apl leukemia

All posts tagged apl leukemia

I’m crying.  I can’t seem to stop.  I dry up for awhile, and then there they are again, tears falling down my face uncontrollably.  I’m not sad… no, not at all.  These are tears of joy.  Tears from days, and weeks, sometimes hours, and two years and four months.

Wow.  What should I do now.  It hasn’t sunk in yet.  I think the sinking in will take some time.

I had blood work yesterday, it was great, then an appointment with my oncologist this morning.  The appointment was fast.  He looked at my blood work, said it was fantastic, listened to me breathe a bit, answered our questions, and then said to me go live a normal life. A normal life. Normal.  Life.

I’m overwhelmed.  Two years and four months, to the day, since diagnosis.  15 pushes of hard core chemo, three bone marrow biopsies, more blood work than I can count, pic line, pic line removal, tests on my heart, x-rays on my lungs, more pills of ATRA than I can count, trips to the urgent care, somewhere around 45 days in the hospital all together, 1065 pills of 6MP, 102 shots, and all the other thousand and one things that’ve gone on over the last two years and four months. Every week, for two years, every week… every Wednesday at 10:00 am.

Now?

Well now I guess I go live a normal life…  and here come the tears again.  They are welcome, and so is the joy the accompanies them. Live a normal life.  Normal.  Life.  That sounds really good to me.

Getting the maintenance phase of this all worked out is… happening.  Had to go in again today (had the CBC yesterday) for another blood test (one of my liver function tests were high from last week and my doc, who is the hospital doc this week, didn’t get it ordered before we went in yesterday).  No biggie.  Just another slip sliding adventure coming back up our driveway.  Have to go in again today to get my shot.  The results of all of this tweaking of my maintenance (my doc lowered my shot dose to half last week as well as my pills from two to one after getting my blood work back last week and finding my white count wasn’t quite as high as he’d hoped)… I will, from now on, be on the half dose amount of both shot and pills.  They will not be raised back up.  The protocol calls for starting at the high dose and if the counts don’t go too low, staying at that dose, but if the counts don’t maintain well enough at the high dose it should be lowered to the half dose amount, which is what seems to work in my case.  My liver test from today also improved with the lower doses so the doc and all feel this is the dose for me.  We will see next week.  We’re hoping to get all this stable in the next couple of weeks… before we fly to England to see the kids and our grand boy, Sebastian.  I can’t wait to meet him!

To clear all this up…  I am now on half the shot amount and one pill a day.  Then, every three months, I take another 15 days of ATRA along with the continued weekly shot and daily pill.  The only thing left to finish working out is getting it squared away  with an oncology department in England to give me my shot every week while we are there.  Four shots in total.  Karen called and talked to them to start the process and got the contact info for my doc to call them.  Kaiser is going to package my shot meds so that Karen and I can carry them to England.  Karen talked to the TSA to make sure we had what we needed from the doc, paperwork wise, etc., to get through security.  So after my doc talks to the doc there we should, hopefully, be good to go.  Yay!!!

I’m not looking forward to the long hours of travel… we fly to Chicago from Portland then from Chicago to Manchester, England.  O’Hare is a bummer of an airport.  Busy, no good services (internet, etc.), and weather effected this time of year.  But hey, we’ve flown through there many a time so we are familiar with it and know how to deal with it well.  We are definitely seasoned travelers.  We make ourselves laugh we are so efficient….  Get to the airport, check bags, go toward security, stop to take off watches, put cell phones in the backpack, get to security and take out computers and take off shoes in line, go through the line… get some food for the plane, get on the plane, get out Bose headphones and laptop for movies if movies on plane aren’t any good and also iPod in case music is the thing, eat our previously purchased food, get to O’Hare, find some floor space in a terminal hallway near an outlet (they don’t have areas with plugins for computers, etc…. part of it being a bummer), plug in and put in a movie or two depending on amount of time, get on the plane to Manchester, repeat all plane activities mentioned before, get off the plane, bags, customs, train to Lancaster, stay up to what is a reasonable evening hour in Lancaster to combat the jet lag, and then crash for like 13 hours.  And that, ladies and gents, is how it’s done. It’s going to be a tiring long day, but it’s so worth it… and always kind of exciting.  I might say it’s tiring, but it’s also sort of fun while it’s all happening.

For now we have tiny bits of snow coming down and we leave in another hour and half to go back in to the clinic.  Tomorrow…  Thanksgiving and really taking time to be joyful and thankful.  As I said in an email to some of my family the other day… to quote myself…

I am thankful every day for the day itself, for my beautiful family loving me and me loving them back, for my friends who also love me greatly and who I love as well, and for the wonder and joy I feel just looking at the world around me.  It’s a glorious beautiful thing, this life.  So thank you both for the Thanksgiving dedication… I think Thanksgiving has, this year and moving forward, become my favorite holiday.  What better reason to have a day of celebration… to stop, pause, and be thankful and grateful in a very conscious way.

Happy early Thanksgiving everyone…

 

I’ve been holding my breath for what seems like a lifetime.  Moments of being so very afraid, but not letting myself think about it.  So scared sometimes.  When something like this happens to you you fight that all the time.  I am, as all who know me would probably attest to, a positive person.  I think positively, I act positively, I smile all the damn time.  It’s who I am.  I have been that person through this process so far and will continue to be I would imagine.  But there have been times… thinking what might happen, what could happen.  Dark moments.  I didn’t let them get the best of me and always managed to push them back and away… but there has been a sort of hum inside.  A holding of my breath.

With each treatment round I’ve kept the attitude, this is killing it, this is curing me.  I kept thinking that, even in the beginning when I was most sick… and subsequently, every time after another round of chemo when I didn’t feel good or couldn’t go anywhere because I was neutropenic.  I kept saying… this sucks now, but it’s killing it, it’s taking care of me.

And you know what?  Today I got the best news of my life…. right up there with when my Mom got past her bought with breast cancer and when Karen told me she loved me for the first and all the times after, and when we sat on that beach in Hawaii making a commitment to each other, and when Mary told us she was pregnant, and when I presided over Mary and Martin’s wedding.  Those, some of the very best moments of my life, were joined by the news today that the molecular scan of the bone marrow biopsy I had two weeks ago, results just back, showed no abnormality.  None.  There was no sign of leukemia in my marrow, in my chromosomes, in me.  It was totally clear.

I just spent the last half an hour crying on and off, and will probably be the rest of the day.  I called Karen immediately (she’s traveling for work) and cried with her on the phone.  She thought, initially, something was wrong because I was crying so hard I could barely speak.  I called my Mom and I called my brother… same thing… crying so hard.  Crying out of happiness.  Crying, and finally… letting out a little breath.

Karen just got off the phone with Nancy.  My blood count is a mixed bag.  The reds are up over a point each (yay!)… they couldn’t get a good platelet count because they were clotted (I guess this happens all the time and is common, but has never happened to me), but they could tell they were OK.  They may ask me to test again tomorrow just to make sure.  Nancy is checking with Dr. Bigler, who is off today and back tomorrow.  The other thing is that my white count is down to 1.9 and my neutrophils are 950.  We were told my white counts could go down with the start of maintenance. They have.  This is another reason they may want to test me again, to make sure they don’t go lower.  We (my doc, Nancy, and Karen and I) weren’t sure how I would respond to this, to maintenance.  The thing is, not many people have this kind of leukemia so they aren’t sure either, there isn’t a big database of info, besides the fact that everyone is an individual and responds differently, hence another reason they may want to test again.  But, for now anyway, I have to be careful again.  I’m not in the danger zone of neutropenia… I can still fight things off.  It’s just that Nancy said I need to not be around anyone who is sick and we need to make sure we wash the vegetables really well before I have them.  We don’t know if my numbers will come back up, if my body will adjust, or if they will stay down in this zone.  We don’t know any of that yet, especially since I just started.  It’s possible Dr. Bigler will want me tested a couple of times a week again just to see what happens.  It’s possible I will have to take neupogen again (for how long or how often I do not know).  At this point we don’t know.  Only time will tell how this is going to work.  The good news is that because my red blood counts are up my energy is getting better by bits all the time.  That is a good thing.  I don’t feel the difference in the white counts, but I definitely do in the reds.  I knew they were probably up a little.  I can feel it energy wise.

So that is that….  I may not get another blood test until Wednesday next week.  Though that seems like a long time away since I want to know if my neutrophils are still falling.  If they get below 500 I’m in that neutropenic zone where I need to stay away from people, not have fresh fruits and vegetables again, etc.  The other thing is that next Wednesday I have another bone marrow biopsy.  Not looking forward to it, and yet I am.  The procedure isn’t fun at all, but it will be good to know where I’m at.  Knowing where I’m at, with all of this, helps.  Knowledge IS power.

Good news is that I didn’t react to my methotrexate this time.  No hives afterward, like last week.  I took the recommended Zyrtec beforehand.  So my maintenance regimen is good to go.  Mercaptopurine pills every day, methotrexate shot once a week, 15 days of ATRA every three months.  That’s a good thing, no real reaction to any of it.  Getting a reaction always worries me since I’ve had med reactions to things throughout this process.  It gives me anxiety so now I can relax a little about that.  Now we just have to get through the bone marrow next week and figure out how my numbers are going to be, etc.  One thing, still one day, at a time.

Hope everyone has a great halloween this year.  We have some plans to go to a friend’s place to do pumpkin carving on Saturday.  Should be fun.  Living life…  I want my numbers to stay up enough so I can do a little living of life.  Let’s all hope that the numbers don’t go down any more.  Let’s hope they settle in or even go up a tad.  That would be great.

 

Just got the news from today’s blood test.  I am, once again, neutropenic.  Numbers are low.  They are hoping they don’t stay low for long, given that I’m on the neupogen.  Here’s crossing our fingers, toes, and whatever else you can cross, that I don’t get another neutropenic fever.  I haven’t had a fever at all so far this time around.  I’m checking, as I’m supposed to, several times a day.  It’s day 9 of my cycle.  Usually my nadir is around day 16, nadir being the lowest point.  I got the fever last time on day 12.  Come on Neupogen, do your duty!!

Otherwise I’m a tad tired, but doing OK.  My red counts are all down slightly, but not enough to really matter.  I’m still way far away from having to have a transfusion or to have platelets.  That’s all good.

Had a great visit from Stan and Stacia today.  They were here for a bit.  Always nice to see them.  I’m feeling tired now, sorry Jimmy for putting your visit off.  Getting the number news sort of zapped it out of me.

One day at a time folks… so far today is OK.  Cheers all….

Hey gang…  here I am, posting again.  Got some good news today… the numbers are up.  I’m still neutropenic, but now I’m in the moderate category instead of critical.  That’s a good thing.  I’m happy.  Means that a couple of little things that have not been healing, one of them being a nasty mouth sore, will now start to heal.  Yay.  Maybe I’ll be able to eat something besides cream of wheat, soup, and fake mashed potatoes with cottage cheese.  LOL  That would be nice.  Pizza?  A burger?  Uh… some pasta with chicken.  All sounds great to me.

More news from the oncology caseworker as well.  My next pushes (there are two) will be done outpatient and not in the hospital.  They finally have this available at the chemotherapy center at Interstate.  So… next week, if my numbers come up enough… it’s the last consolidation round.  One push on Thursday, after my appointment with Dr. Bigler, and the second on Friday.  Yes, Friday.  It’s my birthday, but hey… let’s get this over with is what I say.  Nancy also set up my next cycle appointment with Dr. Bigler for October 15 (this will be the maintenance cycle, which lasts two years).  I have two different kinds of pills on different schedules from each other (one of them is ATRA so I know that one) and a weekly shot.  I’m scheduled to get that shot on the 15th after my appointment with Dr. Bigler.  It’s an intramuscular.  We’re not sure, but it looks like I might have to have that every week for a two years.  We’re hoping they can teach us how to do it.  Otherwise… travel is going to be an issue.  And as you all know… we like to travel.  We even have travel plans.  So… let’s all hope Karen and I can learn how to do this.  We will find out at the meeting on the 15th with Dr. Bigler.

Much love to everyone out there who has been so supportive of us during this.  I am blessed to know you all and have the love of amazing people like yourselves.  I feel it every day.  This has been and continues to be an emotional roller coaster and knowing that I have such an amazing group out there sending me vibes and love and prayers… well… it means everything.

Hey all…  It’s Saturday.  A day when my honey and I can hang together a bit more…. even though she is still the energizer bunny taking care of the house, the grounds, the shopping, the cleaning, the loads to the dump, and me.  She gave me a haircut today.  I was overdue.  Getting kind of fuzzy on top.  She said it was a bit thinner than last time… maybe this round of chemo is going to take a bit more hair off the top… can’t tell yet.  It’s usually a delayed thing.  For now I’m sportin’ the usual shorty baldy look.  I kind of like it actually.  So easy to take care of.  One tiny drop of shampoo does the whole head.  I probably won’t need another cut for a week or so… Mom will hook me up when I need it when she’s staying with me I’m sure.

I’m a tad tired today.  Just still dealing with the after effects.  It goes in waves.  I at least got on the treadmill this morning for 15 minutes.  Not a super long time, but at least I got on there.  That’s earlier than I did last time I got out of the hospital.  It just felt good to move a little.  I may get on there again tonight for another 15… have to see how I’m doing.  It’s sometimes a moment by moment thing.

So Karen and I, based on last time, are thinking I should be heading toward neutropenia again pretty soon.  Probably by Monday or so… which would be 10 days from the day I started the last treatment.  It was about that last time… maybe a couple of days longer.  Time to make sure there are no fresh veggies and no people with colds around…  It’s a roller coaster.  Just like the doc said… take you down, then build you up, just to take you down again.  All I can think of is that I only have one more consolidation round… and it’s only two days.  Granted it’s back up to full strength of the chemo, but only two days.  The first round… the induction, I had full strength for four days, every other day.  This last time I had a different med at about two thirds full strength for five days straight.  And now I’m rambling…

For now… it’s Saturday… and I got a haircut. One day, one thing, at a time.

Good morning Friday.  It was a rough one last night.  New bed, no sleep.  Go figure.  It’s a usual thing, or at least seems to be.  Come home from the hospital… sleep really well the first night, don’t sleep the second.  I don’t think I slept more than an hour last night.  Miserable.  Seems when I am sweating out the toxins my body temp doesn’t regulate properly… so I get hot, then cold, then hot.  Constantly putting the covers on and off myself… sweating like a fiend.  It’s nasty.  I’m very very tired today.  Not feeling that great, but I’m home, so that helps.

I’m ensconced in the family room, heating pad on my back, blanket on my lap, cup o’ green tea sitting next to me, and some design show from HGTV on the TV.  I’m plugging through, as usual.  This will pass.  I will sleep tonight, I have confidence… and a sleeping pill if I have to.  At least the mucous in the throat thing seems to be getting better.  Yay!

Karen is working away in there… as usual.  She is such a… I don’t even know… I love her so much.  She is my strength, my solace, my split apart, my family, my life.  There are no words to explain it really…. It’s love… plain and simple.

Yep folks…  came home yesterday, for those who didn’t already see it on Facebook.  Sorry I didn’t blog, but it was sort of a long day and I just wanted to settle in when we got back here.  Now we’re back into the home routine.  Hanging out…

Not feeing too terrible today.  I am having little bouts of queasiness and this nasty mucous thing happening in my throat still, but this all will pass once I get the chemo from this round totally out of my system.   Good news is that when I’m not feeling queasy I’m not feeling too bad.  Karen called Nancy this morning to make sure I didn’t have to go in for my regular Thursday blood draw… I don’t.  They did it yesterday and my numbers were all in the normal range so I’m not neutropenic and my red blood counts are also up and good.  Still feel tired though, which is a side effect of the chemo and having that poison in me.  Again though… it’s just good to be home and it will get better.

Next appointment with my oncologist got set up for September 16.  If all goes as planned I will go into the hospital for the last of the consolidation rounds on Saturday, September 18 and 19.  It’s only a two day deal the last time (yay!) and the chemo med is idarubicin again, the one I have had and know better.  It’s a push again, and back up to the full strength, but again… only two days.  In one, out the next.  I like the sound of that.  This time around, five days was a lot.  Karen and I were both pretty sick of it by the fourth day.  We both just wanted the day to end so we could go to sleep, get up the next day, get my round done, and go.  So two days sounds great to me.

As I know it, after the last consolidation round in September, I will then have to have another bone marrow biopsy after my numbers come up again, and then I will be on two years maintenance.  We believe that involves three months of one kind of drug, then ATRA every three months for 15 days, and also some other drug which in the protocol says a weekly shot.  We will know for sure after the bone marrow biopsy and such. We’re getting there though… one more consolidation round in the hospital.  One more.

It’s day four and it’s almost over and on to day five. Tomorrow, after chemo and a bit of time after for recovery, pick up of meds, and getting our stuff in the car, we will hopefully be heading home by mid afternoon. Can’t wait to get back home this time. Definitely more relaxed and mellow there.

Today they premeded (not exactly a word, but you know sometimes there are no words but the ones we make up) the heck out of me…. Steroids, anti-nausea, Ativan, Tylenol, and an in iV dose of benadryl. It seemed to do the trick along with holding warm compresses to my vein/iV site during the infusion. Quite the process. The new IV site is in a smallish vein and my veins are small anyway… And they shrink up when I get nervous. Like I said, a process. But hey, one more day in this round. Yay! Almost over and home.

Karen went to Spaghetti Factory again this evening. Food and another dose of Ativan (which is for nausea as well as nerves), plus a walk, has calmed the nausea I was having. That was awhile ago. Now I’m having some tea my honey made. Decaf green mandarin orange. She also rubbed my feet during the infusion and then my back later… Earlier this evening. She is amazing.

Day three…. New IV site this afternoon after my chemo round earlier today. The first one lasted three days. Not bad considering the harshness of the chemo drug and the steroids they have to keep pushing because of my continued throat reaction. The first site was getting sore, hence the change of site. Hopefully this one lasts the two days it needs to. Crossing fingers for that and a lesser reaction to the chemo med. This throat thing is a bit disconcerting.

In other news Karen went to get us some dinner tonight after she worked all day. She was able to get online via the card today so that was great. Made it easier for her to be with me and to do the meetings she had to do. The dinner was from Panda Express…. Orange Chicken over rice for me in a bowl and orange chicken and Beijing Beef with rice for her. Tasty. For dessert we were going to have cheesecake from the Cheesecake Factory because my honey thought she saw one at the Clackamas Town Center. Alas, after getting our taste buds all psyched for it she got there and realized there wasn’t one there. The dessert alternative? Chocolate and toffee nut cookies from Panera (also a great choice!). It was all good if you ask me. We only ate a chocolate cookie each so we still have some for snacks tomorrow. Yay! It’s the small pleasures in life!

We are both anxious to get out day after tomorrow. We’re tired of being here. Everyone is wonderful, as usual, but we would much rather be home. We are over the hump now and heading to the home stretch. Not long and we will be back at home. Two more nights. One more take out dinner. :-)

Had a lovely chef salad today for lunch accompanied by a wheat roll and a small tidbit of a brownie. It was so nice to be able to eat a salad with veggies on it. Really…. You don’t realize how much you miss them until you can’t have them.

Had my second round of the blue stuff today with all the same blue side effects. Denise, I sent you a picture. It was a tad bit of a struggle with the iV, but it held. I got Ativan beforehand to help me, and consequently my veins, relax. Karen also spent the whole time massaging my feet to try and keep me relaxed. Not to mention the warm compress on the Iv site and my arm. A process that worked today. Three days to go, we shall see if it holds. Gracy, my sweet nurse yesterday and today, is off the next two days so we will have to train the new one on all my little idiosyncrasies. They are all pretty sweet so it should be ok. If all else fails I’ll get a new IV site. Hopefully not, but if I have to I do. The nurses wish I had a picc line again, and really so do I. Alas, it is not so. I’m keeping positive, with Karen’s help, and after all, we will be back home with this behind us on Wednesday afternoon. Yay!

Karen has been keeping me company and trying to not get too bored. She is wonderful.

Last night she went out for dinner for us, picked up some pasta and brought it back to the room. It was tasty tasty. Tonight, who knows…. Probably something good as well. We went for a walk around the loop here this morning and probably will again later today.

And now Nate is here to do vitals…. Cheers.

Met with Dr. Bigler today. All went well and we are a go for the next round. We go into the hospital tomorrow at 8:00 and start the first of five rounds of the next chemo med. The doc said it’s simmer to idarubicin with the only exceptions being that it’s blue and it could cause a little more nausea during the days it’s given than the idarubicin did…. Or not. I guess we shall see. The sox did ask If I wanted to wait a couple extra days before going in so my numbers would be up even more, but I said no, let’s get this show moving along. Karen is only going to be home for six days after I get out as it is and I didn’t want to cut that at home time any shorter than it’s already going to be.

So tomorrow we are back in for round three.

Yay!  Just got the results back from today’s blood work.  I am no longer neutropenic.  Which means we are going out tonight.  Costco, Sleep Country to order our new mattress, and probably out to dinner.  Or at least to get dinner to go!  I have two days of freedom… Nancy said we are a go for 8:00 am on Saturday at the hospital.  I have a check up tomorrow with Dr. Bigler at his office at Interstate, and then it’s on to the next thing.  The doc will check me out, including my sad and pitiful left arm… only right arm IV’s for this girl this time around.

I’m just so happy to be able to go out amongst the people.  Woo Hoo!!

On another, but important note, happy 4th anniversary Mom and Don!  You guys rock!  Hope you are having an excellent anniversary day and that your evening is spectacular.  Love you guys!

Karen and I got sprung from the hospital today, not long after my last push was completed.  We just got a call from Nancy letting us know what my blood counts were from yesterdays draw.  They only drew me once while we were there and those numbers are stable and still up.  Nancy told us we could skip the draw this Thursday and wait until Monday to start the whole bi-weekly blood draw that I will still be on.  Mondays and Thursdays, like clockwork.  Nice to have a bit of time off though.

So between now and August 20, when I have my next appointment with Dr. Bigler and then possible entry into the hospital again for round three on August 21, we just watch the numbers, see what happens, take precautions again for neutropenia, and see if I have to go in for any transfusions or saline drips.  The biggie is fever, so let’s all hope that doesn’t happen.  If it does I have to go back into the hospital for IV antibiotics.  We were told, and are hoping it’s true, that this time around will be easier on me.  Each round is supposed to be a bit better, let’s keep our fingers crossed.  I know I will feel fatigued and run down again, and I will probably lose even more of my hair (who really cares about that, I’m lookin’ good bald!  LOL), and I may be occasionally nauseas or get a bit of diahrrea.  As long as it’s not too bad and there is no fever to go along with it, we will be able to manage me here.  And again, that’s what we are hoping for.  We were told my numbers should drop after 5-10 days after my first push.  That puts the start of the decline anywhere between tomorrow and probably some time this weekend.  I don’t know how long they will stay down before rising again, it’s sort of a personal thing, related to me and how I respond.  I guess we shall see.

For now here I am, back in the family room.  I’m tired from the nights in the hospital where a person can’t get more than a few hours of sleep without interruption.  It will be nice for both Karen and I to be sleeping back at home again.  Me in the bed and she on the air mattress next to the bed (I am currently sweating chemo and very toxic so there is no close proximity allowed… not safe for her).  Still, we will both sleep better here.  We just do.  It’s home.

One nice thing… we missed the major heat wave.  There are blessings in every situation.  That was one of ours being in the hospital during the big hot weather.

Now… I’m watching some Dateline thing we DVR’d and my honey is taking a shower.  She just cleaned the house, including cleaning the fresh veggies and fruits out of the fridge and moving the potatoes into the shop, and freezing the blueberries. Getting ready for that neutropenic stage again.  We did this before, so I’m not too worried about it, we know what to do.  I may not even become neutropenic, but the doc said it would probably happen, just not for as long as I was before.  Yay!

Right now I’m just enjoying the fans blowing on me and being home again.  Love it….