Tuesday +61 (10:00 PM) Through the roof!

I am happy to report that Jackie's counts have once again soared through the roof! Today her RBC (Hgl) increased to 10.5 from yesterday's 9.8. In spite of the good numbers she had a lack of energy. I'm not certain why...because usually this is a real indicator of how she will feel. Her WBC count improved to a respectable 2.3 from yesterday's 1.3 and the prior day's 0.8. This count increase is directly related to the use of Neupogen growth factor. Her platelet counts (and I hope the nurse didn't make a mistake in transcribing them) shot up to a record 223 from yesterday's 121. Jackie probably hasn't seen a platelet this high in 5 years! Hopefully the nurse transcribed it correctly.

In spite of the great numbers Jackie felt tired a lot of the day. She had several bouts of back pain. Rather than occurring early in the morning they began in mid-afternoon. She eventually required a pain pill and some extra sleep but in the end she felt good enough to complain about the way I was doing laundry. She thinks I put too many clothes in the combination washer-dryer. I say if room still exists in the tumbler...you didn't put in too many. If there are any guys reading this weigh in and help me out. The woman all seem to stick together on this subject:)

Of course the increase in numbers can also be attributed to a reduction in the Ganicyclovir and Mycophenolate. We received the results of the latest CMV test today. Although still positive, it had dropped to 2500 from 4000 two weeks ago and 3000 last week. We are hoping that the once-per-day treatment will not lead to an increase in this count. With luck her immune system will begin to fight off the CMV. They will perform another CMV test on either Thursday or Friday of this week. If the number has improved they may discontinue the IV Ganicyclovir entirely and switch to an oral antiviral medication.

Yesterday they performed a chimerism test. We should have the results tomorrow. The last chimerism test revealed that Jackie was 100% donor engrafted. They believe the new test will show the same result. If so, they will likely decrease the anti-rejection drug Mycophenolate even faster than planned last week. I think they would like to induce a little more GvHD to make certain it has been effective in clearing and killing all CLL cells.

I had a long conversation with the nurse today about the transplant center. She has been on the floor and doing transplants for a long time. I remarked that I had seen a lot of people come in very sick and walk out more-or-less healthy. I said that to the best of my knowledge I had yet to see anyone die from the transplant. She confirmed my observation and said it was actually a rare event. I found it interesting that she said one of the difficulties in talking with new friends about her job was explaining to them that she rarely dealt with death. She said the real problem for her comes from people who return to visit "their old friends...the nurses" after being away from the center for six months or year. When they leave they are always bald and when they return they have lots of new hair. She never recognizes old patients because they've changed so much and look so much better - and that makes her feel bad.

So, all-in-all the news is good today. As we have all seen this can change rapidly. Hopefully the good news will continue and she will graduate to clinic status shortly.

The photos were taken on the Skyway that connects our building to the one next door. One photo looks toward the Mayo Clinic. The other photo looks toward the convention center.

Until Later...


Bruce and Jackie
From Rochester, MN