Getting out of the hospital was pretty uneventful.  My chemo finished.  They flushed the line.  My port was de-accessed. And then I was free.  Lindsey and I just walked out of the unit.  A few more weeks and I’ll be back.

Thankfully, again, my side effects have been minimal.  The most persistent side effect is fatigue.  Especially at night, my body is just done.  I nap a few times during the day, and then feel a bit more energized.  I’ve also had very mild nausea.  I’ve taken phenergan which has helped.  Other times I just need to be sure that I’ve eaten something, as an empty stomach bothers me too.

If you remember, I mentioned leucovorin a few posts back. It’s the garden hose drug that tries to save your valuables when the house is on fire.  I thought it was mostly related to my blood cells, but talking to my nurse at discharge it actually helps with other fast growing cells.  She told me a story about a gentleman who didn’t take his leucovorin when he left.  Since the leucovorin helps clear the meth from your body, his meth hung out for a bit too long.  He developed blisters in his mouth and was admitted to the hospital for a few weeks until he was able to eat and drink again.  Needless to say, with that parting speech in mind, I took my leucovorin at the prescribed times.

I know this probably comes as a shock on top of everything else, but I’m pregnant.  I’ve been taking note of my symptoms.  I’m tired a lot.  I’m irritable.  I get nauseous.  I can’t eat lunch meat.  I’m constantly getting checked for my feet and ankles to swell.  I had to start taking a daily vitamin. I had an abdominal ultra sound. And my body is definitely changing.  Now I’m just waiting for the little guy or girl to start kicking.

After going to bed around 10pm on Wednesday, the above are all the times I had to get up in the middle of the night to pee.  Constant fluids will do that to you, and now that I’m home and not on an IV it’s gotten a bit better.

I’m glad it’s the weekend.  Technically it’s not a day off from work, so I don’t think about all the things I should be doing.  It’s just Lindsey, the kids and I at home so we’re getting good family time.  In a non Leukemia world I may be cleaning the garage today or doing something outside, but I’m glad for a little relaxation and playtime.

I had my follow up with the optometrist on Thursday.  It wasn’t my normal optometrist, and I wasn’t really impressed.  After being called back around 3:15 for a 2:30 appointment, I sat in the exam room for a bit.  Once the optometrist came in, he didn’t introduce himself or anything, he simply said “You know what I’m going to do after this….take some advil.”  Well okay then.

While his exam chair manner was on par with the local drunk, he did provide a good exam.  I still have a pre-retinal hemorrhage in my right eye.  They even took a picture of it so I could see.  I have another follow up appointment in 2 months to see if it has gotten better.  Really it’s somewhat of a formality as I feel like I’m seeing ok.  I will however be sure to bring some advil for him, just in case.

I made one minor miscalculation in my treatment plan.  At the beginning when they told me I’d be back in the hospital for 4 days a month for chemo, I just figured those would be the only 4 days I was out of action.  In reality, my counts drop just like they did before. They told me that my counts would probably bottom out around days 10-14, and that is when I’ll probably feel the worst.  Day 10 is this coming Thursday.  Here’s to feeling the best kind of bad I can feel.

You may be wondering, as I did, why my initial hospitalization was 3 weeks and now I’m in and out for 3-4 days.  I asked Dr. Cripe this question.  Basically it comes down to the fact that when I was originally admitted, my bone marrow was full of leukemia cells and not health.  Now that my bone marrow is somewhat recovered, it’s starting from a better place to recover.  That means I can recover at home instead of in the hospital.

One of the other differences this time around is that I get a Neulasta shot on day 5 of treatment.  Neulasta is a colony stimulating factor. Colony-stimulating factors (CSFs) are secreted glycoproteins that bind to receptor proteins on the surfaces of hemopoietic stem cells, thereby activating intracellular signaling pathways that can cause the cells to proliferate and differentiate into a specific kind of blood cell (usually white blood cells.

In other words, Neulasta helps stimulate the production of white blood cells in my body.  With Neulasta, my counts will come up a bit more quickly and I can be out in the real world a little sooner.

This will be the next big day in my journey.  Assuming there are no road bumps between now and then, I will next meet with Dr. Cripe on 2/18.  He will perform my bone marrow aspiration (here’s to hoping he’s gentle) and then I’ll know if I’m in remission.  If I’m in remission, then the treatment plan continues and I get admitted for more chemo.  Until then, here’s to a normal life.

The drunk chemo hasn’t lived up to its name, and that’s a good thing.  I still have to take my sobriety test, but oddly enough I haven’t had to say my ABC’s backwards.  My tests consist of writing the same sentence, rubbing my right heal on my left leg and my left heal on my right leg, as well as extending my arms and touching my nose with my finger tips.  I’ve passed with flying colors each time.

B cycle chemo did make me a bit tired this morning.  I also had a touch of nausea that was cured with some ativan.  Otherwise I feel fine.  No soreness in my mouth or vomitting.  I also got my spinal tap today and had some methotrexate injected into my spinal fluid.  The initial results showed no leukemia in the spinal fluid,which is obviously a good thing.

WBC – 3.5

Hemoglobin – 10.6

Platelets 117

ANC – 3.0 (tricky little buggers took a jump)

My chemo finishes up tomorrow night around 8p.  After that, I only have pills left to take, which I can get via prescription.  I have the option of going home late tomorrow night, which I think I just might do.  Three days in the hospital definitely beats 3 weeks.

I’ve got some nice short fuzz on the top of my head.  It’s grown back in a little since the first chemo.  Dr. Cripe told me not to get used to it.  With this chemo and the others it will all fall out until I’m completely bald.  I seem to recall a cartoon on TV, not sure if it was Charlie Brown, where they showed a tree with one little leaf hanging on until that leaf fell to the ground as a sign of winter. I wonder which hair will be the last little hair to hang on to my head until it too falls to the ground.  Might be hard to figure that one out.

That would be the repetitive announcement that is going on right now.  I sure am glad they are announcing it at IUSCC.  You know since Riley Simon Tower is more than a quarter mile away and to the best of my knowledge there isn’t a continuous path of highly flammable material connecting the two.  I’m guessing the fire isn’t going to make it over here.  Even it it does, don’t warn me until it reaches the doors of Uni.

About my fourth or fifth time getting up last night to pee, I thought to myself “I know I didn’t drink this much.”  Then it hit me, I was receiving fluids on top of the big bag of chemo.  I’ve lost track of how many bags they’ve hung.  I think I’m up to 7 or 8.  It’s gonna be a long night.  Last night I topped off both my jugs.  On the plus side though, I’m brewing some nearly clear urine.

Father God, as I continue on this journey I hurry up and wait.  But each step is a necessary step.  Each day a necessary day.  Help me to see you in each step.  Help me to see you in each day.  Don’t let the sun set without me giving honor to you.  Thank you God for another day.  Amen.

Late last week I received information about my port placement from the hematology clinic.  I was told to not eat or drink after 7a, that my port would be placed at 11:30a and that I would be admitted afterwards.  I also received a call from Interventional Radiology, which is the department that places my port.  They told me to not eat or drink after 5a, to arrive at noon, and to have someone to drive me home.  Yep IUH, we’re not quite in sync with what we tell our patients.

Being a good patient, I did not eat or drink in the morning.  I figured I’d get my port placed around noon and order a little lunch afterward.  As healthcare would have it, I didn’t get into the procedure room until around 2:30.  By the time they were done placing the port I didn’t make it back to my room until 5.  Thankfully I had texted Lindsey to order my food, so I didn’t have to wait that long.  However I ended up having lunch and dinner within about 2 hours of eachother.  I might still be a bit hungry.  Too bad they don’t have a midnight buffet.

Lindsey and I met with Dr. Cripe this morning.  While he can’t tell if I’m in remission until I get kicked in the junk (aka, get a bone marrow aspiration), he did say we were “trending” that way.  He also said I could be out in public more as I have the energy, so thankfully that should get me out of the bubble of the house.  Once my numbers come back up after this treatment, Lindsey and I are going on a date!  Speaking of numbers…

I had labs drawn this morning and in the words of the Fresh Prince “they was looking very good, and so was I. Just might say”

WBC – 2.7

Hemoglobin – 11.3

Platelets – 129

ANC – 1.8

Blasts – 0

I added on blasts, but it won’t be a daily value.  Blasts are immature cells and anything above 0 isn’t good.  Blasts are an indication of Acute LymphoBLASTic Leukemia.  So the good news is that I don’t have signs of recurrence at the moment.  The bad news is my poor little blood cells are about to get beat down by some chemo.

My chemo regimen exists of two cycles, A and B.  I completed 1 round of cycle A in December.  This admission, I’m doing my first round of cycle B.  Dr. Cripe told us that cycle B usually knocks people out more than cycle A.  I’ve got a few tricks up my sleeve though, so cycle B had better watch out.

As I type this I’m getting a 12 hour infusion of methotrexate.  I figure if we just abbreviate it to “Meth” there would be a large number of hoosiers who wished they had Leukemia and could get meth for free at the hospital.  Maybe I need to find a chemo drug I can abbreviate as “pot.”  This could be a fun game.

Anywho, I get the 12 hours of meth and then tomorrow I get Leucovorin and Cytosar.  The cytosar is the other chemo and I’ll get 4 doses of that total.  The interesting thing about cytosar is that there is a very small possibility of Cerebellar Toxicity.  The symptoms of cerebellar toxicity are very similar to being drunk.  So twice a day I get to take a drunk test and touch my fingers to my nose and write repetitive sentences among other things.  Not sure if I’ll have to walk a line or say my ABC’s backwards.  I’m practicing up just in case.

Leucovorin isn’t a chemo.  It’s called a rescue drug.  Basically after the meth has started killing cells, they give me the leucovorin to protect the healthy cells.  So the meth kills the cancer (DIE CANCER DIE) and the leucovorin helps prevent the meth from killing my good cells (live little neutrophils, live).  I find it interesting because it’s basically like setting your house on fire and then using your garden hose to try and save some of your valuables.

Thank you God for great support.  Please be with my friends on the unit.  Some of whom have names I’ve seen before, and some of whom I don’t recognize.  Be with those I know who have also been recently hospitalized and please meet their needs and heal them.  Thank you for Dr. Cripe and his staff.  Please kill this cancer.  Thank you for another day.  Amen.