MDS: Good Blood Counts & Good Vidaza News, too

Good news comes on the heels of another football Giants victory (3-0).

Yesterday's blood counts:

• Hemoglobin—12.2
• Platelets—97,000

I'm not personally thrilled with the 97,000 count because it remains below the magic 100,000 mark (magic for me, anyway, although I may be the only one). But, Dr. O was very pleased.

And, anyway, that count comes after Non-Shot Week Two, which means by the time we go back to shots next week, it'll likely be up some more.

The better news:

Dr. O has confabbed with Dr. MDS about the bone marrow biopsy report. Dr. MDS has declared that we should

• continue with the Vidaza treatments
• forget about a bone marrow transplant for the foreseeable future
• and plan for a reduction in Vidaza treatment frequency in either 10 months time or after a total of 10 months of treatment.

But, which is it? Ten months time or 10 months total? I'm not sure.

Okay—go ahead and accuse me, as my mother often did, of not listening. Or of not absorbing what I've been told. But, c'mon—I'd just spent an hour-plus in the waiting room, the joint was jumping with patients in all examining and treatment rooms, and, after all, Dr. O speaks with a pretty strong Indian accent.

Those are my excuses.

No matter. Either in 10 months or after 10 months total, we're talking about shots only every four or five weeks instead of every three.

I'll take that.

MDS: Of Blood Counts & FISH Tests

Another Shots Week has been survived. You remember the old joke, "I flew here all the way from California and boy are my arms tired!"?

Well, I've once again endured 14 shots in the upper arms and, no they're not tired, but boy are they sore and itchy.

Yesterday's blood counts:

• Hemoglobin: 11.7
• Platelets: 98,000

These counts are beginning to drive me nuts. Sure, Dr. O says they're supposed to go down while the shots are in progress, and then move back up during the following three, shots-free weeks. Call me an alarmist, but when the counts top out one week at 169,000 and a few weeks later bottom out at 98,000, I find it confusing at best, unsettling at worst.

It's enough to make a person want to bore into his own bone marrow and demand that some molecules in there tell him what the hell is going on in there.

Speaking of confusing, the rest of the genetics report from the bone marrow biopsy came back, and that has really confused me.

As you may recall, the FISH study seemed to indicate that the chromosomes were okay. Now the regular test indicates no change.

Stop! No change is actually a good thing. We know that once the chromosomes show damage, they can't rebuild themselves. So, no change means that we're holding our own and the syndrome isn't drifting towards a worser level of MDS or leukemia.

So, what the hell does the FISH test report mean? Beats me.

It's enough to make one stop contemplating the question "What's the meaning of life?" and devote all waking hours to pondering the meaning of FISH.

Anybody got a worm?

MDS: Good Bone Marrow Results

The early results are back from the bone marrow biopsy, and the news is good.

This while Shots Week continues with extreme fatigue, faint nausea, sore and itchy arms at the shot sites, and bowels that are uninterested in functioning.

Anyway, enough with the kvetching. The FISH test results show:

• less than 1% blasts
• no involvement of the chromosome #5q

Some brief explanation.

• The FISH (Fluorescence In Situ Hybridization) test "maps" the genetic material in a person's cells. This test can be used to visualize specific genes or portions of genes. More explanation can be found here.

• Blasts are "bad" or "dead" cells that are produced by the marrow. To have 1% or less is optimum/normal; the diagnosis is worse if the blasts exceed 5%. All people—even healthy ones like you—have some blasts.

• Involvement of the 5q chromosome is an indicator that the MDS is developing into more serious leukemia-like stuff.

So, these results are good—especially the blasts count, since it's the marrow producing too many blasts that creates the problem. The Vidaza seems to have the situation under control at this point.

Of course, no one knows how long the Vidaza will work . . . but, that's a whole 'nother story.

We still await the standard cytogenetic report, which last time took two weeks to come back. If I understand things (not a sure bet), it will show what changes (hopefully none) have occurred in all the chromosomes. Assuming no alarming results are reported from that, it appears I'm holding my own.

Good news, yes.

Considering, however, that this news comes in the middle of a Shots Week that has me feeling like I've been run over by a truck after having been summarily head-butted and kicked in the stomach and groin, I'd say it's like receiving $1 million dollars from John Beresford Tipton (remember The Millionaire?) while watching your house float away during a flood.

It's hard to celebrate when you're feeling like crap, so I'm saving much cheerful cheeriness for next week.

MDS: It's All Relative

Having returned from a brief road trip to Connecticut to attend a wonderful wedding, it's now time to prepare for another week's battle with Vidaza.

In theory, at least, I'm prepared to be useless or near-useless by Wednesday. We'll see if my "preparedness" holds up when I'm actually feeling lousy.

Meanwhile, of course, the bone marrow biopsy results may come in about mid-week, which just provides another element about which to convince myself I'm not worried.

The good news is that

• my golf game continues to improve
• and, the NFL season starts this week.

So, I can continue to distract myself not only with the life-and-death results of Giants' games, but with the mysteries of why I can sometimes hit a golf ball so well and other times so poorly.

This black-and-white (good shot/guys-bad shot/guys) orientation contrasts nicely with MDS's relativism.

Go Big Blue.

MDS: Drilling for Bone Marrow

Yesterday we endured the landmark bone marrow biopsy ritual.

Landmark because it comes after the fourth cycle of Vidaza shots, the time when true signs of Vidaza success should show up. Ritual because this is bone biopsy Number Three in what we hope won't be a long line of such tests.

Dr. O now takes the sample from the back of my pelvis. It begins with a couple of royally large novocaine injections. Not a mind-numbing experience. Rather, an upper butt-numbing one.

The procedure itself feels rather like someone is thumping on you with a hammer and a small, dull chisel or nail-set. Since I can't see what she's doing back there, I envision this small device delving into my bone and pulling out marrow as one might take a tree-ring boring or polar ice sample.

Mostly, I don't like to visualize that.

So, why are we doing this?

To see what the marrow is doing, as Dr. O puts it. Apparently we're looking out for

• increased blasts (bad, non-developing red blood cells)
• other abnormalities in the marrow
• and, much to my surprise, cytogenetics—further degeneration, stasis, or even minor miraculous repair (not likely), of the chromosomes.

From these results, we'll decide if the Vidaza treatments continue. (Which they will anyway, beginning next week, whilst we await the results, which Dr. O says should take a week, although last time the cytogenetics took two weeks, so I'm not sure what we'll know in a week.)

Apparently it was Dr. MDS who recommended this biopsy. Dr. O inferred that Dr. MDS wants it as a measure to use in considering the bone marrow transplant "because you're young."

For reiteration and clarification—age-wise, I'm right in the middle statistically for bone marrow transplant success, and still young enough to have decent chance of success.

Heck, I'm just happy to hear someone refer to me as young.

Meanwhile, yesterday's blood counts were good

• Platelets—139,000
• Hemoglobin:—12.0

indicating, as they have been all along, positive things.

So, next week, having graduated from being a core-sample guinea pig, I get to return to being a pin cushion.

Carry on, doc. Fill me with needles.