Mother Superior jumped the gun....

Fentanyl patches are definitely the thing for naggy constant pains.
I found this out yesterday after several days of increasingly worse discomfort in my belly and back. I started talking about the pain to the nurse practitioner and then ultimately Barb Anderson and Dr. Wang. It was a bit scary, and woke me up very early three times in two nights. It was the kind of pain that makes it very difficult to sleep.
In this light, I had a CAT scan and some blood cultures done Tuesday. No signs of infection, no enlarged anything. Kelly told me to continue taking my Dilaudid, and gave me two IV doses of Dilaudid, which was really the thing.
The problem with Dilaudid is the seemed to hit all at once. So Tuesday night, I again fell asleep quite easily, but woke up at two with the bad pain and never could get back to sleep.
Wednesday I finally met with Dr. Wang, who seemed to have a very good idea of what the problem was. Sometimes withleukemia, the body makes so many diseased cells so quickly that they overflow the marrow into the bloodstream. Many times they will end up in the liver, and after poking and prodding she seemed fairly positive that was the case with me. The good news is that this is quite normal for leukemic patients, especially ALL type.
So I left the clinic Wednesday with an appointment Thursday (today as I write this blog!) to have an ultrasound after my chemo. This should tell Dr. Wang much more about the liver or whatever else might be inflamed.
In addition, the good doctor prescribed fentanyl patches for me to use. These deliver 25 micgrograms per hour of fentanyl , a narcotic used very often for cancer patients. I've had it in lolipop form before biopsies. The idea is to quell any pain by having a constant "baseline" of medication in my body. Should I still have acute pain, which I have had but is much less than without the patch, I was instructed to take the Dilaudid every four hours. So far, I'm feeling great! Slept from 10:15 to about 4:30 with no interruptions, which is pretty good for me lately.
Another bit of good news: I'll likely be coming home for a few days, Saturday night through Wednesday morning. As it turns out I have to return to RPCI for a checkup and more tests next Wednesday, but Dr. Wang is fairly positive I can recharge my batteries at home.
One last thing: I know a little more about the next steps of my treatment. The chemo I am taking, Nelarabine, will be administered today and Saturday. I will then merely wait for it to take effect over the two weeks following. On the 21st day I will have a biopsy to determine how many of my cancer cells are left in the marrow. If the results are positive, if the pills have reduced the leukemic cells in a significant way, I will have one more 21-day course of chemo. After that, I would be admitted simply for the biopsy.
If the drug doesn't work so well, they will admit me after the first body as an inpatient and start high dose chemo (they'll really blast my cells!)And as soon as I'm ready in the hospital, they'll do the transplant.
In the meantime, the transplant team is working hard on my donor. They're in contact with him, and i was handed permission slips for BMT research studies, some of which I might actually sign!
Hope all is well in your world
-Matt