I was back at M.D. Anderson for a blood test yesterday.  It seems that three of my liver enzymes, ALT, LDH, and AST, have spiked over the past few days.  Mary Pat and I had hoped to make it to Colorado this weekend and to stay there through Thanksgiving but we cancelled our flight so I can go to MDA for a follow-up with Dr. C on Monday.  The elevated liver enzymes may indicate the start of GvHD which I had luckily avoided up to now.  There are several other signs of GvHD that have popped up.  My fingernails began to split and become brittle in the past month which is one sign.  Today I also developed a light rash on my chest and back which is a very common sign of the condition.  I have mixed feelings about GvHD if that is what I have.  On the one hand, if the GvHD is severe and is not controlled, my new immune system might continue to attack my liver, eyes, lungs, and skin and could be fatal.  On the other hand, mild GvHD is a sign that my new immune system is different enough from my old immune system that it could be more effective in fighting any leukemia blasts that come back in the event of a relapse.  I will know more on Monday.  My bet is that Dr. C will put me back on an anti-rejection drug like a steroid of some sort.

While waiting for the elevator at MDA yesterday, a mother and her four-year-old daughter walked by.  The little girl’s head was shaved and she looked scared.  I have seen literally thousands of cancer patients at MDA over the past nine months.  Most are older like me.  It’s seeing the kids that cuts me to the quick.  I can’t stand to see a child in pain or suffering cancer.  I was told by one of my nurses who rotated through the pediatric unit that there wasn’t a day that she didn’t find herself crying.

Happy 75th Birthday to the M.D. Anderson Cancer Center.  I understand there was a celebration there yesterday and that Vice President Joe Biden thanked the staff for taking such good care of his son, Bo Biden, who was treated there for glioblastoma, a fatal brain tumor.  I want to add my thanks to all the doctors, nurses, staff, and workers at MDA.  They literally saved my life and gave me comfort and care when I was helpless. It’s a great institution doing great things for people from all over the world on a daily basis.