Day 14: Hellooo.. Wake up Mr Marrow! It's nearly time to go home.

Oh dear! Still no activity on the bone marrow front.. My counts are worse today than yesterday.
Whites are still .6 but my platelets have dropped to 20. Maybe I was expecting too much, It was day 15 and 16 that things really got going last cycle. Day 16 unfortunately is also the day I fly home. I have a couple of options.. pull the plug tomorrow and rebook my flights if the counts have not improved, or hang out till Monday and hope for a last minute rally. If my marrow recovers exactly as it did last time then Monday will be the big day. My counts on day 16 last cycle were 4.7 WBC and 100 for platelets, easily safe enough for travel.

Dr D and I covered our options at this morning's meeting. I showed him my notebook full of meticulously detailed blood counts for each day of each cycle. ..Was good when he picked it up, studied the figures and concurred that we should see some improvement tomorrow.
He said that the airlines are usually very happy to alter flight plans when they are told by a doctor that a patient would be put at serious risk of infection if they were to fly. The big question is how soon I could get another flight.. I only need one or two extra days.

Treatment-wise, today I've had another two lots of antibiotic IV's, four of the std daily infusions, and two units of platelets. I really cranked up the speed on the drips, and managed to get through all eight by lunchtime. I hate being tied to that IV stand. Darn thing can't even dance very well.

So it's another day stuck in this tiny room unable to leave. I'm not even allowed to walk outside to stretch my legs. Everyone that enters is masked up. I feel like the boy in the bubble! Only I feel completely well, think I look healthy, and am slouching around in jeans and a tee-shirt.

Day 13: Cycle Two. Dum dee doo...

Aah the waiting game.. sigh.. I'm stuck in my room for another day of isolation. WBC has dropped further to just .6 (normal 6.8+), however my platelets have climbed slightly to 32 (normal 150-450). I'm expecting to see a big improvement tomorrow. In fact I'm really hoping to see some sort of miraculous climb in counts over the next three days, as I really want to fly home on Monday as scheduled.

Last night was a bit of a worry, I had been feeling hot one minute and cold the next. So I asked the nurse to check my temperature. Sure enough I was running a fever. It looks like it was probably just a reaction to the growth factors, but it could just as easily have been an infection.

I'm severely neutropenic at the moment, so any sort of infection can run rampant in just a few hours. Ignoring it and going to sleep could prove fatal. There's nothing quite like waking up dead in the morning to ruin your day!

This morning I've had another round of antibiotics and IV's, plus another Granocyte (GCSF) injection to stimulate neutrophils (a type of white blood cell).

I've been a proponent of the healing power of honey for quite some time. This week I've been adding Manuka Honey to my green tea to ward off any repeat of the problems I've had in the past with mouth ulcers and infection. Today I read an item on an internet news site that Canadian scientists have discovered that some forms of honey, including NZ's Manuka honey is far more potent at killing bacteria than even the most powerful antibiotics available. This included the drug resistant strains of the so called super-bugs, such as MRSA. Gee ya think!

I wonder if the staff at Wellington hopsital's radiation dept will take the study by the Canadian scientists a little more seriously than they did when I told them about the healing properties of manuka honey earlier this year?

There is no shortage of studies and articles about the amazing healing, anti-fungal and antibacterial properties of manuka honey. It's been a Kiwi home remedy for years, now the world is finally catching on. I wonder how the big drug companies are going to react to that? No money to made there! and it works better than anything they currently have.. Hmm.

On a similar note, while doing some research on platelet counts, I discovered some articles on the tropical disease 'dengue hemorrhagic fever' which kills countless people through-out the world and which has no vaccine and no cure. Apparently it has been treated quite successfully by thousands of sufferers by making a tea from the leaves of the Tawa Tawa plant. It's been said that there is a cure for every disease to found in the plants of the world. Sadly if there is no money to be made from discovering and cataloging these cures, many of which have been used for centuries by indigenous people, then it is unlikely that they will ever be researched and used in mainstream medicine.

Day 12: Cycle Two. Isolation, No counts of my own.

Remember that parachute I talked about building a couple days ago? Would have been kinda handy about now. I had a blood transfusion late last night, two units of whole blood. This was in anticipation of a reduction in red cells when the neumega kicks in. It's a lucky thing I had the trans, I'd say my blood counts are basically made up of what I got from that blood.
White count is 1 and platelets are 24. I would say that my marrow is all but gone right now. However despite the low numbers, they are still better than same time last cycle. But I'm splitting hairs with such low counts.

Oddly enough I feel fine. However I won't leave my room for a day or two. It's just not worth it.
The doctors just dropped by, all masked up. Nothing new to add, we just discussed where the counts are at and what the plan is. I'll get another platelet transfusion immediately, plus this evening IV antibiotics just in case of infection.

Doctor Kopic keeps talking about possible further treatments. That really bothers me, as I'm not planning on relapsing! He talked about possible treatment options based around the results of a PET scan in 6-8 weeks time.(That would make four PET scans I've had in total, equal to the most anyone has had in NZ according to Pacific Radiology). I'm totally focused on being disease free when I leave here. I don't think it's healthy to think about relapsing unless it actually occurs.

I told the doctors that I went for a long walk yesterday, They looked at each other in horror!.
I said I was fine. But apparently they still think I'm going to bleed to death on the side of the road from some minor injury. Maybe they aren't familiar with the Kiwi attitude!
You have to remember that Dr K speaks very poor English. Most of the details are relayed via Dr D. However I didn't miss the dig that he made about me thinking I was Lance Armstrong.

7:24pm.(5:24am NZ time) I had a suspicion that I was running a slight fever, I asked the nurse to check my temperature.. I was right, 38.3. She's gone to get the doctor.. I'll keep you updated.

8:37pm: I've been given some industrial strength antibiotics via IV, and had some blood taken to be tested for any nastys. I should say that other than feeling chilled one minute and hot the next, I don't feel in any way like I have picked up anything. Tests will tell. With almost no immune system to speak of,this is a very serious situation, so I'll stay awake until I'm sure I'm OK. It's probably just a reaction to the neumega, it's a known side effect.
Will start a new post if I get worse..

11:11pm: I appear to be stable. So it's probably just a reaction. Going to get some sleep.

Day11: Cycle Two. A long walk and some computer stuff

Just another average day in Bad Heilbrunn, Not a lot has happened, but I thought I'd post an update anyway.
My white cell count was only 1.3 today, so I have had a shot of GCSF this morning.
I'm to have Neumega tomorrow and possibly the next day. Platelet count today after yesterday's transfusion is 44.

I just got back from a very brisk 6km walk. I feel really good! It was basically the same walk Sarah and I did on Day 14 of the first cycle. Only this time I didn't need to stop for a rest. In fact I felt like I wanted to break into a run on the downhill sections!.
That really surprised me because my red cell count is quite low. I figured that was why they were going to give me whole blood today. However some more research tells me that when Neumega kick-starts platelet production, there is a corresponding drop in red cells.


Non-computer/techie people can stop reading here.

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I stayed up late last night doing computer stuff.. I got this idea in my head about running the Linux operating system from a USB flashdrive. I went hunting on the Internet and found a website that specialises in doing just that. The benefits are that you can plug your USB drive into anyone's computer, turn it on and it loads an alternative operating system. All your bookmarks, favorites, passwords and documents are right there as if it were your own PC. There is no access to the hard-drive of the host computer at all. There's no chance of picking up a nasty virus from the host machine as they can't run on a Linux system.
All run from a thumb-drive. Beats lugging a laptop around!
And it's much faster and better looking than windows.. oh and it's a free!

Day 10: Cycle Two. Out for the count.

It looks like I've hit the nadir on my platelet count. They tallied up at 32 this morning. Still 50% higher than the same point last cycle, but low enough to warrant some intervention. I'll have a platelet transfusion this evening.

I've queried Dr K on why I was given only one dose of Neumega two nights ago. Personally I would have started a more aggressive approach to avoid bottoming out. I thought maybe five days worth and then reappraise things from there. His answer was that there is no way of knowing how the drug will affect any one individual patient and he wanted to see how I reacted to a single dose. I could have told him. He must have forgotten that we went through the same thing last cycle. (Remember last cycle when I warned him he'd miss the window, and he came into my room saying "sorry, sorry, sorry")

I think yet again we have missed the window and blown the opportunity to build a parachute that would prevent platelet free-fall. Oh well.. a transfusion will come to the rescue, Great!.
If the previous pattern repeats, my counts will again drop at around day 14, not giving us enough time to administer Neumega before I return home. Therefore I'll need another transfusion, possibly just before departure. I've told both the doctors that I want to start a five day course of Neumega by Thursday at the latest. I wonder how many other patients make those sort of demands... I can't see him taking my advice any way, but at least I've said it.

Don't get me wrong, the treatment I'm getting is first class. Back in NZ they were only doing blood tests weekly and I was left for six weeks with no treatment at all and a count below 20.
It's just that I have marrow that has been described as being like "Snow on the desert sands". Conveying this seems to be the biggest problem. Ultimately I'm sure no harm will come of it. But just for once I'd rather we were in front of the eight ball, rather than behind it.

It looks like I will have the last dendritic cell vaccine on Sunday now. The lab has promised to have it ready for that time. Good, will save me from running a fever on the flight home.

5PM: I've just finished the platelet transfusion. So far I'm not seeing any signs of another histamine reaction like I had the previous two times. I also spent some time in the gym this afternoon as I was not allowed out for a walk in case I injured myself and bled to death on the side of the road.. somehow I just can't see that happening.

Nurse Biljana now trusts me completely with my IV's. Today she laid the whole lot out in the order she wanted them to be administered and told me how fast each could be delivered. I usually slow them down anyway, too fast and I get a doughy feeling in my head. Selenium is given first and Vitamin C last, there has to be at least an hour between these two.. The reason for this has not been fully explained, but some research shows that it's to do with the way the two interact, causing the selenium to change into a form not able to be absorbed by the body.

Since the base drugs were left in my room for the first time ever. I got to read the labels and do some research on the net. (usually I only see the IV bottles with the drugs already mixed in saline). Google is our friend.
First up is Selenium, then Tationil followed by Actovegin and lastly Pascorbin (Vitamin C).
It looks like most of them are for reducing the toxic effects of the chemo and helping reduce both liver damage and neuropathy.
I'm not entirely convinced that any of them make a huge difference, but the doctors believe they do, so I'm happy to go along with that. Any little thing that gives you an edge..