We had a long day today at M.D. Anderson. I say “we” because Mary Pat insisted on going along to keep me company. I started by giving ten test tubes of blood for the lab to run my CBC and for the leukemia researchers who are running the clinical trials in which I am participating.
Then I reported to the CardioPulmonary Unit for a PFT (pulmonary function test). I sat in a glass booth and went through a series of tests through which the technician could measure my lung capacity. One test required me to suck in a large amount of carbon monoxide, to hold it as long as possible, and then to blow it out. The machine measures how well your lungs process the carbon monoxide. The PFT is designed to reveal whether the donor T cells are attacking my lungs. I understand that my test came back better than expected so it looks like GvHD didn’t affect my lungs.
After the PFT, I reported to the Bone Marrow Aspiration Unit where the technician augured a hollow stainless steel tube into my back and punctured my hip bone to suction bone marrow out for genetic and molecular testing. I’ve had a large number of bone marrow aspirations and biopsies but this one was more painful than any of the others. When the procedure started my blood pressure was 110/70. By the time it ended it was 158/78.
Next we saw Dr. C for an exam. We learned that my blood numbers were okay but my WBC, Hemoglobin, and Neutrophils Absolute counts were lower than last month’s numbers. That’s disappointing and a little worrying since the risk of relapse is still pretty high and we don’t yet have the results of the bone marrow aspiration and biopsy.
Our next stop was the Survivorship meeting. Nurse S specializes in consulting with stem cell transplant patients. She guides us through the steps we need to take to stay healthy and to achieve the best quality of life we can under the circumstances. She confirmed that most of her stem cell patients suffer from chemo-brain symptoms like the ones I have been working through. Short term memory problems are common, especially since busulphan is such a powerful chemo drug and it is one of the few that actually crosses the blood-brain barrier. She was concerned that my vitamin D3 level was below normal despite the fact that I am taking 5000 IU of vitamin D3 daily. She also thought it was odd that my Magnesium levels continue to be low despite the 6 tablets of Mag-G that I’m taking every day. The tacrolimus is known to strip magnesium from your bloodstream but my levels are lower than expected.
Our last stop was the ATC (Ambulatory Treatment Center) where I received a 90 minute IV drip of Pentamidine which is a chemotherapy chemical I receive every month to prevent fungal pneumonia which is one of the dangers you face if your immune system is suppressed by tacrolimus.
It will take a week to get the first results back from the bone marrow aspiration and biopsy. The little voice in the back of my head whispers that the lower blood counts might be a sign of a relapse while the rational part of my brain says that I’m feeling fine and it’s probably just a normal variance in blood counts.
Tomorrow and the rest of this week I will be back at Baylor College of Medicine for fitting of the Prose lenses I ordered to protect my corneas from the occular GvHD.