Friday 30 March
I have to say (and I have told her this many times) that I admire this woman tremendously. True, she had her doubts, before she went in, as to whether she should even go through with this. I didn't answer, for we both realized this was a rhetorical question. However, from there to make the leap towards folding back into the fully blown hospital routine she had come to know all too well, is quite another matter. Starker still, to muster the courage for deliberately walking into harm's way after what she has been through, is like taking on a second tour of combat, after barely making it through the first. She shows fortitude and stamina, taking the daily routines in stride. But she also tries to suppress any fears or even thoughts of what may or may not happen to her once she enters aplasie. I do, too. Fretting is pointless. We are beyond the point of no-return. We shall have to take it as it comes.
We speak over the phone several times a day ("Just to hear your voice"), from the wake-up call at around 8:15AM to the sleep-well call of around 9:15PM. I visit once a day. This afternoon, around 6:00PM she was on the line with her sister Christine in California. My sister Hanneke had called earlier, and while I visited, there were several other calls including one from Elisabetta in New york. I could tell the attention was uplifting, if only as it showed that so many people actually care about her. It is heart-warming to her.
We talked but there was hardly any news to convey. What I did bring was a pack of flans caramel (one of her favorite desserts) and a supply of pyamas (the hospital no longer issues gowns to patients except in Intensive Care). We went over some current affairs and solved the Jumble with some difficulty. Tomorrow we are going to try and get the iPad going, so she can contribute to the blog herself and whip out some emails. I promised to sort email addresses off of her PC at home. So perhaps many recipients will get a weird textless message from me. Pay it no attention.
Oh, and the sound is back in the TV.
zaterdag 31 maart 2012
donderdag 29 maart 2012
Odd One Out
Thursday 29 March
Lara's room mate is an intelligent woman in advance state of treatment for leukemia. (She has lost all her hair.) The two do quite a bit of talking when alone - and even when I was visiting at midday. Trouble is that sooner than later hospital talk revolves around diseases, treatment and above all: mishaps. Good news is no news. Exceptions to the rule, the odd one out, and the "shouldn't have happened but did" weigh in heavily.
To Lara this is disconcerting and one doesn't need to wonder why. Leukemia is a lethal disease when left untreated and its treatment is fraught with risk. When you are a patient in the middle of a fully blown chemotherapy, sensitivity to outside stimuli is probably enhanced. You hear a disaster story and seconds later you start feeling the corresponding symptoms yourself. Your brain tells you to not worry, for no two cases are alike. You tell yourself there are multiple variants in leukemia, and in its treatment, as there are in individual responses to protocols implemented. That is what the brain tells you, once you have calmed down and thought about this. Meanwhile your heart - or wherever your emotions are centered - fills you with trepidation; from there you may easily spiral down, and before you know it you're convinced you're not going to make it. Even if you don't say so out loud, your face is easily like an open book to the occasional visitor who can afford more distance to reality. Such as I.
Lara whinced as her room mate had retired to the bathroom momentarily. Then avoid those conversations, I told her. There is plenty of other material to talk about, much more inocuous. Or don't talk but read instead. I know, she said.
Her blood pressure was too low (lower than her normal low) so they had put her feet up and her head back. When I came in, she was sitting up while making a respectable dent in her hot meal of the day: roasted chicken, potatoes and assorted peas. She ate with appetite. No further symptoms of any import at this point in the chemo. A light nausea was effectively suppressed with medication. Too early for a rash. She is only in the first 24 hours of treatment, after all.
As a point of reference: one major annoyance is that the two TVs in the room have no sound. The malfunction was duly reported twice, but hospital technicians probably had more urgent business to attend to. With a government crisis going on in Holland, Lara wouldn't mind some news reports. But that is about the level of comfort versus discomfort. At least for now.
Her friend Andreina visited, with her son Alexander. They left just before I arrived. I stayed until two, due back at 6:30PM. Will bring the Herald Trib for her reading pleasure, and we will possibly do the "Jumble" together (a word riddle, and a fixed item on the cartoon page), as we do every morning over breakfast at home.
Lara's room mate is an intelligent woman in advance state of treatment for leukemia. (She has lost all her hair.) The two do quite a bit of talking when alone - and even when I was visiting at midday. Trouble is that sooner than later hospital talk revolves around diseases, treatment and above all: mishaps. Good news is no news. Exceptions to the rule, the odd one out, and the "shouldn't have happened but did" weigh in heavily.
To Lara this is disconcerting and one doesn't need to wonder why. Leukemia is a lethal disease when left untreated and its treatment is fraught with risk. When you are a patient in the middle of a fully blown chemotherapy, sensitivity to outside stimuli is probably enhanced. You hear a disaster story and seconds later you start feeling the corresponding symptoms yourself. Your brain tells you to not worry, for no two cases are alike. You tell yourself there are multiple variants in leukemia, and in its treatment, as there are in individual responses to protocols implemented. That is what the brain tells you, once you have calmed down and thought about this. Meanwhile your heart - or wherever your emotions are centered - fills you with trepidation; from there you may easily spiral down, and before you know it you're convinced you're not going to make it. Even if you don't say so out loud, your face is easily like an open book to the occasional visitor who can afford more distance to reality. Such as I.
Lara whinced as her room mate had retired to the bathroom momentarily. Then avoid those conversations, I told her. There is plenty of other material to talk about, much more inocuous. Or don't talk but read instead. I know, she said.
Her blood pressure was too low (lower than her normal low) so they had put her feet up and her head back. When I came in, she was sitting up while making a respectable dent in her hot meal of the day: roasted chicken, potatoes and assorted peas. She ate with appetite. No further symptoms of any import at this point in the chemo. A light nausea was effectively suppressed with medication. Too early for a rash. She is only in the first 24 hours of treatment, after all.
As a point of reference: one major annoyance is that the two TVs in the room have no sound. The malfunction was duly reported twice, but hospital technicians probably had more urgent business to attend to. With a government crisis going on in Holland, Lara wouldn't mind some news reports. But that is about the level of comfort versus discomfort. At least for now.
Her friend Andreina visited, with her son Alexander. They left just before I arrived. I stayed until two, due back at 6:30PM. Will bring the Herald Trib for her reading pleasure, and we will possibly do the "Jumble" together (a word riddle, and a fixed item on the cartoon page), as we do every morning over breakfast at home.
woensdag 28 maart 2012
The Die is Cast
Wednesday 28 March
Of course we arrived a half hour late at the hematology ward, but what were they going to do? Tell her she couldn't come in? It always takes longer than you think, extricating yourself from a life, even if temporarily. Nobody seemed to notice, though, let alone mind.
The place looked so familiar to us that it was almost comforting. If you had to take a rigorous treatment, it might as well be here, we thought. Few of the nurses had a familiar face, however. There had been quite a bit of turnover in recent months, we were told. One senior nurse, a Spanish lady of whom Lara had grown particularly fond last time, greeted her with enthusiasm.
The rest of the morning was spent making a grand tour - Lara and I hand in hand - along different services for an X-ray, an echo and an ECG. The blood sample they took came up worse still than the last one. We were slightly disappointed. Lara has felt so energetic over the last few days, that we were hoping for a last minute miracle, allowing her to bow out in the nick of time. No such.
We went down to the hospital restaurant (le Medoc) and ate like grown-ups in a regular setting, one Lara will have to do without for several weeks.
In the afternoon (I had left by then), she was wheeled down to surgery for the implantation of the central line, on the right side of her neck. Previously, the procedure had caused her agony, so she was a tad nervous, dulled by half a Xanax. It went off without a hitch and she sounds chipper over the phone. Try her any time while she is still feeling fine.
Late this afternoon she is expected to be hooked up to the Cytosar, and will remain so for the next five days. The drug is not administered in the form of a constant flow, but rather at certain intervals, bag by bag. In addition she is supposed to get her first shot of Vosaroxin - or a placebo (see yesterday's post on the double blind study she has signed up for). Seven days from now, she will be in total aplasie (no white blood cells or 'WBC'). That is the period in the treatment you have to be wary of, for it entails being super susceptible to pathogens of any kind: viral, bacterial or fungal. Statiscally, the aplasie starts coming to an end 21 days from now and all this time Lara and all staff and vistors have to take extra care to avoid infections. She will stay in her room, except for quick sorties with her physiotherapists.
She is a bit afraid she won't be getting too many visitors, like during the time she was really really sick last year. There has to be an easier way to attract attention, she figures. So don't hold back on any form of contact as you please. Soon she will be getting weaker as the days grind on.
Of course we arrived a half hour late at the hematology ward, but what were they going to do? Tell her she couldn't come in? It always takes longer than you think, extricating yourself from a life, even if temporarily. Nobody seemed to notice, though, let alone mind.
The place looked so familiar to us that it was almost comforting. If you had to take a rigorous treatment, it might as well be here, we thought. Few of the nurses had a familiar face, however. There had been quite a bit of turnover in recent months, we were told. One senior nurse, a Spanish lady of whom Lara had grown particularly fond last time, greeted her with enthusiasm.
The rest of the morning was spent making a grand tour - Lara and I hand in hand - along different services for an X-ray, an echo and an ECG. The blood sample they took came up worse still than the last one. We were slightly disappointed. Lara has felt so energetic over the last few days, that we were hoping for a last minute miracle, allowing her to bow out in the nick of time. No such.
We went down to the hospital restaurant (le Medoc) and ate like grown-ups in a regular setting, one Lara will have to do without for several weeks.
In the afternoon (I had left by then), she was wheeled down to surgery for the implantation of the central line, on the right side of her neck. Previously, the procedure had caused her agony, so she was a tad nervous, dulled by half a Xanax. It went off without a hitch and she sounds chipper over the phone. Try her any time while she is still feeling fine.
Late this afternoon she is expected to be hooked up to the Cytosar, and will remain so for the next five days. The drug is not administered in the form of a constant flow, but rather at certain intervals, bag by bag. In addition she is supposed to get her first shot of Vosaroxin - or a placebo (see yesterday's post on the double blind study she has signed up for). Seven days from now, she will be in total aplasie (no white blood cells or 'WBC'). That is the period in the treatment you have to be wary of, for it entails being super susceptible to pathogens of any kind: viral, bacterial or fungal. Statiscally, the aplasie starts coming to an end 21 days from now and all this time Lara and all staff and vistors have to take extra care to avoid infections. She will stay in her room, except for quick sorties with her physiotherapists.
She is a bit afraid she won't be getting too many visitors, like during the time she was really really sick last year. There has to be an easier way to attract attention, she figures. So don't hold back on any form of contact as you please. Soon she will be getting weaker as the days grind on.
dinsdag 27 maart 2012
Double blind
Tuesday 27 March
Lara is due at Saint Luke tomorrow morning, Wednesday, at 9:00AM. She is to undergo chemotherapy with Cytarabine and takes part in a double blind test for a new agent called Vosaroxin. Three treatments are scheduled like last year, and normally she would enjoy home leave in between them.
Cytarabine (aka Cytosar and Arocytine) is an old faithful. Lara received it through all three treatments last year. Vosaroxin is a new compound presently being tested by a company called Sunesis Pharmaceuticals in San Francisco in the form of a double blind procedure. She has only 50% chance of getting the real compound instead of a placebo. In other words, Lara and her treating physician don't know which. That formula is to be followed through all three treatments.
Cytarabine is administered in the from of a drip bag at a rate of 1 gram per square meter of body surface (an odd way of calculating, come to think of it). She will get that for five days. On day one and day four she will also receive injections of either Vosaroxin or a placebo. More on these compounds can be easily Googled for the need-to-know among you.
Lara has been seeing a specialist on nutrition, an Israeli doctor called Tcachor, here in Brussels. Yesterday we went to see her, after she had studied an elaborate blood test taken several weeks ago. It turns out that Lara is super vitamin D deficient (Jeffrey was right in suggesting she probably would be!) and is now receiving highly concentrated doses which will help her deal with the chemo better. In addition she is receiving other supplements, including anti-oxidants and Omega 3, while at the same time she has to follow specific dietary advice (to the extent possible in a hospital) in order to enhance deficiencies in other minerals etc. Meanwhile, we have also established a link with Professor Frederik Schroyens, the number one in classic homeopathy here in Belgium, working from Ghent. Lara will see him in four weeks time, during her first home leave. And finally, Lara is going in this afternoon for one last session with her acupuncturist. So you see, we are taking this from different angles.
One of her first stops after registration will be to have the central line installed, a surgical procedure by which an intravenous needle is embedded in her chest. In Lara's case these procedures have been cumbersome and painful; so looking forward to one, she is not.
This morning Lara came with me while I had my regular bicycle thallium test at a different hospital (Sainte Anne in Anderlecht). It worked out allright. I have to go back on Monday for two different kind of heart scans, while resting. We had a lovely breakfast together at Pain Cotidien, to celebrate and enjoy our freedom together one last time. Tomorrow she has to arrive a jeune.
We try to keep our moods at an even keel, but with some difficulty, I have to say. Don't let the casual tone in Lara's voice during phone conversations fool you for a minute. We are both a bit daunted and overwhelmed. How could we not be?
Light those candles and keep them burning.
Lara is due at Saint Luke tomorrow morning, Wednesday, at 9:00AM. She is to undergo chemotherapy with Cytarabine and takes part in a double blind test for a new agent called Vosaroxin. Three treatments are scheduled like last year, and normally she would enjoy home leave in between them.
Cytarabine (aka Cytosar and Arocytine) is an old faithful. Lara received it through all three treatments last year. Vosaroxin is a new compound presently being tested by a company called Sunesis Pharmaceuticals in San Francisco in the form of a double blind procedure. She has only 50% chance of getting the real compound instead of a placebo. In other words, Lara and her treating physician don't know which. That formula is to be followed through all three treatments.
Cytarabine is administered in the from of a drip bag at a rate of 1 gram per square meter of body surface (an odd way of calculating, come to think of it). She will get that for five days. On day one and day four she will also receive injections of either Vosaroxin or a placebo. More on these compounds can be easily Googled for the need-to-know among you.
Lara has been seeing a specialist on nutrition, an Israeli doctor called Tcachor, here in Brussels. Yesterday we went to see her, after she had studied an elaborate blood test taken several weeks ago. It turns out that Lara is super vitamin D deficient (Jeffrey was right in suggesting she probably would be!) and is now receiving highly concentrated doses which will help her deal with the chemo better. In addition she is receiving other supplements, including anti-oxidants and Omega 3, while at the same time she has to follow specific dietary advice (to the extent possible in a hospital) in order to enhance deficiencies in other minerals etc. Meanwhile, we have also established a link with Professor Frederik Schroyens, the number one in classic homeopathy here in Belgium, working from Ghent. Lara will see him in four weeks time, during her first home leave. And finally, Lara is going in this afternoon for one last session with her acupuncturist. So you see, we are taking this from different angles.
One of her first stops after registration will be to have the central line installed, a surgical procedure by which an intravenous needle is embedded in her chest. In Lara's case these procedures have been cumbersome and painful; so looking forward to one, she is not.
This morning Lara came with me while I had my regular bicycle thallium test at a different hospital (Sainte Anne in Anderlecht). It worked out allright. I have to go back on Monday for two different kind of heart scans, while resting. We had a lovely breakfast together at Pain Cotidien, to celebrate and enjoy our freedom together one last time. Tomorrow she has to arrive a jeune.
We try to keep our moods at an even keel, but with some difficulty, I have to say. Don't let the casual tone in Lara's voice during phone conversations fool you for a minute. We are both a bit daunted and overwhelmed. How could we not be?
Light those candles and keep them burning.
donderdag 22 maart 2012
Falling Numbers
Thursday 22 March
We were in Saint Luc early this morning. In an email last night, Lara's treating physician had urged her to be on time since two labs were poised to look at her bone marrow samples, so the puncture had to be performed before 10:30 AM.
As we were summoned to cabine 4 - a small office equipped for simple procedures - the results of the blood test were not even available yet on the hospital Intranet. Always present (and weighing in) during the initial doctor-patient conversation, I make myself scarce once the physical examination begins; the more so, since during the last two visits there was also a trainee present from the Medical School. So I waited outside in the corridor, burying myself in the morning's newspaper.
As Lara came out, her face behind a mask, she was shaking her head a lot, looking me in the eye. Yes, they had done the puncture, she said, but her stats were in free-fall. She showed me the print-out, which I compared in my mind to what I remembered from a week ago: red blood cells down now to 2.39 per microL, white blood cells to 1.78, platelets to 35, neutrophils to 0.23 and hemoglobine to 8.5 g/dL. All of the stats way, way too low. This was not looking good.
Lara had to stay downstairs and was administered one unit of red blood cells to crank up her HB and improve the oxygenation in her lungs. All in all we were in the hospital for seven hours, Lara breathing all the while through her mask. We were kindly offered some hospital food for lunch.
We went home in a mood of forced optimism, waiting as we were for the dropping of the other shoe: the doctor was going to call us tonight or tomorrow on the results of the cytology testing in the two labs. She had made clear that we wanted to be sure Lara was indeed no longer in remission and that the disease had come back. No treatment would be started without such positive identification.
The waiting is what grinds us down, folks. We refuse to believe the worst before the verdict is in. Biding our time, we take a walk in beautiful spring weather, the trees and bushes budding into bloom.
The perfidious call came at 7:30 PM. Lara took it like a trooper. Both labs concurred that they had seen acute leukemia blasts in the bone marrow to warrant the conclusion the disease had returned - perhaps in a slightly different variation. Treatment is to start promptly, probably Monday, and more particulars about the chemotherapy are to follow. Promptly because Lara is now free from infections.
We are digging in for the long haul. It will be summer by the time she finishes three treatments. If everything goes off without a hitch.
We were in Saint Luc early this morning. In an email last night, Lara's treating physician had urged her to be on time since two labs were poised to look at her bone marrow samples, so the puncture had to be performed before 10:30 AM.
As we were summoned to cabine 4 - a small office equipped for simple procedures - the results of the blood test were not even available yet on the hospital Intranet. Always present (and weighing in) during the initial doctor-patient conversation, I make myself scarce once the physical examination begins; the more so, since during the last two visits there was also a trainee present from the Medical School. So I waited outside in the corridor, burying myself in the morning's newspaper.
As Lara came out, her face behind a mask, she was shaking her head a lot, looking me in the eye. Yes, they had done the puncture, she said, but her stats were in free-fall. She showed me the print-out, which I compared in my mind to what I remembered from a week ago: red blood cells down now to 2.39 per microL, white blood cells to 1.78, platelets to 35, neutrophils to 0.23 and hemoglobine to 8.5 g/dL. All of the stats way, way too low. This was not looking good.
Lara had to stay downstairs and was administered one unit of red blood cells to crank up her HB and improve the oxygenation in her lungs. All in all we were in the hospital for seven hours, Lara breathing all the while through her mask. We were kindly offered some hospital food for lunch.
We went home in a mood of forced optimism, waiting as we were for the dropping of the other shoe: the doctor was going to call us tonight or tomorrow on the results of the cytology testing in the two labs. She had made clear that we wanted to be sure Lara was indeed no longer in remission and that the disease had come back. No treatment would be started without such positive identification.
The waiting is what grinds us down, folks. We refuse to believe the worst before the verdict is in. Biding our time, we take a walk in beautiful spring weather, the trees and bushes budding into bloom.
The perfidious call came at 7:30 PM. Lara took it like a trooper. Both labs concurred that they had seen acute leukemia blasts in the bone marrow to warrant the conclusion the disease had returned - perhaps in a slightly different variation. Treatment is to start promptly, probably Monday, and more particulars about the chemotherapy are to follow. Promptly because Lara is now free from infections.
We are digging in for the long haul. It will be summer by the time she finishes three treatments. If everything goes off without a hitch.
donderdag 15 maart 2012
Stable but low
Thursday 15 March
We had gone to the hospital for the weekly check-up with a fair amount of optimism. After all, Lara was feeling better by the day and there were concrete accomplishments to underscore it, such as the 4 kilometer walk last Sunday. But it was not to be. Disappointment came instead.
Lara is still anemic. The good news was that Lara's blood balance is stable, but with a downward pressure. Her red blood cells now stand at 2.77 per MicroL (should be 4.00), down from 3.09 last week. Her white blood cells are at 2.23 per MicroL (should be 4.00), slightly down from 2.25. Her hemoglobine should be at 12.0 per g/dL but now was at 9.7 (down from 10.6). The platelets had come down from 56 to 42 per MicroL (should be at 150). Worrisome are her neutrophils, essential to an effective immune system. They should be at a minimum of 0.5 to provide a base level of protection against pathogens. Last week they slipped underneath the critical level and were at 0.43; today they had dropped to 0.32. Lara is now super susceptible of picking up a bug somewhere and her body would have little to put up against it.
The doctor was somber and had trouble hiding it. She found Lara looking "fort pale". The downward trend evident in the stats moved the doctor closer to the conclusion that we are looking at a rechute of the leukemia. We ourselves had the impression she is just waiting for the lab to come back with a positive ID of bad cells; which then would catapult Lara into another series of chemotherapy. Lara was asked if they could take another bone marrow sample today. We agreed on next week Thursday. Meanwhile we remain in limbo.
The reason we opted for another week's respit, is that we both have the idea that Lara's blood balance is bottoming out and is going to improve. We stay optimistic.
We had gone to the hospital for the weekly check-up with a fair amount of optimism. After all, Lara was feeling better by the day and there were concrete accomplishments to underscore it, such as the 4 kilometer walk last Sunday. But it was not to be. Disappointment came instead.
Lara is still anemic. The good news was that Lara's blood balance is stable, but with a downward pressure. Her red blood cells now stand at 2.77 per MicroL (should be 4.00), down from 3.09 last week. Her white blood cells are at 2.23 per MicroL (should be 4.00), slightly down from 2.25. Her hemoglobine should be at 12.0 per g/dL but now was at 9.7 (down from 10.6). The platelets had come down from 56 to 42 per MicroL (should be at 150). Worrisome are her neutrophils, essential to an effective immune system. They should be at a minimum of 0.5 to provide a base level of protection against pathogens. Last week they slipped underneath the critical level and were at 0.43; today they had dropped to 0.32. Lara is now super susceptible of picking up a bug somewhere and her body would have little to put up against it.
The doctor was somber and had trouble hiding it. She found Lara looking "fort pale". The downward trend evident in the stats moved the doctor closer to the conclusion that we are looking at a rechute of the leukemia. We ourselves had the impression she is just waiting for the lab to come back with a positive ID of bad cells; which then would catapult Lara into another series of chemotherapy. Lara was asked if they could take another bone marrow sample today. We agreed on next week Thursday. Meanwhile we remain in limbo.
The reason we opted for another week's respit, is that we both have the idea that Lara's blood balance is bottoming out and is going to improve. We stay optimistic.
donderdag 8 maart 2012
W8&C
Thursday 8 March
Time for another check-up for Lara in Saint Luke's, one we had anticipated with varying degrees of trepidation since the previous one, a week ago. Over the past three days, Lara had felt better each day so we were hoping for better stats. Apart from that, Lara had set up an acupuncture treatment on Monday, expecting that it would bring on better results as indeed it did three weeks or so ago.
It is often indicative to look closely at the doctor's face as she (or he) meets you in the corridor for your appointment. No matter how hard they try sometimes to conceal what they are about to tell you, you can still read the gist of it in their eyes. This happened last week.
This time she was clearly upbeat as she met us, an impression Lara and I shared. I whispered something to that effect in Lara's ear - in Dutch. It turned out that the overall blood balance had remained stable compared to last week, be it that she is still in a condition of anemia (low blood values). All major values are still way too low but don't move, with the exception of neutrophils. They now stand at 0.43 per microL, dipping just below the minimum level of 0.5 required for a proper immune defense.
The latter is not without risk. It means Lara is now more susceptible of picking up a bug or something. She has to stay away from large crowds and be careful what she eats from where.
The prognosis remains uncertain. None of the labconsultants knew how to interpret the bone marrow samples. So for the moment we have to wait and see. Next Thursday they will do another blood test and take it from there.
Now we're off to the opera. Lara is wearing a mask.
Time for another check-up for Lara in Saint Luke's, one we had anticipated with varying degrees of trepidation since the previous one, a week ago. Over the past three days, Lara had felt better each day so we were hoping for better stats. Apart from that, Lara had set up an acupuncture treatment on Monday, expecting that it would bring on better results as indeed it did three weeks or so ago.
It is often indicative to look closely at the doctor's face as she (or he) meets you in the corridor for your appointment. No matter how hard they try sometimes to conceal what they are about to tell you, you can still read the gist of it in their eyes. This happened last week.
This time she was clearly upbeat as she met us, an impression Lara and I shared. I whispered something to that effect in Lara's ear - in Dutch. It turned out that the overall blood balance had remained stable compared to last week, be it that she is still in a condition of anemia (low blood values). All major values are still way too low but don't move, with the exception of neutrophils. They now stand at 0.43 per microL, dipping just below the minimum level of 0.5 required for a proper immune defense.
The latter is not without risk. It means Lara is now more susceptible of picking up a bug or something. She has to stay away from large crowds and be careful what she eats from where.
The prognosis remains uncertain. None of the labconsultants knew how to interpret the bone marrow samples. So for the moment we have to wait and see. Next Thursday they will do another blood test and take it from there.
Now we're off to the opera. Lara is wearing a mask.
donderdag 1 maart 2012
And wait some more
Thursday 1 March
Some things can be unnerving and a relief at the same time. The short of today's posting is that the doctors still aren't sure.
This morning Lara and I went to Saint Luke's to undergo a well-rehearsed routine. Register, wait, blood sample, wait some more, bone marrow puncture and evaluation.
As we talked to Lara's hematologist, we learned that the blood sample was not looking good. Major values were down compared to the most recent sample; in other words the upward curve we saw last time (call it a surge) was not sustained. The platelets continued their downward trend. The doctor had no explanation for the surge, but didn't find the overall picture very encouraging. Lara generally had felt well over the intervening days, she told the doctor, even though recently she had met with a loss of appetite and was tiring more easily. With her current blood balance that was not surprising, was the answer. The doctor was all the more eager to do a puncture, and would call us tonight as usual.
She called as we were getting dinner together, at 7:15PM, and came straight to the point. The bone marrow presented a picture similar to that of two weeks ago: immature cells that were not dispositive either way, and sightings of chromosome-12 with a piece missing. None of it convincing, no basis for an unequivocal judgment and certainly no grounds for treatment at this point. They were going to send the sample to another lab for a second opinion and would let us now tomorrow, Friday, or Monday in case that would yield anything worth mentioning.
Another reprieve. Better news than "sorry, but there has been a complete rechute and we have to start treatment as soon as possible". That is the big relief with all of this. Unnerving is the Damocles predicament in the story. You don't know if or when, if ever, it will come down. It looks to us as though Lara's body is somehow fighting back. Whoever has a better opinion, please speak up. Now would be a good time.
Some things can be unnerving and a relief at the same time. The short of today's posting is that the doctors still aren't sure.
This morning Lara and I went to Saint Luke's to undergo a well-rehearsed routine. Register, wait, blood sample, wait some more, bone marrow puncture and evaluation.
As we talked to Lara's hematologist, we learned that the blood sample was not looking good. Major values were down compared to the most recent sample; in other words the upward curve we saw last time (call it a surge) was not sustained. The platelets continued their downward trend. The doctor had no explanation for the surge, but didn't find the overall picture very encouraging. Lara generally had felt well over the intervening days, she told the doctor, even though recently she had met with a loss of appetite and was tiring more easily. With her current blood balance that was not surprising, was the answer. The doctor was all the more eager to do a puncture, and would call us tonight as usual.
She called as we were getting dinner together, at 7:15PM, and came straight to the point. The bone marrow presented a picture similar to that of two weeks ago: immature cells that were not dispositive either way, and sightings of chromosome-12 with a piece missing. None of it convincing, no basis for an unequivocal judgment and certainly no grounds for treatment at this point. They were going to send the sample to another lab for a second opinion and would let us now tomorrow, Friday, or Monday in case that would yield anything worth mentioning.
Another reprieve. Better news than "sorry, but there has been a complete rechute and we have to start treatment as soon as possible". That is the big relief with all of this. Unnerving is the Damocles predicament in the story. You don't know if or when, if ever, it will come down. It looks to us as though Lara's body is somehow fighting back. Whoever has a better opinion, please speak up. Now would be a good time.
Abonneren op:
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