Another lazy Sunday here at Princess Margaret. Spent most of the day outside on the roof because the weather was so beautiful.
Count came down again today, to 2.0. I also talked with the on call doctor today, who happened to be one of the doctors who dealt with me when I first arrived and things were hectic; when they weren’t sure if I had AML or ALL (AML meant a high likelihood of not making it, given my extremely high white count). Since then, he’s been monitoring my blood work and has been very kind when I see him around. He explained a lot about what remission really is, because apparently it’s not getting to 0 white blood cells in the blood. Apparently “complete remission” (the first layer of remission) is having bone marrow with fewer than 5% blast cells. Blast cells are cells in the bone marrow that just divide. One of the cells from each division will go on to develop to become a white blood cell. So their job is to keep dividing to ensure that more white blood cells can be created. With my disease, the blasts turn cancerous and start going crazy and keep dividing when they’re not meant to, and so white blood cells continue to cram into the blood stream until it looks like the 401 on a Sunday evening in July.
Anyway, so the amount of blast cells in the bone marrow is more important than the concentration of white blood cells in the blood, because it’s the blasts that are cancerous. The white cell count in the blood is more used as an indicator of what is going on with the bone marrow. This doctor (I actually don’t know his name, which is a little embarrassing) seemed to think that the downward trend of my count after this second blast of chemo is a good sign, and we might see remission. So it looks like this second dose of chemo might have been enough. While I hope he’s right, I’m not counting my chickens quite yet. Hope for the best, plan for the worst.
I hope my attempted explanation of my situation is somewhat clear. I think it’s accurate, I’ll do some more research and talk to my regular doctor (Dr. Anna) about it tomorrow.
Surprisingly, I haven’t really felt any symptoms from the second round of chemo, which is nice (knock on wood). I figured I would at least get some more mouth sores but even those haven’t shown up. Back and shoulder pain is still persistent but more of a nuisance now than a hindrance. I was taken off the arthritis medication so now I just get a small dose of morphine before bed because the pain is quite noticeable while lying down trying to sleep.
This week we find out if one of my brothers is a full bone marrow match. Keep your fingers crossed for me please!