“… And pick up on one and leave the other behind?
It’s not often easy and not often kind.
Did you ever have to make up your mind?…”
So, let’s go with the blunt approach – since the last post in May, Karen’s platelets counts have been on a Kamikaze dive from the high above normal, sliced through the normal range, and may crash into the might need a blood transfusion prior to the scheduled bone-marrow biopsy on 9 September. She was at Hopkins Monday for blood work and consult and will be going back for a recheck Friday. The white and red cell counts seem to be impacted as well.
Relapse – is the candy coated word wrapped in barbed wire for consumption. However, that is the function of the biopsy to confirm.
“…And if I’ve built this fortress around your heart…
….Encircled you in trenches and barbed wire…
…Then let me build a bridge…”
Communication with Karen’s transplant doctor has not been any easier or less stressful since May; and to our good fortune, Karen discovered that her original oncologist from University of Maryland is now at Hopkins and she tip-toed through the bureaucratic bullshit to switch doctors (one only wishes it would have been that simple). However, our Monday visit at least had a miraculousness to it, despite the dire prospect of a relapse on the horizon.
“…Well you better check it out before it goes
‘Cause you may not be seein’
Things just the way you should…”
Ok, post biopsy, the branches and sequels will most likely follow down the path of reactivating chemotherapy (Vidaza (azacitdine)) to rebound and stabilize the blood counts. Beyond that, Donor Lymphocyte Infusion (DLI) may be the next step. Vidaza and the DLI, aside from potentially being life saving, have a Pandora’s box of side effects which we can open in the future once the bone-marrow biopsy results come in.
In the meantime, Karen is immunocompromized – so any visitors will be masked and doused with flaming alcohol sanitizer at the door. Flames only necessary when the victim – oops, visitor, has no mask. This ain’t a Covid protocol …it is a life protocol; remember 2010?
Three ‘standard’ tag line lyrics included.