between treatments. Certainly it's nice to sleep in my own bed in my own house. I'll be heading back to Buffalo a week from Wednesday, and have appointments in the hospital for the three subsequent days, with another two weeks from Wednesday. Mom has volunteered to drive so long as we spend a night in Buffalo, which is reasonable. I'd drive back myself, but the Doctors say I'm not supposed to.
Got a letter today from Excellus Blue Cross, our insurance company, approving coverage for the bone marrow stem cell harvest and transplant. I'm not sure if this covers the search or just the actual harvesting and the transplant, or if it helps with some of the testing too. We will see. It was comforting teo receive in the mail, as until now we assumed it would be covered, but just didn't know for certain.
If you're intersted, you should check out the pictures of the apartment (and me!) posted below. They were taken by my best photographer...DI!!

Pictures!My Aparment and such

Forget so soon...

Well it's been all chemo all the time the last couple of days. Yesterday I had my first treatment in the outpatient clinic. Pretty uneventful. Arrived about 7 am, had the bloodwork, then after about an hour wait in the waiting room, the nurse called for me and I went into the infusion center. This place is huge! About the size of a high school cafeteria, and full of partitions and easy chairs, it is set up for handling a lot of patients at a time. Anyway, I recieved two different chemo medications and then at about 10 a.m. two "transport" thugs ferried me upstairs on a gurney to radiology. The lumbar puncture I had under the flouroscope was pretty painless this time, but there was a twist! They shot my spine up with chemo after taking spinal fluid out. The good news (though I'm sure its unrelated) is that I'm not having those terrible spinal headaches I had before. Much relieved!
Today was a little less busy--still had to get over to the clinic by late dawn, but I only had one chemo drug, plus a chemo eye drops I've been taking four times a day. But the fun had little to do with chemo today, while I was being evaluated by Nurse Practitioner linda, she asked if I was planning on going home after my final chemo treatment on friday, or if I would be staying in buffalo. I said I didn't know I had a choice. See, there are 10 days between friday, and my next chemo treatment a week from wednesday. Dr. Baer had INSISTED I stay in buffalo for the entire time I was having chemo...but it looks like that might change. I'll keep you posted, plans seem to change by the minute up here.

Back in Buffalo

Well Di and I are back in Buffalo tonight. We have successfully moved into the very nice apartment they have set aside for me at the Kevin Guest House. We stopped at the local wegmans...which isn't nearly as nice at the wegmans at home...for some cold goods that wouldn't keep in the back of Di's car and then moved all the stuff in. Di has already made quick work of organizing the kitchen. We are very tired and must get to bed early, as I have an appointment at the hospital at 7 a.m. Yikes!

Will post again tomorrow with updates from my (yay oh how exciting) day at Roswell Park tomorrow.

--Matt

Packing my bagsI

Well, it's official. A week from today Di and I will be heading up to Buffalo and I'll be moving into A VERY nice apartment at Kevin Guest House in preparation for my month-long course of chemo. Di and I visited the apartment after my clinic appointment monday and the apartment is well stocked.
So, check it out: this apartment has a full kitchen: stove, sink, DISHWASHER, fridge, microwave, plates, pots and pans, toaster oven and other assorted fixings. Living room has flat screen TV, computer, internet access and couch, loveseat and chair. The TWO bedrooms and three beds should house whoever needs to come over, and downstairs the brand new washer and drier is free....you just provide the soap. HOT.
I am looking forward to getting on with treatment. It has been a bit too long hanging out here at home. I'm sure as soon as I get up there I'll be a little homesick, but that's cause the grass is always greener. Apparently according to Dr. Baer I am doing very well and am very healthy. She did have me stop the Flecanide (heart condition drug) and the cardiologist finally called me back today and agreed. It has been giving me these itchy rashes on my legs, and the doctors will start me on some different medications when I return to buffalo.
Kind of a rainy wet crappy day today. What is up with this weather, anyway?
Hope you all are hanging in there.
-Matt

Off the neupogen

Well, it looks like I won't be giving myself a shot for awhile. Had a blood test today at Dr. Khan's office, and my blood counts now resonably approximate a normal person's!
White blood cell counts at 6.54, PLatelets at 126 and everything else looking rosy. That's the good news. The bad news is this won't make my treatment re start any sooner. Talked to Dr. Baer's office today and we're still on track for a Sept. 6 start for my chemo. Lovely!
Other than that life has been pretty boring. I've been hanging out at home. Looks like things are going well at work without me, which is good. I'm gaining great knowledge of Daytime TV in he meantime!

Family proves to be good medicine

Saturday night Mom, Dad, Kathy, Mike, Pam, Megan and Uncle Dean came over bringing dinner and a whole lot of fun to our home on Earl Road. There was Chicken wing dip, chicken wings from the mosquito lounge, kathy's baked ziti and other goodies of all kinds. Fun! Ted wasn't feeling so good and Nathan was out of sorts, too, so they couldn't make it. In the absence of her dad and brother, I think megan enjoyed being the center of attention, though. She was hamming it up! Meg picked out and wrote out a card just for her uncle matt, then when she saw the cards with matt's mug on the front that his dad made for him, she wanted matt's autograph. Cute!
Anyway, all the family around must have made some kind of difference. Matt and Di trekked up to buffalo again Sunday night, and monday there was some big progress in matt's disease. My blood counts have risen quite a bit, even since visiting Dr.Kahn on thursday. White counts up from .75 to 3.06!!! Big jump. The family and the growth factor shots must have combined for some big progress.
Wierdly though, the big progress hasn't meant fast progress in treating my disease. Dr. Baer wants me to come back next monday for a bone marrow biopsy and general checkup. If counts are above 5 at that point, I will start chemo a week later. I asked Dr. Baer if maybe we could start treatment sooner, and it didn't seem likely. She said, "we'll see," but I'm learning what that means: Probably not!
Just seems like I'm spinning my wheels here waiting at home. Want to get headed back on the road to recovery (please forgive the pun!).
In the meantime, we discovered that I have something else wierd about my body: When I came into the clinic they took my vitals, and my pulse was really fast: about 150 beats per minute. It was a little fast the last time I came to the clinic, but on doing an electrocardiogram, Dr. Baer said I had some wierd kind of heart anomaly.
On meeting the cardiologist after an echocardiogram a few hours later, we found out
what exactly I have:Wolff Parkinson White Syndrome. Apparently, I have an extra 'wire" connecting the top of my heart to the bottom of my heart. Apparently this nerve (wire) is like having an extra open circuit, and in the right (unusual) conditions it will repeat the impulse that makes my heart beat, thus making it do doubletime.
The cardiologist basically said I probably would never know about this were it not for my cancer. Great. Then he gave three options for treatment: Do nothing--risky; Minor surgery to "zap" the extra nerve, a little less risky; or take medication to minimize chance of a problem occurring, the least possible risk with the least chance of complications due to treatment for leukemia. He prescribed a pill for me to take twice daily, and I was glad as at least we know what the problem is now.
Anyway, thanks for reading. Your reactions and emails are great. Remember: If you post on the blog and DONT leave your email address, I probably won't be able to respond to you. So if you are expecting/hoping a response either post or send me your email address. Thanks!

Decisions, decisions

Well, the verdict is in. Dr. Baer called wednesday with the results of Monday's bone marrow biopsy. Though the first round of chemo did kill most of the leukemia in my bones, there is a "significant but small" amount of leukemic cells remaining. What this means, Dr. Baer said, is that my cancer is responding to treatment, just not enough. Thus I need a bone marrow transplant. I will go through 1 more round of regular chemotherapy, possibly the one that was scheduled for me next, as the bone marrow team narrows down a match from the 42 possible donors on the bone marrow registry. Dr. Baer isn't sure if I will get this inpatient in the hospital, or outpatient it the clinic. I was supposed to start my next round of chemo on monday, but it looks like that will be delayed at least a week as my counts are kind of low.
After that second round of chemo, they will hopefully ave found a donor for me, and I will be admitted to the hospital and they will start the transplant process with the superstrong BMT chemo. I will emerge 4-6 weeks later with new bone marrow and will stay in buffalo for at least 100 days, and I will fully recover within a year-- or so we hope.
In the meantime I wait. I am feeling OK, have been a little nauseous over the past few days. Got blood yesterday at wilson hospital. A whole lot of it--two bags of red blood cells and a bag of platelets. Ran into meagan mitrus which was kind of nice, and spent most of the day getting all that blood. They ran it really slow compared to how they do things at roswell. Wierd. Also saw Dr. Kahn, who prescribed the blood. He seemed excited to see me, and It was good to see him, but I can totally understand how the doctors at Roswell like to handle everything themselves. A lot can get lost in translation, and there was quite a bit of figuring and re-understanding of the case going on between the instructions from roswell and the prescriptions Dr. Kahn gave out at wilson. Interesting to see going on.
Otherwise, all is well. Looking forward to saturday night, as Di's family and my mom and dad will be coming over for a big dinner. Should be fun!
Hope to talk to you all soon.

Matt

"The drugs are (not so) quick..."

Well, I had my first clinic appointment with Dr. Baer on Monday, 9:30 in the AM in Buffalo. So early, diane and I drove up to ithaca the day before, stopping to see Mike and Kathy Malloy as well as the entire Travis Family, which was great to do! I think my niece and nephew Megan and Nathan were a little bit wierded out by seeing me, which I totally understand. If I was 5 and remembered last seeing my uncle 20 pounds heavier with a full curly head of hair, I would be wierded out when this masked skinny bald guy showed up to say hi!
Anyhow, Di and I woke up in Buffalo after a very comfortable evening in the Dream Room at Kevin Guest Guest house. The Dream Room is a plush, newly furnished room with a fantastic pillow-topped queen-sized bed, new furnishings, a well matched decor and DREAM inscribed in brass letters above the bed. Slept so well it was tough to get up in the morning! We walked over to the hospital, through the beautful gardens and walked up the information desk, where we were given our first batch of misinformation. The nervous-looking information guy said we should get right in line across the room, get our blood taken and not to wait a minute if we were smart. We did the usual thing--ignored him--and headed upstairs to the cafeteria, where I had a fantastic cheese omelet (I'd bet there were 5 eggs in it) and crispy bacon and toast, plus some OJ. Finally headed downstairs and got in line for the clinic, where we were sent over to the Hematology/oncology section. They then ordered blood tests for me, and sent me over for about 12 blood tests.
This is where the wierdness started. I sat town with the phlebotomist--they let me right in--and I got my line out for her to take my blood from one of the lumens. Heck, I spend a lot of time and materials maintaining, cleaning, re-dressing and flushing this thing, and figured it was now useful again.
As it turns out, the nice lady said, "I can't use your line to take blood. We (the phlebotomists) can only take stuff out. To flush your line out, we'd have to put something in."
Now this, to me, is crap. It, I'm sure, would be way less risk of infection and stress on my body and another needle prick to take blood out of my line. I mean, that must be half the reason they gave it to me in the first place. In the meantime though I figured it wasn't worth the battle, so she pricked me up and took the quart of blood all those tests required. Then I headed back over to hematology/oncology and they shooed me into an exam room posthaste. Not a lot of waiting, at least until I got into and saw staff!
After the usual vitals, wieght etc. I was interviewed by the office nurse and nurse practitioner, who I had seen before on rounds and who had ordered my mouth care script the other day. I told them of my somewhat anemic symptoms I had been having for a day or so, and reported about my dedicaed line care, headaches, temp taking and all that stuff. As it turns out, my counts were all quite low. Platelets had dropped to about 11, my red cells were down and even my white cells were down to 55.
As it turns out, I can get my blood taken through the central line, so long as I request that at the clinic when I check in. Heck, If I can be a pain in the butt to someone, I guess I'll just have to be. No more silly pinpricks if they're not necessary.
Later, I was told I had to get platelets and red cells, the platelets coming before my bone marrow biopsy.
So, for the next several hours I lay flat in an exam room fading in and out of consciousness getting benadryl and hydrocortizone and then platelets. After getting all this I was feeling pretty darned good, and I think I surprised the nurse when she prompted me to walk down the hall to the biopsy room. As the phenobarb lolipop was dissolving in my mouth, I met the most interesting pair of nurse's aids. They were laughing and joking and carrying on in very much the same way the staff at theo's ribs do when you go there and order sweet potato pie. We talked about popcorn and friends and by the time my barbituate lolipop had disolved, they had my shorts down and my shirt up and I was ready for the biopsy. Dr Baer did the honors and it (honestly) only hurt for a second. Apparently I am a fantastic patient, but I have strong bones. It is quite an odd sensation to hear a highly-educated doctor grunt as she struggles to remove the very large biopsy needle from your backside. She got it out, and they bandaged me up and told me to change the dressing the next day.
The long and the short of my visit in the end was that I need to call Dr. Baer's office on Wednesday for the results of the biopsy, that my blood counts went down quite a bit and I should have them checked again while I am here -- I have an appointment with Dr. Khan on thursday and he has been prepared for the likelihood of giving me blood transfusions of various types -- and my chemo, which was scheduled to start again next monday, has been pushed back by a weeks time. We'll see what Dr. Baer has in mind when I visit her next Monday.
On the way home from the clinic we stopped at Anchor Bar. Cool looking place inside. Di let me order wings than ousted me to the car while they were being prepared. No wings are worth getting an infection over! She was right. I ate the famed wings in the car on they way home. They were ok, but nothing to write home about or even drive to buffalo for. I'd eat the wings at the mosquito lounge anytime before doing that!
Today was quite a bit more relaxing. Headed to syracuse in the AM for another visit to the fertility clinic, then came back here and mostly rested in the afternoon. Ordered a new shipment of the nupogen shots per my doctor's request. Got the tracking number, and I see they're on thier way as I write. Diane made one of my favorite dinners tonight: Curried chicken flourentine. YUM! So, otherwise that's About it.
Hope all is good in your neck of the woods. Long post tonight, but I've been off for awhile. Thanks for writing and reading!

Hi! My Name is Matt and I am a Starbucks addict

I received certified proof today that I am a starbucks addict in recovery.
My Dad has been driving the Alligator Scion since I started treatment. Every day, he stops at starbucks on the parkway.
Now, if you frequent starbucks, you know the baristas remember you. They especially remember you if you drive a scion with an alligator on each side. So, i had gotten to know everyone there pretty well over the last few months, and they saw me coming.
When dad started to drive the alligator, apparently they asked him where I went. He told them about my ALL and they have been following the blog here.
Today, my dad dropped off the sign I am showing you here. How cool is it that they put that together! And lo, how clear it is that I am a certified starbucks addict?!?!?

Diane and I drove to Syracuse today to visit the CNY Fertility Clinic. There is competing information out there about whether chemo for ALL permanently impedes sperm production. Some say function returns after chemo is complete, others say I will be sterile forever. As Diane and I are certain we want to have our own biological children, we are not leaving it to chance that my "boys" will swim again after I finish treatment. Hence we made our first of at least two trips today. I was impressed by the operation they have up in Syracuse. The waiting room was furnished with more plush furniture than Jon Miselnicky's living room. There was a fireplace, coffee and tea maker, and more people than I've ever seen in any doctor's office. While I was inside for about 20 minutes, Diane said she saw more than 20 people come in and go out. All through the parking lot were nearly new cars, mostly of the exotic imported type. All I kept thinking as I left the place is, gee, did I ever get in the wrong business! No, not really, but judging from the volume of people I bet the doctor who owns the place just about prints money.

On they way back from syracuse my tongue started to get really sore. It has been deteriorating the past couple of days; the doctors didn't write a script for the mouth care products I had been using in the hospital. There was this special mouthwash and a lozenge that helped control and kill any bad bacteria in my mouth. I've been using listerine now that I'm home, but it seemed to really irritate the mouth and not help at all. So I called Dr. Baer's clinic. Thankfully, the nurse in charge quickly got back to me, and they called in a script for the Peridex mouthwash I had been getting in the hospital, and the lozenges that generally calm and sooth my mouth. Di an I went to get them (and ran into kim leonard...Hi Kim!) and as soon as I got home I took the medicine, and Immediately my mouth felt better. Phew. It was really starting to get uncomfortable, and I'm glad I have what I need now.

Well, I'm going to get going now. We're gonna have spaghetti and meatsauce tonight, and I'm getting really hungry, so I'm going to bug Di and see if we can get some yummy eats on the table. OHO! ne more thing. If and when you comment on the blog, can you please leave your email address for me. The comments are forwarded to my gmail account, but if you don't leave your email address, and I don't already have it, I am unable to respond to your posts. Thanks!

There's no place like home

Today is a really great day. Instead of updating my blog from a hospital bed in Buffalo, I am writing from my living room sofa in Vestal. I've been discharged from Roswell; I am home at Earl Road!
I got the first inkling I might be going home yesterday, when I received the results of my routine 5 a.m. bloodwork at about breakfast time. White cells were a whopping .92! Now, in the scheme of things, a .92 count is pretty pitiful (healthy counts are 3 or higher at least) but when 3 days before your white count was .19, the near inverse is worthy of dancing a jig. And no, I didn't dance a jig, but I sure felt like it.
Dr. Wang came to see me, and she was impressed. Not too impressed to cancel the lumbar puncture I had scheduled for that day --she was still worried about my blurry vision-- but impressed enough to tell me that if I still felt well in the morning, I could go home.
The lumbar puncture, this time done in radiology with real live medical equipment and a real doctor, went seamlessly and quickly (and came out negative for lukemia), and I went to bed last night confident I would go home. After meeting with half a dozen people--pharmacist, dr. social worker, master plumber (no, not really a master plumber) I was given my discharge papers and Di drove me home. She had gone into work for a few hours, then zipped up to buffalo to pick me up.
I am not home for good however. Monday I head back to Buffalo for the day, as I have a clinic appointment with Dr. Baer. Bone marrow biopsy. Ugh. Good news is we'll come back that night and I'll be able to stay in bingoland till the 19th. Then I go back to Buffalo and move into a new "off campus" residence. I'll start my second round of chemo on an outpatient basis bright and early the next day.
A note about visitors while I'm home. I would really like to see everyone, but I have a problem. Though my counts are looking good for me, compared to every other healthty person in Broome County I have a sickly and weak immune system which would hospitalize any of the rest of you. So, I really have to limit visitors to family, and even they can't come if they've been exposed to a cold or disease within the last few weeks. It's not something I like, but it's really a matter of life and death. Any infection I get will delay the progress of my chemotherapy, and that's just not worth the risk.
I'd like to thank everyone who visited, sent cards, letters, gifts and emails while I was at Roswell. You have no idea how great this made me feel, and helped to pass the time. All the nurses and doctors really thought I was something special because of all the evidence of friends and family hanging on the wall. And I felt like something special, too. I am grateful and humbled by the response, and I consider all of you true friends for your support during this difficult time. It really means more than you can possibly imagine!
Thanks again for everything.

Matt Kensey

Not such a triple threat

When I woke up this morning, groggy from the pre-platelet drugs my nurse Kiera had given me about 6 a.m., I was nervous. As it turns out, I should have been happy. My usual 5 a.m. blood test turned out really well. White cell counts jumped from .19 to .58 overnight. Whoohoo! Now, don't get me wrong, I am still quite sick and they aren't letting me out of the hospital just yet, but such a immediate and big jump has to be a good thing.
Dr. Wexlar agreed when he saw me about noon. I was hanging out with Di and had just finished the MRI Dr. W prescribed to investigate the blurry vision I am still having. He came in the room and said "You must have been scared, because your blood counts are finally getting in shape," he said (or something to that effect, as I can't ever remember conversations verbatim. I was doing so well, he said, that he would skip the Bone Marrow Biopsy he had planned for today. I said "Cool!" really loud, and all the residents (there must have been at least 10) were smiling and giggling in the hallway. Too funny!
Bad news is I will still be getting a lumbar puncture tomorrow, but it will be done down in radiology and won't (hopefully) be such a big deal as the last fiasco that left me on my back for a week. At least that stupid fellow who did it before won't be doing it; Di always gives him the evil eye, but we haven't seen his face lately. I'm kinda hoping he got fired!

It's kind of boring here today, so I am thinking about what I would do if I weren't here. Maybe you want to do one of these things because I can't! The worst thing about being in the hospital is the lack of control--it's kind of like being in jail. So, I guess I'm just thinking about all the things I would do if I had the chance.

Top 10 things Matt would do if he weren't in the hospital

10. Eat some anchor bar chicken wings!
9. Get in the alligator car and stop at starbucks.
8. Drive with the windows down and the music playing loud.
7. Stop in at a movie theatre and buy a bag of popcorn
6. Hit a bucket of golf balls.
5. Mow the lawn--I'll bet it needs it about now.
4. Up and decide it's time to cut out of work early
3. Play with the star-nugget, because she probably misses me.
2. Open up and expensive bottle of wine, just because I want a glass
1. Have a picnic with Di at the back yard of our house, enjoying the view of our huge green back yard.

Hope everyone is doing well. Thanks for the letters!

Grow, white cells, grow.

Woke up this morning and asked for my lab results from the blood they took at 5 a.m. White cells dropped to .19, platelets held strong at .52, so at least I didn't have to have more platelets today. It's odd to me that my white cells would dip again, but what can you do. I've been feeling really glad the doctors didn't let me out when they had originally thought they were going to, as I'm sure if I were home all this bad cell count stuff would've meant a very annoying and immediate four-hour drive back to buffalo. Not very nice to think about.
Met with Dr. Wexlar on rounds today and he didn't make any guesses. We talked about my blurry vision, and i've got it narrowed down to being more like double vision, in that i can focus on things but often see another image close by. Dr W is concerned about the blood counts, specifically the stalled and slightly retreating white count. The plan tomorrow is for lots of tests: Bone marrow biopsy (with atavan and narcotic lolipop) MRI, and if those two aren't conclusive I'll also get a lumbar puncture, this time under the x-ray in radiology by someone who knows their stuff. Dr. W was hesitant to say anything or make any guesses today, just said he needs to get more information, which I can appreciate. So, again, we wait!
In the meantime, I totally impressed Diane. My nurse, Val, dropped off my growth hormone shot about 5:30, and asked if I needed help giving it to myself. I declined, and about shocked Di out of her shoes by cleaning a small spot on my belly, jamming the needle in and squeezing in the growth factor shot. It's funny--I never thought I'd be able to give myself shots, but when faced with actually having to do it, it really isn't that big of a deal. I even like it better than when the nurse does it, because I have control. Funny how that is.
Well, going to get going and spend time with Di. I haven't heard from many of you lately and am beginning to feel like a Pink Floyd song. Is there anybody out there?

Holding on...and liking it

Getting more back to normal here today. Di showed up last night which was a great development. Didn't sleep very well due to being in bed most of the day Friday. I took a more pro-active stance when waking up. When my nurse came in about 8 a.m. I asked her to find out the results of the blood test I took at 5 a.m. As it turns out, my platelets had dipped slightly and white count stayed exactly the same. I got out of bed, and hit the treadmill before breakfast, knowing they'd have to give me platelets and benadryl and hydrocortizone later on, pretty much binding me to my bed for 4-6 hours. Had a really vigorous workout, came back and my breakfast was waiting. Made quick work of the breakfast -- eggs and bacon and english muffins, oh my! -- and called the nurse to tape my dressing up for the shower. Hopped in the shower, cleaned myself up, brushed with the mouth care stuff and got dressed. Wasn't even 10:00 AM yet! Meanwhile, the nurse had re-made my bed with fresh sheets. Still not done, I called the pharmacy about these growth factor shots that, several days ago, were supposed to ship and arrive Friday at All Ready. According to Dad and peggy, they did not arrive at all. The pharmacy that was chosen for me called back, and said that they didn't ship the growth factor shots after all, and we made arrangements for the shots to be delivered here at Roswell Monday, as no one is promising or expecting me to be discharged before then.
After all that, it wasn't even lunchtime! Felt very good to be in charge of my day for a change, getting all the stuff done and out of the way so I could enjoy the platelety comfort of drugs and sleep all afternoon. I will try to repeat the performance in the future.
Dr. Wexlar came in about the same time as my lunch came (again). He basically reiterated the tests: White cells too low, need platelets, no leaving the hospital until counts go up. I had just gotten all the pre-plately drugs, and was pretty hyper actually. Told him that my blurry vision had started again. He said if it persists, another lumbar puncture on monday, this time done in radiology by a pro. Getting these guys trained with the right attitude is a good thing ;-)
It's weird, now that I have no promises or prospects of actually leaving, I feel quite a bit better about being in the hospital. It really would have sucked if they let me out too early, and we had to make the trip all the way back to buffalo. Still annoyed at the doctor for letting the confusion happen in the first place, but I am finally getting over it and getting on with treatment.
Dad came to pick up mom this afternoon and spend a couple of hours visiting. Nice to see him. Had a good time talking shop and catching up on random Binghamtonyness. They seemed sad when they left....
Thanks for reading
Matt

Waffle me discharge

It's been a weird couple of days. Been getting a hard and fast lesson in how hospital life can be. Looks like Dr. Wexlar spoke out of turn a bit on Wednesday about the Bone Marrow transplant and my imminent discharge. After speaking with him for quite sometime wednesday night, I emailed my nurse coordinar, kind of like the liason between Dr. Baer and myself, asking for some clarification on the matter, particulary timing of the bone marrow transplant process and follow up. The Nurse Coordinator emailed me back in the morning and said she's be over to talk to me about everything. She seemed concerned.

When the nurse coordinator showed up the next afternoon, she said she was quite surprised I'd heard such a definite decision about the Bone Marrow procedure, as she had been talking to Dr. Baer that morning and the good Dr. has been doing some research on the very fact of when or even whether such a transplant would be implemented. Apparently I have a rare form of ALL, which does not necessarily place me in the risk category where Bone Marrow Transplant is prescribed. Because my disease is rarer than the average ALL, Dr. Baer has been searching for supporting evidence of what to do with me. Hence, the surprise over the opposite opinion being told to me by Dr. Wexlar, as Dr. Baer doesn't even quite know what to do yet. It may be that I go through the whole of my chemo and not have a transplant. I may go through only part of the chemo. What the nurse coordinator made clear to me is that decision has not been made yet, and really won't be made for a couple of weeks yet, or perhaps even longer.

For the future, the nurse coordinator/liason told me this: Major decisions about my case are made only by Dr. Baer. She is my attending physician and all of those decisions go through her. Other physicians are on the case in her absence, but it's Baer's show, and she decides the biggies.

All this has been compounded on the fact that on Wednesday night Dr. Wexlar told me my blood levels were rising and I was going to be discharged today. Well, on thursday my White Blood Cell count dropped to .29. I was told then that I wouldn't be allowed to leave until Saturday. Fine. Today, I was informed that the white cell count dropped again, to .26. Argh! After telling me that, Dr. Wexlar finally said that they are not going to make any more predictions about discharge, that I will be discharged when my blood levels rise again, and to just plan on being here until that happens. This statement of course would have been fine in the first place, had the doctor not raised my hopes of leaving and maybe actually going home to Vestal for a few days well before I thought possible. As of now, I don't know when or whether that is going to happen at all.

It wasn't like they were kidding around about discharge, either. Preparations were being made. In the past couple of days was dropped off what must be several hundred dollars worth of the drugs I am to take once I go outpatient. A home health nurse met with me yesterday and showed me how to purge my central line out with these special Hepharine shots, as well as showing me how to change the dressing and other accoutrements that go along with it. Last night and tonight the nurses here observed while I gave myself the subcutaneous growth hormone shots that I will need to give myself every day. A different home health aid came today with all my bandages, line care supplies and spare parts, and we went through the whole procedure again so I would be comfortable with it. I now can change my dressing, change the little tippy things that go on my catheter, purge the line, give myself shots--I'm a regular Matthew nurse here, but still stuck in the hospital. I guess I'm glad I know all this--I had to learn how to do it sometime anyway -- and I'm glad they didn't discharge me in an unhealthy state, but I just can't understand why the doctors would have jumped the gun so much. I was in no hurry to leave; they were the ones who got all excited, and I pay the price. If it helps at all, most everyone on the nursing staff says that this kind of crap is pretty normal, is frustrating for every patient and family member, and everyone wishes it could be different. Well, of course!

So, anyway, learned a lot in the past couple of days. I'm still at Roswell, with this new knowledge, and am actually feeling better now about everything that I've kind of let go of my expectations. Awfully hard on a guy though. In the future, I'm going to be a lot more skeptical about everything I hear, unless it comes from Dr. Baer herself.

Pecking order for future reference:
Attending Physician: Dr. Baer--Makes any and all major decisions about my case period.
Physician on rotation: Dr. Wexlar, Dr. Wang--Make smaller day to day decisions about care, can offer opinions on major procedures and treatments, but these opinions should be taken with a grain of salt, as they must be finalized by Dr. Baer.
Nurse Practitioner: Rotation physician's eveys and ears, can prescribe small drugs and does the examining and bad-news-breaking when appropriate. Often a good liason between myself and Physician on rotation

I wish someone had told me this was the pecking order to begin with, as much of my misunderstanding and stress during all of this has come from not knowing this pecking order. As usual, however, I do eventually figure things out for myself!

Cheers and hope this wasn't to rambling of a post.--Matt

News of discharge and beyond...

Had a very important meeting today with Dr. Wexlar. Here's the scoop. This week my chemo is focused, for a change, not on killing bad cells, but bringing back the good cells that I have and building up my immune system. This will be done with hormones (the L-aspariginase shot) growth factor, etc. What we are attempting to do is what I rationalize in my head as raising my "autoimmune quotient." That is, the medication and treatment I receive this week will raise that quotient so that I am healthy enough to live on the outside. My autoimmune quotient right now, Dr. Wexlar said, is about .28 of some measurement I'm not entirely sure of the name. During the week, my antibiotics, antifungals and other autoiummune builders will slowly be scaled back, while the growth hormones etc will be increased. When that autoimmune quotient reaches .50, the very next day I will be released, provided I have acquired no infections in the meantime. What this means is, at the very earliest I will be discharged to outpatient care by Friday night, provided no infections and everything going as planned. Big ifs. At the very worst, I think, I will be discharged by the beginning of the week.
Regardless of when I am discharged there will be about a week of downtime between the end of module "A" of my chemotherapy and the beginning of module B. Dr Wexlar said that it is possible for me to return to Binghamton during this time, but I am thinking that is probably not the best idea. To me, it's not worth the risk of the drive or possible infection. I would rather get settled here in my new home in Buffalo during that time. I have to donate sperm so that Diane and I can have kids when this is all over, and that must take place before Module B begins anyhow, so I will be busy visiting that clinic, too.
I have aain contacted the social work housing coordinator about a place to stay , and informed her that I could be discharged as early as Friday night. That way, if we have to push things back, at least I will be in line for the places that I would prefer. So we will see how that goes.
I then asked Dr. Wexlar if a decision had been made about the bone marrow transplant. One has. The doctors want to proceed with the typing for a bone marrow donor from the list of 42 that was found in the nationwide databank, with the ultimate goal of giving me a bone marrow transplant. Even if they had a donor lined up today, however, they would not proceed with the transplant until at least module b, c, and possibly d of my chemo were completed. Some of what module b and C address is leukemia inside the central nervous system. Though the doctors have no indication of any lukemia inside the CNS, it is not prudent to go ahead with a BMT without treating first and making sure no leukemic cells are hiding in the spinal fluid, cord or brain. And it is very hard to go back, once a transplant has taken place, because the doctors don't want to kill the shiny new bone marrow cells that will be growing inside me. At the same time, module b and c double back and kill any leftover lukemic cells in the bone marrow, which have to be completely gone before transplant can occur.
Even if I had a bone marrow donor (actually no one donates marrow, they donate stem cells overproduced as a result of medication. But we'll call it marrow now for short) ready to donate tomorrow then, It will be a month or three before the transplant can proceed. In the meantime the doctors will test, retest and finalize candidates, so when I am ready and the donor is ready, all the planets will fall into place and I will have a perfectly successful bone marrow transplant, and ultimately I will be cured.
Dr. Wexlar told me, and wanted me to tell all of you, that this is a long process. Understand that as good as I am feeling today (which is great) It will probably be two years before I feel this well again. Two years is a long time, but it's my only and definitely the best alternative. Though I may do better than that timewise, in two years I can be sure of a cure. I'll have new bone marrow and a new immune system for the price of one. I will be out of the hospital for a long time and home and back to work before then, but that's the actual timeframe for a full cure, in case anyone wants to roll that around in their heads and think about it for awhile.
So, when all the planets are aligned here in a couple of months and a donor has been lined up, this is what I can expect. I will be readmitted to the same floor over here at Roswell Park. Going to see what I can do to get a better view next time. Be nice to see the city! Anyhow, I'll be readmitted and they will immediately start a new, stronger regimin of chemotherapy that will last at least a week, as well as antibiotics, antifungals, basically reestablishing my artifical autoiummune shield. After a bone marrow biopsy to confirm that yes, indeed, all the bad cells are now gone, they will stop the chemo and start the transplant. What they are transplanting is not bone marrow. The donor will be given doses of hormones to make him or her overproduce stem cells from his healthy bone marrow. These stem cells will fill up his bone marrow cavity, and will spill over into his or her bloodstream. These stem cells form the basis for red cells, white cells, hemoglobin, platelets, and other clotting factors in my blood. These stem cells will then be harvested in a machine that I imagine is quite like the platelet donation machine some of you will be donating your platelets into within the next few days. The stem cells are taken, the donor's blood is returned. I will then receive these stem cells into my bloodstream via a transfusion, the same way I receive all the other blood products though my central line. I will also receive anti-rejection drugs, as even though I will have a perfect match for the donated cells, some alleals etc may not be exact, and we need to suppress the body's natural defense mechanism to avoid the stem cells rejecting my body.
These stem cells are very smart little guys. They want to go to to thier home, that is they want to find the bone marrow cavities. Henceforth they will find a cavity and start doing what they do best. Divide and conquer. From what I have read, in about 4-6 weeks they will have restored much of my blood creating function. They will begin to make good blood on their own! I will start to get a new immune system (we'll be watching the Autoiummune Quotient) Of course nothing will be perfect and I will not be cured yet, but I will be on my way. Remember what Dr. Wexlar said. To feel as good as I do today will probably take two years. Let's understand that, become accstomed to that and hopefully we will be pleasantly surprised any good results that might happen sooner.
I am very relieved to have heard this news today. At least, finally, we have a longterm plan we can follow and look forward to and there are many fewer what-ifs. We've got a plan, and now it's time to live it. I know with everyone's help I'll succeed and I will be cured. Now it's time to go about doing it.

Thank you everyone's love, care and thoughts so far. I couldn't have made it this far without such fantastic support, and I am thankful beyond words for everything that I have.

Thanks again.
Matt

Turning a corner today?

Today has been a very long and very exciting day. I met with my attending's resident today and he had some news. Apparently I was going to undergo a follow up CT scan to confirm that whatever minor problem came up with the MRI last week had gone away. Also, he repeated what trish said the day before: my original, botched LP may have been messed up so badly they didn't get enough fluid for the test. Hence, all the pain I'd been through all week was worthless.
A little later, Dr. Wetzler (my new attending) came into examine me. He said I would get a cat scan today, and unless there was something weird in it, he would forego the LP. He said that for some reason there was something about me that made for a difficult puncture.
That's when I let him have it. Nice guy, but he wasn't about to blame me for all this. I told him, look. The first time I had a spinal tap back home in Binghamton, the attending brought in a neurologist, and the whole procedure took about 10 minutes. My attending in bingo did this because, even though he could have completed the procedure, he wanted to go as smoothly as possible. Now when I came to roswell, for whatever Reason Dr. Wang permitted her "fellow" to attempt the procedure. He sure as hell didn't know what he was doing, as finally after a half-hour of poking, he hadn't been able to get in and Dr. Wang had to (apparently unsucessfully) finish the procedure. I was getting to resent feeling like this student's guinea pig. The problem, it seems to me, wasn't me. The problem, I said, was with letting this fellow attempt a procedure he wasn't capable of/wasn't ready for or whatever.
That certainly got Dr. Wetzlar's attention. He repeated that the LP probably wouldn't be necessary, that they were doing the CAT scan as a follow-up, and if the scan was clear they wouldn't do an LP. He added that I would be VERY well taken care of if a new LP was required.
It was apparently very busy down in radiology today. I spent most of the afternoon sleeping, getting new platelets and waiting for a spot to open up in the cat scan area. Finally one opened, and I was whisked pole and all down to the basement for the scan. It was rather anticlimactic. About 20 minutes and 3 pathetic little scans later I was back upstairs on 5E, my unit.
Didn't see Dr. Wetzlar again, but the asian Nurse Practitioner came in and said everything was cool with the scan, and I was still on track for the original study schedule. This is great. I can expect very possibly to be discharged next week by that rationale.
As I was eating dinner a little bit later, Dr Minood from the bone marrow team came in. He asked if I had heard the preliminary news about the blood donor search. Apparently there are 42 likely matches for me, which means two things: the odds of my finding an exact match are almost certain, and because there is such a good chance of finding a donor I will likely qualify for a grant to pay for all or nearly all of the donor search costs. Don't know if I'll even need a bone marrow transplant, but it's really nice to know the likelihood of it making us go bankrupt just got quite a bit lower!
Getting tired but am happy and wanted to share the good news with everyone. This is the best day yet, and I'm feeling good again about my prognosis. My headaches are pretty much gone; I think I will take one more dose tonight of Oxycodon before going to bed, but that's just so I don't wake up with a headache or something in the AM. Hope all of you are doing well, and thanks for reading.

Holy greetings, Batman! ...and other roswell pics

None of the nurses, doctors or other visitors can believe the almalgamation of cards on my hospital room wall. This picture hardly does it justice. Thank you so much for all the pick-me ups. Your notes encourage me whenever I'm having a less-than-perfect day. I'm gonna need a new wall!



My bed is the command center of the kensey empire. I handle all email and blog postings from this comfy, air cushioned perch. Just beyond my left hand is the remote control. I change the channel, turn on the radio and call the nurses for more of just about anything with the red-and-white nurse button.





This big green easy chair reclines with an extended ottman for total comfort. I eat many of my meals here, especially when soup is involved and I don't want to muss up the sheets. It is also a great reading spot, as the chair is just firm enough to keep you from falling asleep ater 10 pages.







All of my blood counts are extremely low during chemotherapy. One ingredient in blood, platelets, is so low that if I get even a small cut it might not stop bleeding without specialized medical attention. Believe it or not, during toothbrushing it is quite common to end up bleeding from the gums in several locations. These green sponges glued to lolipop sticks are called toothettes, and they allow for bleed-free teeth cleaning when combined with a special mouthwash for Lukemia patients. A small sacrifice for the cause, but what would I give for a normal, FIRM toothbrus and minty crest.

Fast times at Roswell High

Friday started as good day but turned not so good in a hurry. I had been taking my pain meds consistently, amd by the morning had started to feel like sitting up, doing emails etc. So I did just that. No one had told me to do otherwise. Made it fine through breakfast, fine through lunch, and fine through rounds with Dr Wang. She seemed pleased that I was improving, and Dr. Wang never seems pleasd.
So I continued the afternoon much like the morning: some sitting up, some lying, showering etc. About 2 p.m. My headaches just started to return. So I called for Marima the nurse and she got me more oxycodon. An hour later though, my head regained it's former achy fury. Sigh. So I laid back down, and rested, and of course it went away while I was on my back. Meanwhile, Marima was really encouraging me to walk laps around the unit after seeing how well I did in the AM. So finally, even with the gritty headache, I started to walk with Marima around the unit. Walking was OK, but my head hurt so bad that I had to get back inside and in bed after just one lap. I could barely keep my eyes open.
Marima, concerned, called the doctor. This is when things started to get wierd.
About an hour later, a usually nice nurse practitioner came in, aplogizing that she hadn't gotten my page earlier. Without even questioning me, this formerly unserstanding NP lit into me about how "you need to slow down, and "We don't want you to be walking around the unit. You are really sick; we want you to rest." She basically blamed me for the ongoing headache problems. I pointed out that I hadn't had the problems until the botched-up lumbar puncture, to which she argued was a separate issue. She then said I was right and to report the new symptoms.
How, exactly, should I report problem if when I do I get flak and blame for reporting new symptoms? GRR
So I just wanted that NP to get out of my face. After stewing in my own anger for a few hours, at 6 p.m. Dr Wang showed up at marima's request and asked what heppened. I told her about the new symptoms, and she kind of minimized them saying that "you'r really sick. You need to rest on your back for several days.
Meanwhile DI chimed in, pointed holes in Dr. Wang's cheesy argument that I was at fault, not the mized message nurses and physicians kept giving me for the past 3 days.
Dr. Wang, taken aback, acutally explained what the problem might have been, that I was probably a bit sensitive to the LP, plus my blood counts were almost at thier minimum. The combination of the two, she thought, was the reson for my crappy achy headaches and general phyiscal state. We left it with me promising to rest, seriousy rest, all weekend long, as she finally acknowledged some wrongdoing on her and her staff's part.
My figety, glasses-flicking ass, just wanted to get her the HELL out of my room!

Bruised lumbar, bad headaches and 100 miles an hour

To recap the past couple of days:
Tuesday
Dr. Wang wanted to give me a lumbar puncture (spinal tap) due to some blurry vision and slight headachyiness I had been having. One of her fellows -- kind of like a fancy resident -- started the procedure. He really botched it. After a bout a half hour of him poking into my spinal column, missing, and poking again, sense took over and Dr. Wang finished the procedure. A spinal tap isn't all that comfortable of a job to begin with. The doctors poke a big needle into your spinal column and suck out spinal fluid. By the end of all the poking and prodding, I was pretty sore in my lower back, and seriously pissed off that I was some advanced student's guinea pig.

Wednesday
About 3 a.m., my nurse came in and told me I needed to have a platelet transfusion. For those of you who have ever been in the hospital, you will understand that these middle-of the-night interruptions are fairly routine. I've had platelets before, so it was no big deal. The nurse hooked me up, and, in about 10 minutes my central line area started to itch. Then my chest started to break out. And my legs, knees, feet, my face, everywhere. Bright red and white hives, hives so thick on my kneecap there were peaks and valleys and craters. I buzzed the nurse in, and he rather freaked. The charge nurse came in and said she would page a doctor. They knew exactly what to give to stop the breakouts, but couldn't administer it without a prescription. The nurse had to page the on call doctor THREE TIMES before getting a response. Meanwhile, I was really suffering. Big red welts and hives all over my body. itching and itching and itching like hundreds of bug bites. FINALLY, a half hour after I buzzed the nurse, they finally brought in intravenous benadryl, and the hives went away within 10 minutes.
How does this happen? Even though I have had platelets before, sometimes something in someone elses blood, even something they ate, will react with the donee, causing breakouts. For all future platelet transfusions I will be given both benadryl and hydrocortzone before hand, to prevent any possibility of reaction happening again.

Later Wednesday, I woke up with a splitting headache. What I found out is that this headache was from the lumbar puncture the day before. The doctor explained that this sometimes happens, and I should lie flat in bed all day long. FUN. True to her word, the minute I got op, sat up or went to the bathroom, I started to get headachy again. Though i took pain pills, they didn't seem to help...the only thing that helped was lying down.

Meanwhile, the doctors were actively pursuing a Bone Marrow donor for me, even though they aren't sure I will actually need a bone marrow transplant. It is quite a long process finding a donor, and if they waited to start searching for a donor when I needed one, it would be too late. I met with a financial counselor from the hospital, who explained a crappy thing about insurance companies. Though insurance will fully cover a bone marrow transplant (a couple of hundred thousand dollars), it would NOT cover the required testing of donors in the nationwide databank of typed bone marrow donors. Cost of finding a good match, the lady said with a straight face, are between $3000 and $30000. That's quite a range. So in the meantime the financial counselor lady gave me a financial aid package, which i need to fill out and hopefully will help me get grants and stuff to pay and discount for the search. The doctors have stressed that they will make a decision about the transplant before they start all the expensive testing on donors, and will narrow the search as much as possible so the costs are minimal. It's still a bit scary, and not something I really wanted to have to deal with when I was already feeling crappy.

Thursday
The same headaches and bed rest apply today. Trish, the nurse practitioner who is a good patient advocate, met with me, and I gave her an earful about the spinal tap. I told her that no one but an attending doctor or neurologist will be doing any spinal taps on me. I feel like my headaches must be related to the "fellow"'s botched job. Though she said that probably wasn't the case, Trish said she understood and my wishes would be shared with Dr. Wang.
Later on I met with Dr. Wang. She apologized for the botched job on tuesday, and said that she had thought the fellow would have been able to do better than he did. She guaranteed me that no one but an attending doctor or a surgeon would do the spinal tap in the future. This made me feel better. She also said part of my issue with the headaches is that I kind of gave up on the pain medication. I am supposed to now take my 10 mg of oxycodon every four hours, and the cumulative effect of those doses should knock out the headaches. She also said that right now my blood counts are SUPER low, so the headaches are a combination of the crappiness I should be feeling, and the lumbar puncture to which I am apparently very sensitive. Her orders were to "stop going 100 miles and hour" relax and lay flat for another day. That is really really hard for me to do!

Holy cow, that is a long entry. It's been a wierd couple of days. Hope everyone is doing ok at home. All in all, I am fine, but this headache crap has made me quite cranky.

I can use your help!

It seems like every time someone sends a letter, email or calls me on the phone, they want to know how they can help. Well today I found a real way people can help, if you're interested. I require platelets, the part of blood that helps clotting, on a regular basis as long as I am on chemo. If you like, you can donate platelets here at Roswell Park. The process takes about two hours from soup to nuts, and the good news is if you are an eligible donor, your platelets would be assigned to me for up to 2.5 days. If it turns out I didn't need any platelets during that time, the donated platelets would be given to another cancer patient. No platelets will be wasted, as they only have a shelf life of 5 days altogether, and they are a precious commodity especially here at the cancer center.

The donation does require that you visit Roswell; you cannot donate back home and have the platelets transferred here. However, you can be pre-screened by calling or emailing Patrick McGuinness, donor recruiter here at Roswell. His phone number is 716-845-8282 and you can email him at patrickmcguinness@roswellpark.org

Otherwise today was kind of a wierd day. I had a lumbar puncture (spinal tap) this morning. That left me feeling kind of headachy and lethargic most of the day. The good news is they are 95% sure there is no lukemia in my central nervous system. This was a concern because of the headaches and the blurry vision I have had. All signs point to good things, however, so I am happy about that.

Anyway, thanks everyone for your emails and phone calls and letters, and I look forward to talking to you soon.

High school biology lessons and chicken salad

Kind of a wierd day today. Woke up with a pretty bad headache and the blurred vision again, which was kind of wierd because I hadn't been reading or anything. The nurse gave me some oxycontin which helped with the headache and soon after my vision improved, which is good. Talked to the nurse practitioner and she wanted to consult with my attending-doctor-on-rotation, Dr. Wang. Dr. Wang has ordered an MRI for me today just to rule a few factors out. Apparently they just want to make sure there's no bleeding. Also I'll get a lumbar puncture sometime today or tomorrow just to confirm there's no lukemia inside the nervous system. They did that before at wilson but I guess they just want to make double sure, because of the new symptoms in the past couple of days.

As far as high school biology, I had a consult with the bone marrow transplant Dr. this afternoon. Apparently I do have an unusual "risky" genetic trait in the white cells. I guess it's 47 chromosomes instead of the 46 that I am supposed to have, plus some other random genetic fuzz. So the long and the short of it is they are going to get me on the list for bone marrow transplant just in case I might need it. The doctor said they don't really know if I need it now or not, but it's good to get on the list because it can take up to 3 months to line up a donor. If for some reason my ALL doesn't respond correctly to the chemo, they'll dump that plan and do the marrow transplant instead.
The good news is, as a white caucasian male, finding an exact match should be a snap. Interestingly enough, my parents can't donate, as they would have only half the match that my chromosomes would need.
Frankly, the bone marrow transplant procedure at first blush doesn't sound so terrible. Apparently it's even anticlimactic. They do a different kind of chemo on me for about a week, then they just hang a bag of donor blood and connect me up, and eventually it works its way into the marrow and hopefully will start growing the new stuff. I'd be in the hospital another 4-6 weeks, then have to stay in buffalo for another 100 days at minimum. The wierd part is, let's say a female donates to me, my bone marrow chromosomes will be XX, but the rest of my chromosomes will be XY. Apparently my blood type would change too, because that's where the blood is made (inside the bone marrow.)

Oh, and I had a really yummy chicken salad sandwich for lunch today. That's where the chicken salad reference came from. I know, a little random!