Battle Scars

Just a note on the effects of bleomycin: This is a picture of my right forearm, taken a few days ago. On my first day of treatment, December 9th, I was given a small test dose of bleo to check for allergic reaction. No swelling, but I was left with this red welt. There is a small straight line (shown here, horizontal) on the scar which is the mark left by the needle. I shudder to think about the effects this drug is having inside my body when it is capable of leaving such a toxic stain on my skin.

It's nothing compared to the golf scars Wilbur has!!!

Actually, doc decided to take me off bleo completely. He notes my absolute neutrophil count has dropped to 0.5 x 10e3 /uL. In order to continue chemo, we must get that number higher by administering Neupogen. As you may remember, Neup and bleo together increase risk of pulmonary side effects. Findings were shown in 26% of the sample population, versus just 9% of those only taking bleomycin. In older patients 55+, Neup and bleo can reduce the 5-year mortality rate from 90% to 60%. Therefore, no more bleo. Now I'm on AVD for 4-6 cycles; that means a possibility of 2 more months of treatment plus more radiation than originally planned. Of course I'm prepared to continue treatment without delay, so I'm ready for this new plan of action.

I feel blessed that my doctors are willing to ask for help and consult specialists when its needed. Humility in MDs, oh my! (Just kidding, MDs). There is some debate as to my treatment, since most patients with healthy bone marrow should be able to reach an absolute neutrophil count of 1.5 x 10e3/uL even at the nadir of white cell loss. They have consulted with prominent hematologists at UCSD, Stanford, and Yale, and they are referring me to a second opinion at City of Hope.

On a side note, as a clinician in a patient's shoes, I'm more comfortable asking for a second opinion. But you all, you must never hesitate! If you're unsure about a diagnosis or treatment, it's ok to collect more information.

Here's a chart showing my white blood cell, absolute neutrophil (granulocyte), and red blood cell levels since I started getting blood tests. Remember, first cycle was second week of December.

Can you tell when the Neupogen was administered?