A journey in life - musings of a doctor, husband, dad, grandad, brother, and friend

This past week has been one of continued rehabilitation and... Establishing good "hand-offs", that is coordination of care between Shenandoah Oncology (Dr Gemma) and Johns Hopkins (Dr Luznick/Viki Anders CRNP). Due to the Valganciclovir side effects of affecting the bone marrow.  I received a unit of platelets (level 14K) and I sit today after my appointment with Viki at Johns Hopkins getting a unit of red blood cells (Hemoglobin 6.8 - a measure of the red cells - low normal is usual 13-14 ).  As a result of the anti-viral for cytomegalovirus, I will, more than likely be dependent on platelet and red blood cell transfusion in the coming weeks.  The prayer here is that the Valganciclor works but doesn't severely affect my bone marrow. Dr Mikus gets thanks for stopping the nose bleeding which as been going on for a week (due in large part to the low platelets which help "clot" formation.  He cauterized (in this case, he used a chemical known as silver nitrate ...

I was speaking to Dr Gemma yesterday.  He warned me that sometimes the post-transplant period I am currently in is sometimes as challenging as the acute phase of post-transplant.  He was right. On discharge this past Tuesday, Jan and I were excited to go home.  Oops!  First bump... Cytomegalovirus!  This virus in almost all who get this viral infection, usually in childhood, will  cause a mononucleosis like illness or minimal symptoms, if any.  It then goes dormant (like chicken pox) and resides in the body in a kind of suspended state.  It can reactivate (wake up if you will).  This happens in a lot of different transplant patients.  It can be a dangerous, causing encephalitis (brain infection) and affect other organs including causing the transplant to fail.  There is an oral medication, valgancicyclor, which can help.  But this drug can be quite toxic including causing the transplant to fail as well. Platelet counts rema...

The bone marrow went well today to check to see if there is any residual cancer.  Plus, had to have platelet and red cell transfusion along with the biopsy. The GREAT NEWS is that if everything goes well over the next 24 hours, I will be discharged from the IPOP transplant unit tomorrow!   Effectively discharged from the intensive program, AND, we will pack up and COME HOME! They'll be lots of trips back and forth in follow-up but being back home...beyond words! For those of you who've sent some very nice cards to the Baltimore address, you may use our home address if you want to:  127 Cabbage White Drive, Lake Frederick, VA  22630 I should be back in the office (initially limited hours) in the next few weeks and I look forward to seeing all of you! It is nothing short of miraculous that this process has moved along so well recently.  I have you all to thank for your prayers, help and concerns for this .   But, to GOD I give the glory.

Things are progressing as we move closer towards discharge from the stem cell in-patient/out-patient program. I am now at the weight I was before the ACC conference swim finals back in 1975.  Lot less beef in this case.  I DO NOT RECOMMEND my diet plan!😉 Today, the usual routine.  Get up early, prepare and go to IPOP at the KIMMEL CANCER CENTER.  As Jan came to the car, the driver side window was smashed in (during the night apparently).  REALLY!  Jan had to stay for the police and insurance and clean up with my mandatory appointment in 30 minutes! This was a real personal challenge... I still am reconditioning and walking is difficult.  Thank goodness for Uber as I went on my own to IPOP.  I made it (slowly but got there) and took Uber back after my appointment to our apartment (Jan still tied up with break-in).  As the saying goes, "Necessity is the mother of invention!" Seems like as Jan and I have come to say, "It is what it is!"...