Merry Christmas! I hope your holidays have been wonderful, and New Year's is yet to come. We spent Christmas day with Molly and her family, and Dave's sister Sandy joined us for dinner. Tomorrow we'll head for the Atlanta area where we will see my brother Steve, Dave's son Dale and their families, and we'll stay with my sister Libbie. Mom is already there with her. We have many friends and cousins in the Atlanta area, and we are hereby making a resolution to get there more often, specifically to spend time with them. On this trip we have family holiday visits and a wedding reception to attend, and will have to be home on the 30th so Dave can get his blood tested on the 31st.
He had blood work done today, and his counts went up a tiny bit. I guess Dr. S. knows what he's doing (ya think?). My current theory is that it's better to have a steady (3 times a week) injection of his medicine than to have a once a week injection. Maybe the spikes in medicine was causing the ups and downs of his counts. He will continue on the 3 injections/week schedule, still at the 50% dosage, get his blood tested again on Tuesday, and hopefully it will continue to improve.
Dave had some severe abdominal pain today, but it seems to have resolved. We called our local family doctor (that would be the inimitable Dr. Chad) who talked us down from an almost panic state. All's well that ends well.
For those of you who want details, Dave's WBC went from 2.6 to 2.8, and the GRA from 0.8 to 1.5. We are happy with the improvement, though Dave is trying to reach 4.1 and 2.0, respectively.
I'll be posting again after Dave gets his counts on 12/31/13. Then it's on to a New Year! Hooray.
Thursday, December 26, 2013
Friday, December 20, 2013
WHAT GOES UP MUST COME DOWN - REALLY?
Our elation at Dave's counts going up two tests in a row came to a screeching halt today. He has dropped down to the same point where, two weeks ago, he was told to wait a week before giving himself another shot. This time Dr. S. is pursuing a different strategy; Dave will continue the next 3 shots - today, Monday and Wednesday at half dosage, then get his blood tested again on Thursday, 12/26/13. The question is will he stabilize at this level? The level is lower than we want it (WBC = 2.6 and GRA = 0.8) but if he can continue treatment without going down more, that will be a good sign.
I wasn't at the doctor's office for the discussion, and being a non-medical person, it doesn't make sense to me. It seems we can fully expect the numbers to drop with more treatments … but, we'll see. I do understand it's worth trying to see what will happen, since it's only for one week. Also, Dr. S. is a very smart guy.
Dave finished his twice-daily shots of heparin this week. Now his bruised tummy will get a bit of a break. The doctor believes the blood clot in his arm has dissipated.
I wasn't at the doctor's office for the discussion, and being a non-medical person, it doesn't make sense to me. It seems we can fully expect the numbers to drop with more treatments … but, we'll see. I do understand it's worth trying to see what will happen, since it's only for one week. Also, Dr. S. is a very smart guy.
Dave finished his twice-daily shots of heparin this week. Now his bruised tummy will get a bit of a break. The doctor believes the blood clot in his arm has dissipated.
Today is Dave's birthday! We had the pleasure of brunch with Mom yesterday; she drove down from Charleston for beignets and an omelette at Huey's and to wish Dave a happy day. This evening we're going out to dinner with Molly, Chad, Chase and Coleman. Dave is going to take a walk, then a nap, and he'll be ready for a steak at Ruth's Chris.
Happy Birthday, Dave!
Thursday, December 19, 2013
COUNTS UP AGAIN
Things are going in the right direction! Dave had his blood tested again yesterday (Wed.) and because his WBC and GRA were both up 0.1, he was told to have another 50% dosage shot last night. He made it through the night without the chills then fever he gets at the full dosage. He will have his blood tested again tomorrow to determine treatment for the next week. With the holidays approaching, and our travel at the end of next week, we all want to be sure Dave is stable. Medically, that is. :-)
Monday, December 16, 2013
COUNTS ARE UP A LITTLE
For the occasional reader, this obsession with blood counts may be tiresome, but for us, it is a major factor in how Dave's treatment is managed. First, the results, then the conclusions -
Dave's white blood cell count went up from 2.2 to 3.1. The expected range is 4.1 to 10.9. The GRA which helps prevent infections, went up from 0.8 to 1.1, with the expected range being 2.0 to 7.8. Both numbers, the WBC and GRA, showed improvement, but both are still lower than what the doctor would like to see.
Also, this improvement came after one shot in the week, and that one shot was at 50% dosage. He is supposed to be have three shots per week at 100% dosage. What we are all wondering is if his body is "saturated" and just cannot absorb any more of the interferon without it causing the problems with his blood.
We're going to try again today. Dave has taken a half dosage shot, and will go back for more blood work on Wednesday. If he's stable, he'll have another shot Wednesday. If not, we have to consider whether to keep up the treatment. What we don't know is if anything less than the standard treatment is effective. If Dave cannot tolerate the standard treatment, does it make medical sense to continue at less than the recommended dosages?
In the meantime, we had quite an eventful week. Dave's sister Candace was here from Tuesday to Friday, and we had fun catching up with her. We enjoyed cocktails at a neighbor's home. We joined a group of 50 Landings folks for a party and trip to St. John's Cathedral downtown to hear the Savannah Philharmonic's Holiday Concert. We took Chase and Coleman to breakfast one morning, and made it to church on Sunday. Dave has been taking 2+ hour naps in order to be able to join in the fun, though of course he still feels weak and tires easily. It's the most wonderful time of the year!
Dave's white blood cell count went up from 2.2 to 3.1. The expected range is 4.1 to 10.9. The GRA which helps prevent infections, went up from 0.8 to 1.1, with the expected range being 2.0 to 7.8. Both numbers, the WBC and GRA, showed improvement, but both are still lower than what the doctor would like to see.
Also, this improvement came after one shot in the week, and that one shot was at 50% dosage. He is supposed to be have three shots per week at 100% dosage. What we are all wondering is if his body is "saturated" and just cannot absorb any more of the interferon without it causing the problems with his blood.
We're going to try again today. Dave has taken a half dosage shot, and will go back for more blood work on Wednesday. If he's stable, he'll have another shot Wednesday. If not, we have to consider whether to keep up the treatment. What we don't know is if anything less than the standard treatment is effective. If Dave cannot tolerate the standard treatment, does it make medical sense to continue at less than the recommended dosages?
In the meantime, we had quite an eventful week. Dave's sister Candace was here from Tuesday to Friday, and we had fun catching up with her. We enjoyed cocktails at a neighbor's home. We joined a group of 50 Landings folks for a party and trip to St. John's Cathedral downtown to hear the Savannah Philharmonic's Holiday Concert. We took Chase and Coleman to breakfast one morning, and made it to church on Sunday. Dave has been taking 2+ hour naps in order to be able to join in the fun, though of course he still feels weak and tires easily. It's the most wonderful time of the year!
Tuesday, December 10, 2013
COUNTS ARE DOWN AGAIN
We had quite a surprise at Dave's Monday check up. His counts were down again. Last Monday his white blood cell (WBC) count was 2.2 and his granulocytes (GRA) were 0.8. He was told to skip his Monday shot, and he was retested on Tuesday. On Tuesday, his WBC was 2.3 and his GRA was 0.9. Those numbers were going in the right direction overnight. He was to skip his Wednesday shot and reduce his dose on Friday by 25%. Monday's results: WBC = 2.2 and GRA = 0.8. So even with a week off of his shots, and a reduced dosage on Friday, the results were just as bad as they were before he was skipping shots and reducing the dosage.
This time he was told to skip the Monday and Wednesday shots (again) and reduce the Friday shot by another 25% (for a 50% reduction from the original dose). We shall see how that works for him.
In the meantime … we did get the tree in the house and in the tree stand. This year, I did the lights while Dave watched. Notice, I did not say he 'supervised.' It was the first time in 25 years I put the lights on the tree. The next day I did the ornaments and the rest of the house decorating. It's beginning to look a lot like Christmas!!
Dave, as usual, is not feeling sick, but he is very tired and weak. We've decided he needs to take serious naps in the afternoon. He has been lying down, but has the television on and therefore does not get good sleep. Yesterday we had a party to attend in the evening, so he did lie down in our quiet dark bedroom and he slept soundly. That was better. This afternoon, I was guilty of getting him out to approve of some Christmas gifts I was contemplating. No nap. Oh well, we'll do better tomorrow.
Dave's sister Candace has arrived and is visiting with her twin Sandy. We haven't yet seen her, but she'll be here later this evening and she'll be staying with us until Saturday. We love to have our family visit!
This time he was told to skip the Monday and Wednesday shots (again) and reduce the Friday shot by another 25% (for a 50% reduction from the original dose). We shall see how that works for him.
In the meantime … we did get the tree in the house and in the tree stand. This year, I did the lights while Dave watched. Notice, I did not say he 'supervised.' It was the first time in 25 years I put the lights on the tree. The next day I did the ornaments and the rest of the house decorating. It's beginning to look a lot like Christmas!!
Dave, as usual, is not feeling sick, but he is very tired and weak. We've decided he needs to take serious naps in the afternoon. He has been lying down, but has the television on and therefore does not get good sleep. Yesterday we had a party to attend in the evening, so he did lie down in our quiet dark bedroom and he slept soundly. That was better. This afternoon, I was guilty of getting him out to approve of some Christmas gifts I was contemplating. No nap. Oh well, we'll do better tomorrow.
Dave's sister Candace has arrived and is visiting with her twin Sandy. We haven't yet seen her, but she'll be here later this evening and she'll be staying with us until Saturday. We love to have our family visit!
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| Dave contemplating my decorating. Hmmmmmm |
Tuesday, December 3, 2013
BLOOD WORK 2 DAYS IN A ROW
It was back to the doctor again today for more blood work to see if the downward spiral had stopped. Dave's white blood cell count was up a fraction, as were the neutrophils. They are still too low, but the slight upward tick was good. Dave is to skip his Wednesday Intron injection (and skipped last night's) and he will begin again Friday with a lower dose (15 units instead of 20). He will have his blood checked again on Monday.
The visit took almost 2 hours from start to finish, and most of the time was spent waiting, but we did see Dr. S and not just the nurse practitioner. Dr. S. is always very thorough and wanted to know how Dave was feeling, he didn't want to make adjustments just on the blood work numbers. Dave does not like feeling so weak, and that added to the decision to skip tomorrow's injection. We'll have to see how a regular routine of a lower dosage works for him.
After leaving the hospital, we stopped to get a tree! Fortunately, the young man working the tree tent put it on the Jeep and tied it on for us. On the way home we stopped at Chicken and Waffles for fortification. When we got home, Dave was able to get the tree off the Jeep and into a bucket of water in the back yard, but then had to go lie down. This rubbery-muscle feeling is not fun!
Dr. S. feels Dave's arm is progressing well, and by that I mean he thinks the blood clot is dissolving. Dave has less than 2 weeks left getting the 2 shots per day of heparin, and hopefully will not have to continue any more blood thinner. He nicked himself shaving the other day, and had to wait forever for a clot to form. Dr. S. suggested he use an electric razor, but Dave is not interested in that change. I'm just glad he didn't participate in No Shave November.
The visit took almost 2 hours from start to finish, and most of the time was spent waiting, but we did see Dr. S and not just the nurse practitioner. Dr. S. is always very thorough and wanted to know how Dave was feeling, he didn't want to make adjustments just on the blood work numbers. Dave does not like feeling so weak, and that added to the decision to skip tomorrow's injection. We'll have to see how a regular routine of a lower dosage works for him.
After leaving the hospital, we stopped to get a tree! Fortunately, the young man working the tree tent put it on the Jeep and tied it on for us. On the way home we stopped at Chicken and Waffles for fortification. When we got home, Dave was able to get the tree off the Jeep and into a bucket of water in the back yard, but then had to go lie down. This rubbery-muscle feeling is not fun!
Dr. S. feels Dave's arm is progressing well, and by that I mean he thinks the blood clot is dissolving. Dave has less than 2 weeks left getting the 2 shots per day of heparin, and hopefully will not have to continue any more blood thinner. He nicked himself shaving the other day, and had to wait forever for a clot to form. Dr. S. suggested he use an electric razor, but Dave is not interested in that change. I'm just glad he didn't participate in No Shave November.
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| Dave, two years ago, summiting Mt. Katahdin, and with a full beard. |
Monday, December 2, 2013
THANKSGIVING AND BEYOND
It's been 12 days since I last posted and Thanksgiving has come and gone. It was a big week, as Dave saw Dr. S. on Monday, Dale married Gina in Jamaica on Tuesday, we had Thanksgiving dinner with Molly, Chad, Chase and Coleman in Savannah, then on Friday we went to Molly's beach house on the Isle of Palms with Molly and the boys. Chad had to work so stayed in Savannah. Friday evening, Mom, Libbie, Jon and David came out to the beach and we were able to have dinner together. Saturday, Jon and David left to go home to Houston, and Libbie left for her home in Hoschton. We stayed until Sunday.
Dave has been injecting himself with heparin twice a day, and his Intron every Monday, Wednesday and Friday. The good news is that he seems to have overcome the chills and fever he was getting after the first few shots. His routine is to take his shot at 8 pm, turn on his heating pad, and get into bed not long afterward. He's been sleeping about 10 hours a night.
The not-so-good news is that his white blood cell count is down again. It was on its way down when Dave saw Dr. S. last Monday, and it was down farther today. We saw Rosemary this morning and she told Dave to skip his Intron shot this evening and come back for more blood work tomorrow. We were hoping Dave's WBC wouldn't dive so quickly. Now Dr. S. has to decide whether to reduce the amount of Intron Dave is taking, or stop it.
Dave is actually feeling pretty well. He generally has overall muscle aches the day after his Intron shot, and he is very weak and fatigued, but he does not feel sick. Not a lot of food appeals to him and he has dropped a few more pounds (he is down 12). The only thing that seems consistently good to him is the homemade peanut butter a dear friend makes for him. He has no taste for his beloved Scotch or even red wine, but a glass of white wine will do. So unusual for him!
I was hoping to get our Christmas tree today, but with Dave's appointment with the nurse practitioner, then having to pick up and deliver meds and contacts to Sandy, it was all he could handle. We had taken two cars, so I scooted off to get a couple of fresh garlands and a table wreath for my advent candles. Maybe tomorrow? Dave will have had 4 days 'off' from the Intron and I'm hoping he will start feeling better and of course that his WBC count improves.
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| Coleman and Dave |
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| Dave and David - Cheers! |
The not-so-good news is that his white blood cell count is down again. It was on its way down when Dave saw Dr. S. last Monday, and it was down farther today. We saw Rosemary this morning and she told Dave to skip his Intron shot this evening and come back for more blood work tomorrow. We were hoping Dave's WBC wouldn't dive so quickly. Now Dr. S. has to decide whether to reduce the amount of Intron Dave is taking, or stop it.
Dave is actually feeling pretty well. He generally has overall muscle aches the day after his Intron shot, and he is very weak and fatigued, but he does not feel sick. Not a lot of food appeals to him and he has dropped a few more pounds (he is down 12). The only thing that seems consistently good to him is the homemade peanut butter a dear friend makes for him. He has no taste for his beloved Scotch or even red wine, but a glass of white wine will do. So unusual for him!
I was hoping to get our Christmas tree today, but with Dave's appointment with the nurse practitioner, then having to pick up and deliver meds and contacts to Sandy, it was all he could handle. We had taken two cars, so I scooted off to get a couple of fresh garlands and a table wreath for my advent candles. Maybe tomorrow? Dave will have had 4 days 'off' from the Intron and I'm hoping he will start feeling better and of course that his WBC count improves.
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