Less is More!

We are just in from our bi-weekly clinic at Northwestern and have some great news to share.  As always, we are cautiously optimistic and don't want to get too far ahead of ourselves emotionally.

Steve's mouth absess was cause for a bit of attention after my last post.  We were asked to have it assessed, and were allowed to seek out help with our own (local) dental experts.  Our (always!) wonderful Dr. Steve Heaney took us right in on Tuesday of last week and determined it was a bacterial infection, and that the wisdom tooth was most likely fine.  Steve was already responding to the penicillin, so that, too, was good.  Dr. Altman ordered up Neupogen injections as a backup plan to the antibiotic.  That $10,000 of medicine was on chill in the fridge since late September.  I had only jabbed him once back then, so I had to remember how to stab the poor guy, not too fast, not the same spot, pinch up...reminds me of learning to golf.  Wine helps.  

Neupogen is also what Mary needed to take to prepare her body for her stem cell donation.  She injected herself.  Here's a lil copy and paste from an NIH site regarding Neupogen:

Why is this medication prescribed?

Filgrastim is used to decrease the chance of infection in people who have certain types of cancer and are receiving chemotherapy medications that may decrease the number of neutrophils (a type of blood cell needed to fight infection), in people who are undergoing bone marrow transplants, and in people who have severe chronic neutropenia (condition in which there are a low number of neutrophils in the blood). Filgrastim is also used to prepare the blood for leukapheresis (a treatment in which certain blood cells are removed from the body and then returned to the body following chemotherapy). Filgrastim is in a class of medications called colony-stimulating factors. It works by helping the body make more neutrophils.

Since Steve's white count was NOT going up, it was going down and was starting to cause puzzlement and concern.   No immune system, risk of infection, not good.  Giving him Neupogen can cause the spleen to enlarge, so Dr. Altman played this card earlier than planned, if at all.  We began daily injections on December 28.   It worked.

Steve's white cell count on January 1 was 0.6.  On Monday, January 3 it was 1.6, and today it was 3.9!!  His ANCs (absolute neutrophils) are 1.7, which are Olympian!  Now he will get a shot every other day, we are seeing if his body kicks in or if this nice plump number is artificially high.  His hemoglobin is in the high 6's; he has a standing appointment every Friday morning at Christ Hospital for a fill-up.  Platelets are good in the 70's.  Here's the kicker:  That damn spleen got smaller!!!!  It now measures 8cm, versus 11cm just 6-8 weeks ago.  I would love to know the measurement from his April admission, probably a meter!  He laughed AT me when Dr. Altman said 8cm, so I quickly asked when his splenectomy surgical consultation would occur.  Dirty looks were exchanged, and Dr. Altman got out of the exam room before we came to blows.  She will schedule a consult after he is done with his Tacrolimus (anti-rejection drug).  His weight, with jeans, a heavy hoodie, and running shoes, is still only 148 pounds. 

More good news is that we are eliminating one of his "Day 1" drugs, a prophylactic antibiotic (Avelox/moxifloxacin), as well as the penicillin.  Another drug (Ursodiol) has gone from x3 daily to twice, and his Tacro was dropped to 0.6ml from 0.8ml.  I got in the house and, like a mad scientist, rearranged his med schedule and "advent calendar" of drugs.  We are also extending out our visits to the Hematology/Oncology clinic at Northwestern's Lurie to every THREE weeks, hooray!

Thanks for all your positive thoughts, prayers, and juju.  Please send some the way of my online friend, Greg Dymerski, who is my inspiration for this blog.  Greg is also an ALL patient in the Pacific Northwest, and he has had a set-back in his recovery.  You can follow and encourage Greg by following his blog, "The Long and Winding Road."  The link is in my bio.

Peazzz out!