Day 83

I'm in the clinic about to get my fourth big bag of Rituxan in as many weeks. It's 1:30 now and I won't be done until about 8:00 tonight. The nurse just started the Benadryl pre-med, so I'll be out like a light shortly.

Blood counts are all looking pretty good. Although we are pretty much over worrying about the white and red counts, we still look at the various other things like the liver enzymes, creatnine, etc.

I don't have the Tacro level back yet for today, but it was at 4.9 on Monday. Dr. Hosing said she would like to increase the Tacro dosage to maintain the level in the blood stream at around 7. As I taper off the Medrol we'll have to increase the Tacro dosage to offset not having Medrol to fight the GvHD.

As you may recall, Dr. Hosing reduced the Tacro level about a month ago in order to actually induce GvHD to make sure the graft was working. The idea is that if you have GvHD, you would also have GvL, graft vs. leukemia. Getting the graft to attack the leukemia, the GvL effect, is the point of the transplant.

Once we proved I could get a healthy case of GvHD, then we had to stop the GvHD in it's tracks with Medrol and increase the Tacro level up to a point where I don't get GvHD. I said "a healthy case of GvHD" but that is actually a misnomer. GvHD can kill you very very quickly. It's much deadlier than the leukemia short term wise. That is why they monitor you so closely and keep you in Houston for so long. They have to make sure that you are stable before you can go home. But what you gain in physical stability you may be losing in mental stability.

They reduced the Medrol dosage today down to 48mg per day. They will reduce it every five days providing I don't have any problems. Medrol really saps your strength and weakens your muscles, especially in the legs. So I work out 4 or 5 times a week in the fitness room at the hotel. Most days I don't really feel like excercising, but I have to make myself do it.

The nodes are still down, not completely gone, but way down. That's courtesy of the Medrol. Corticosteroids are very good at temporarily reducing the nodes. So as long as I'm on a significant dose of Medrol the nodes should stay down. The problem is that Medrol is just a quick fix for that. It was really prescribed to get rid of the GvHD. Steroids are amazing drugs. No wonder the baseball stars like them so much. LOL They take a different kind of steroid, of course.

What we really want is for the graft and the Rituxan to permanently take care of the CLL/Lymphoma. Once the Medrol is gone, we'll see what we have. I'll be monitoring these nodes for the rest of my life. I guess all cancer patients are always looking over their shoulder to see if it's going to catch 'em. I can deal with that I guess. At least I'm vertical and warmer than ground temp.

Alan, you asked for my Super Bowl prediction. You could get just as good a prediction asking a tree. My record this fall has been pretty poor in the college ranks, and I know even less about the pros. But, not knowing about something has never stopped me from having an opinion on it. LOL I like the Pats if Brady's leg is okay.