New Numbers in Arcata

My doctor wrote a script so that I could get my labs done while we are in here Arcata, California visiting our pals Naomi and Peggy. We were hiking around the Arcata marsh watching the panopoly of birds when I realized that I had a message from Tanya at Duke. Peggy had taken me to the local hospital this morning to have my blood drawn. Tanya wanted me to have another blood count done this week, just to track the white cell count. Thankfully my numbers are continuing higher still-my white count is now up to 4.9 with 2200 neutrophils, my hemoglobin is up to 14.0, and my platelets are 217,000. Everything has improved from 2 weeks ago when my counts took a brief nosedive. Tanya thinks my bone marrow needed more time to recover after that last chemo treatment and the stress of recovery.

Regardless, it's nice to have all the numbers behaving themselves. And I'm free to run longer distances again. Watch out!

Merry Christmas

We've dropped off the kitties and Quigley at Carver St Animal Hopsital in anticipation of our trip out tomorrow. We enjoyed the dinner here last night with 11 other friends for Christmas Eve, Eve. We had a terrific time; so glad everyone could make time to come and share their friendship.

Today we've been doing odds and ends, last minute details before our 9 day trip to Kansas and California. We opened our gifts tonight and ate delicious leftovers from last night's feast. We also shared stories of childhood Christmas's past-the year of my sister's Gemeinehart flute, Holly's guitar and bow and arrow set, etc.

Everyone have a Merry Christmas and Happy New Year. Thank you for remembering us with all of your cards, well wishes, and gifts. Though it has been a trying year in many respects, I feel incredibly lucky to have so many caring people in my life.

Photos: Christmas Eve, Eve dinner; Christmas sweater, Spread the Joy

Better Numbers

I had my labs redrawn yesterday at the bone marrow clinic. They are improved from last thursday, and my doctor thinks the "blip" is just my bone marrow resetting itself. He did have me back off some on my running since exercise can drop your white blood cell count. Who knew? I've never had a doctor tell me to exercise less. That's a first.

Anyway, we do get to leave Dec 25th on our trip. (Leaving on a jet plane...) The numbers were white cells 2.5 with 30% neutrophils, hemoglobin 13.0, and platelets 158,000. Everything is normal except the white cell count. At least my neutrophils have come up out of the dangerous range and are above 500. Just to be safe, we've decided to cancel the side trip from California to Oregon. I don't want to tempt fate and get into any health issues out on the cross country ski trail.

When I was checking into the lab yesterday, Kristen, the young girl with the fancy shoes, was checking out. She did not seem happy, and they made her another appointment for Dec 29th. Apparently something is going on with her labs too, and she got bad news. I know how she feels. We almost had to cancel our whole trip to Kansas and California, the first after 7 months of chemo and blood transfusions and pneumonia medications. Christmas is no time to hear you have to be galavanting back and forth to the clinic for anything, even if you are wearing fancy red leather pointy toed shoes. She had a transplant for aplastic anemia when her bone marrow just stopped working. The last time I saw her, she was so happy, sitting in the blue recliner next to me, waiting to drive home several hours away after her transplant and other treatments ("I've been here 43 days," she said to me). This bone marrow stuff is hard. There's the hard of I have a life threatening illness; there's the hard of chemo and other treatments, and there's the hard of whatever else the bone marrow just decides to do like quit making blood cells or reject the transplant or make a new cancer. Well that's just the life we're going to have, one that lacks even the illusion of control. I'm still trying to get used to it.

Photo:My nephew Ethan with Lacy the Rein Dog

Old South, New South

I went back to the clinic this afternoon when we got back from our weekend trip. My white cell count was low on Thursday, and Tanya wanted me to come back today to have them rechecked. I'll hear about my numbers tomorrow and hope they are better. I want us to be able to go on our 10 day trip on Christmas (to Kansas and then on to California). Even more, I don't want to have anything wrong with my bone marrow. I am hoping the dip in the counts was just a "blip" as Tanya said. It's very nerve wracking having to wait for the news. I have had to get used to this kind of thing, but it never gets any easier. My mind goes through all the possible explanations-everything from a temporary dip in the counts to a relapse of my leukemia. That would be the worst outcome, of course. However, I had a bone marrow biopsy only 6 weeks ago, and it was normal. I suspect that if my counts stay down, they will want to do another bone marrow biopsy sooner rather than later. My next one was supposed to be January 12th. I'll be very disappointed if we don't get to go on our trip. We finally get to travel after 7 months, I book us flights to Kansas and California, and then this comes up. Hopefully all will be better tomorrow.

We drove to Georgia for the weekend to visit my sisters. One lives in Atlanta and the other one lives about 2 hours further south in Columbus. Becky had to work unexpectedly so we went by her house in Atlanta on our way home Sunday. I finally got to see Haley, Becky's new dog, and the house she is now renting. It's a cool bungalow with old pine flooring. Very nice and near her work and lots of other fun city stuff.

Saturday morning Beth, Henry, Holly and I drove over to Ft Benning so that we could show Holly the post. Henry is a Ranger in the Army, but he and Beth live off post in their own house about 20 mins from Fort Benning. We drove all over my old biking and running routes and saw our old housing. Some of it seems a bit run down after all of these years. But then that was more than 30 yrs ago. Wow, it really has been a long time!

Saturday night we attended Emma's dance recital along with about 150 other families. They held it in one of the local HS auditoriums-that's how many people attended. There were wee little girls (2-4 yr olds) up to HS students, who did an elaborate Hairspray number. It was all quite fun, and Emma seemed happy to be part of it. I took a photo of her with her roses after the performance. I'm not sure why dance is so big in the south, but it is very popular. It's a little like soccer with all the practices and recitals and even competitions sometimes. Ethan thought something was wrong with Emma's face when she was in costume. She pointed out that she had on makeup. Oh to suffer the comments of a bigger brother.

Sunday we attended Ethan's hockey game. Part of the New South experience after our Old South one the night before with the dance recital. He was tough and focused and even scored 1 goal and 1 assist. I'm biased, of course, but I thought he did well. He is quite an athlete and knows no fear. Hockey is great for him.



We are having friends to a potluck here tomorrow for Christmas Eve Eve. That will be lots of fun with 13 of us getting together. Holly is doing a turkey; I've made sweet potato casserole and pound cake. I bought a carrot cake from one of the nurses at the bone marrow clinic when they did the bake sale to benefit the Leukemia and Lymphoma society. Everyone else is bringing a dish to share. Should be fun and yummy.
Photos: Old South and New South Fun

Low Counts Again, Darn It!

We are on our way to Ga to visit with my sisters for a few days. Before we left Hillsborough, I had my blood counts drawn yesterday at the Bone Marrow Clinic. It's been about 6 weeks since my last chemo treatment and 2 weeks since my last lab tests. They were beautiful the last time -so beautiful that they pulled the catheter in my chest and told me that I could eat anything I want, get a flu shot, etc.

But I just got a call from Tanya, the Physician Assistant for Dr Long, telling me that my counts are low again. My white cell count is only 1500 with the absolute neutrophil count at 400. A count lower than 500 is dangerous since these are the cells that fight infection. My hemoglobin and platelets are low too at 11.3 and 128,000 respectively. So it's back to food precautions again-no salad, only cooked vegetables, no playing in the dirt, back to avoiding those with a fever or illness, and off to the hospital for IV antibiotics if I run a fever. Oh bother!

Tanya told me to go on GA trip, but I have to be back in the clinic Monday to have my blood drawn again. She is hoping that the counts will be up by then, and this is just some blip. Only 2 weeks ago my neutrophil count was 2200-more than 5 times what it is now. Darn.
Despite the lab numbers, I feel great. I just finished a 7 mile run around the lake here and included 2 steep hills on my route. Hmmmm, wonder what is going on now???

Good Advice

After writing that I am still having hot flashes & can't sleep if I don't take the meds my doctor gave me, I got a very helpful email from my old friend Karen N, who is also a doctor. We were interns together at UVA in 1996-1997 and shared many a night on call together during our training. You develop a special relationship when you've seen each other bone tired from trying to keep up with all the work on the floor. We shared a call room often and helped each other answer the nurses questions when they paged us frequently. In her email, Karen reminded me that I need my sleep to heal, to fight infection, to resume work with energy, and to maintain my immune system. She made me see that this thing I have of toughing it out w/o sleep medicine is just plain stupid. Thanks for that. It takes a hard headed, no nonsense doctor to get through to this hard-headed, no nonsense doc what is right. Truth is I am not that far out from my last treatment, only 6 weeks, and my body still has work to do. I keep forgetting that. I keep forgetting how much sleep is part of good health. I owe Karen a big thanks for reminding me of all that and giving me "permission" to keep taking those little pills that let me sleep, even if I don't want to need that. Get over it already.

Little Things I'm Getting Used to

Now that I don't have to go to the hospital or clinic on a daily basis, I am not sure how much writing I intend to do here in the blog. It's been a great way to keep my family and friends abreast of my daily events, but I don't have much to report these days now that my treatments are completed. Your comments and emails have been very helpful and uplifting, especially when I had to stay here to avoid infection or take chemo for 5 days in the hospital. Soon my life will be getting back to normal and I won't have much out of the ordinary to report.

Recently, I received my job paperwork from Piedmont making January 5th my official restart date. That was the last piece to complete before heading back to work at the Drew Community Health Center, where I worked previously. I was always a little nervous about the whole job situation. In June, I took Family Medical Leave which guaranteed my job for 12 weeks. That put me to September when I had to resign my position. I still had 2 more chemo treatments to go, the economy was tanking, and I worried about whether my non-profit, indigent care clinic would even have a place for me in 2009. I really didn't want to have to find a new job, interview and explain this baby bird hair. I know that primary care doctors are hard to come by, but they might be hesitant to hire someone who has had not one but two cancers, finishing treatment only a month earlier.
But I don't have to worry about any of that. Piedmont is taking me back, at my former center. The staff there is terrific, and I have a lovely supervisor and colleagues. I'll try to shake out all of the cobwebs for them before I get back there on January 5th.

There are some things I am still getting used to with my health and body. They include this baby bird hair, that seems to curl and frizz in its grayness. I'm still waiting on my MaMa hair. Maybe it will be brown & thick again eventually and maybe it won't. My eyesight is worse again-the readers are now 1.75, and I seem to need some distance correction too. Gotta get that checked in a few months once the chemo effects are completely out of my system-they say I should wait 6 months. I'm still having chemo-induced hot flashes at night. I tried to sleep w/o medication last night, but I was up at least 6-7 times between 10pm and 2:30am. Thankfully I have more of the sleeping pills they gave me, but who likes to take those? And like every other woman in menopause, I forget words just moments before I have to use them. I can't wait to see how bad it is when I'm speaking spanish all day because even the english is halting at times. I thought it was my own special chemo brain thing, but Gail says she has it too. Whew, I'll rest easier.

Photo: Me in the Asheville garden this past w-e