MONICA SMITH AT MDACC 9/14/11

MONICA SMITH AT MDACC 9/14/11
MONICA SMITH AT MDACC 9/14/11

Thursday, January 20, 2011

01/20/11 !!!!!!!!PROGRESS!!!!!!!

On Tuesday it was the day to visit the Infusion Department at Winship/Emory. The waiting room was wall to wall of people and caregivers where the crowd overflowed into the hallways. The backlog of patients was from the Ice Snow storm that paralyzed the Atlanta area last week along with Martin Luther King Jr Holiday on Monday. The wait was long. A nurse made an announcement that all 88 infusion chairs were in use and that they would get to each patient ASAP. It was about 5PM when we finally got to the back where the infusions are done. Joe's white blood cells were low at 1.4 thus I would start Joe on the neupogin shots daily. Joe's hemoglobin was at 8.6 so no red blood cells would be needed. Joe's platelets were at 82 thus a platelet transfusion was not necessary. We were delighted that Joe escaped transfusions or we would not have gotten home till 11PM at best.

Joe's next visit to Winship/Emory was today, Thursday, January 20 which turned out to be a very special day for us. Since the Infusion Lab completed a Type and Cross on Tuesday, we could escape the mob scene at the Infusion Department by going to the 2nd floor lab which was only a 10 minute wait rather than an hour and fifteen minute wait. Next on the schedule was Dr. Winton and his Physician Assistant, Jessica Neely. Jessica is such a delight to be around. She does all the leg work for Dr.Winton. She also agreed with me that the lab needed to get Joe's magnesium, phosphorus and uric acid levels so she called the lab requesting they get those completed ASAP. Joe told her (with my prodding) about the cramping of his fingers fifteen minutes at a time about an hour after he eats. She measured Joe's spleen which had decreased to 14 cm from a high point of 30 cm. We both grinned from ear to ear with that news since we have been trying to get that spleen smaller for the last three years. Joe's muscle mass is still small but thankfully he has been eating quite well. Jessica gave me a copy of the CBC (blood report) and stated that Joe did not need any transfusions. I anxiously looked at the report. After only two days since his last CBC, Joe's WBC improved to 3.2 with only three days of neupogin shots. Joe's RBC improved to 3.18. His hemoglobin went to a respectful 9.4. The hematocrit increased to 28.6. The platelets jumped to 107. It was good news indeed.

Dr. Winton came in and told us that Joe was doing GREAT in spite of the Myelofibrosis (MF-3) which was a concern of both cancer centers. Winton stated with Joe's neutrophil percentage being 16% and his red blood cells being 3.18 would make Joe's absolute neutrophil count at .51. Winton stated that being over .50 made him delighted with the results. He told us that we would not have to come back until a week from today when he would be readmitted to Emory for Part b of the HyperCVAD-R chemotherapy for about five days. Winton also instructed Joe to stop taking the neupogin and the antibiotics with the last day being Saturday. He stated that Jessica would contact us upon getting the results of the magnesium, phosphorus and uric acid to give us further instructions. Our next stop would be the Infusion Department for the interim Vincristine chemotherapy.

We took the elevator down to the Plaza level of the Winship Cancer Institute where the Infusion Department is located. It was a pleasant sight to see only five patients waiting to be called to have their infusions. We got beeped quickly and Joe was seated in his chair about 3:15PM but we had to wait till Winton's office faxed the chemo instructions and then for them to get the Vincristine. The RN asked Joe initially what he was there for and Joe says, "You tell me!" She proceeds to tell him that it was for platelets. I just do not understand why Joe does that. I told her that he was there for Vincristine. After she left, I asked Joe why did he ask her, "You tell me!" He mumbled some words to me that I would not want to decipher with that sneer of his. One these days he is going to harm himself by being a pain in the tush. Joe was through with the chemo about 4:45pm. We hung around waiting to get the rest of the lab results and finally for them about 5:30pm. A brief stop at the Emory Pharmacy was done to pick up Joe's needed cough medicine. We headed to the parking garage at 5:45PM when I got an e-mail from Jessica stating that Joe's phosphorus levels were low but it was not considered low enough to cause the cramping in his fingers. His phosphorus level was at 1.8 whereas normal is between 2.4 to 4.7. Winton's instructions were that Joe should drink 2 glasses of milk a day. The uric acid and magnesium levels were in the normal range. Joe's calcium level was 9.0 where as normal is between 8.9 and 10.3.

On the way home we stopped at Chili's for dinner on La Vista Road since Pig'N'Chick had not opened up yet where Dusty's BBQ used to be on Briarcliff and Clifton. As we waited for dinner, I went over and gave him a big hug and kiss since I was so happy with the news of today. It was our day to cheer good news and live happy for it, right now, since who knows the future holds.

Progress is the word of the day. Thank you to those who said prayers for Joe and me. God has been listening and we are so thankful.

Ciao and God be with all of you!

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