The latest numbers are in

Went to Conlon this afternoon. Vlad's numbers are very low again, but it's expected. His white count is 800, hemoglobin is 9.7 and his platelets are 18,000, which is extremely low. He's got to get a platelets transfusion on Thursday, and depending on his RBC count that day, he may need an RBC transfusion as well. This is all expected.

The only small surprise is Conlon said he expects Vlad will be out of the hospital more like 4 weeks than 3 weeks between chemo treatment #1 and chemo treatment #2, anyway. If it's all the treatments, well, multiplied by 4, then that means possibly an extra month of this fun. We shan't speak of it anymore. But at least this way we're pretty much assured of his being healthy enough to go to Fort Worth for Mother's Day weekend.

In the past couple of days, Vlad has started the decline toward nadir and he's not as peppy, his eyes look "sick" and his mouth is starting to get sore. He's rinsing orally with hydrogen peroxide as a preventative. Conlon said to refill the Levaquin antibiotic. That a $60-a-pop prescription. Last time he prescribed only 10 pills. $6 a pill. I hope it's worth it. Update: The $60 refill was for 7 pills!

The short-term disability people sent Vlad two checks and then stopped, saying they wanted more information to make sure this was not a pre-existing condition. I think the papers said, "Bring me the broomstick of the Wicked Witch of the West." We gathered all the papers and prodded doctors to fax their copies. Then Vlad called and annoyed a few people until the disability gatekeepers were satisfied with the quantity of paperwork. Now we're waiting on an analyst to approve the quality of the paperwork. Blah, blah, blah, blah. We've started pushing through the long-term disability paperwork. I'm just so thankful he's able to handle some of this stuff. I'd be in the loony bin if I had to do all of it. And I'm thankful we can handle this crisis financially by sacrificing only our big Hawaii 5-0 vacation. There's some prayers answered, lemme tell ya.

Anyhoo, I'm so behind at work it's laughable. But it'll work out somehow. In the meantime, I'm incapable of holding a thought for more than 15 seconds. I haven't had any Shiraz in about two weeks. Maybe that's my problem?

Neutropenia looms again

Conlon said Vlad's white cell count is 1.2 today; for all practical purposes, he's neutropenic again. He feels OK, though he's a little less OK every day, which is normal. He's having very intense cold sensitivity in his fingers and toes. He cannot touch anything cold, like stuff from the fridge. My friend Linda had the same side-effect after her chemo for colon cancer several years ago.

We finally had to say "no" to going to Sasha's birthday party Saturday night at Russian Bear. Vlad's going to have a lower white count by then. He'd be a sneeze or cough away from a fever and being forced back into the hospital. Too many sneezes and coughs at the restaurant.

Bill called and we talked a long while. He's a real comfort.

My PC is not happy. I worked at home today, but it was difficult with all the crashing software and rebooting. I'm going downtown tomorrow to work.

We'll be home this weekend, working on our cabin fever.

He's home

Vlad's home safe and sound. He had his last round of chemo today and we left the building around 4 p.m. He's feeling fine.

The Prodigal Keezee

Mr. Keezee returned on my last check before bed last night. I fed him and then there was a purrfest before bed. He's staring at me as I type this. And he's already had breakfast and been out this morning. He's saying, "Lady, it's spring. There are birds to chase. There are anoles to chase. To say nothing of that black cat smart ass who thinks he owns this block. Tick tock tick tock."

I got to get downtown anyway. Vlad started his 2nd chemo this morning. I'm emotionally on the edge. I don't like this about myself. Vlad sounding pretty good.

Late for an important date

Some kind of communication snafu between Conlon and/or nurses and pharmacy pushed Vlad's 5th chemo drip until after 9 p.m. We had quite a scare around 6:40 p.m. when it became apparent no one was going to give him his 6-6:30 p.m. chemo tonight. Not knowing how important the timing was, we didn't know how serious the problem was so we freaked. Earlier this evening, the day charge nurse said as long as he got it by 8 p.m., it would be OK. Well, it was after 9. What does that mean? Maybe Conlon will enlighten us.

We've felt so confident with the staff here. But tonight it was such a frightening freefall. Like nobody was in charge. Nurses blaming the pharmacy and Conlon. You know, we just want the medicine. Quit yer yappin' lady, get him the drugs. We called Conlon and they paged him twice but he never called us back. Very disappointed. Very, very sucky day.

And no Keezee. I hate it when he vanishes. Especially when I'm alone. Heartless alley trash!

Sunday afternoon

Vlad is doing pretty well. Today he's taking his 24-day break from chemo, which will end in about an hour and a half. The final round of this first hospital round begins around 6-6:30 pm. He should be able to go home tomorrow afternoon. He's finding this regimen of Ara-C makes him crankier, a little nauseated and he's got constant heartburn. The biggest thing is the hiccups. It's a side effect. He's been hiccuping off and on since he started. But his appetite is strong.

I'm pampering his feet today. A foot soak followed by some minor sloughing and a moisturizer treatment. Maybe he'll return the favor when he gets home?

I didn't get here till 3 today. I'm moving a lot slower today than normal. Trying to preserve my energy and keep the stress levels down. Ifind the slo-mo technique helps. I need to go to the office tomorrow and Tuesday because of meetings. That'll eat up a lot of mojo. The commute alone is insanity. OK, enough whining.

Can't wait till he's home tomorrow!

Chemo begins

The consolidation chemo drip began around 6 p.m. It's supposed to be 12 hours of Cyterabine (also known as Ara-C) every other day. The bag went dry around 10:30 p.m., so I presume he'll get a new bag.

We're getting new information every time we ask a question. So it goes with cancer. Anyway, nurse Ruby, a delicate and gracious person who I think could, if necessary, wrestle a tiger to the death, said his last dose of the Ara-C would be Tuesday morning. So Vlad's already a day later getting home than we guessed. The chemo warning on his door says he's in until 4-23, which is Wednesday. Hard to tell where the real story is.

I went up for a little while. He was in a much better frame of mind than earlier. He felt bad about his whining on the phone. He also had to cut short a phone conversation with my brother, Bill, because the nurses et al were messing with him and he was in pain. He's going to call him back Friday to reconnect. I dropped by the grocery store to get him some bottled water, chamomile tea and Splenda to take tomorrow. I must go downtown early tomorrow. My PC is acting up. Everything always falls apart the minute he leaves. Sigh. Now who's whining?

Long day

Just finished my work. Have too much left to do for tomorrow. I'm headed to the hospital soon.

Vlad called earlier. They put in a central line. It was much more painful this time than last. The nurses were having to call the doctor to get permission to give him pain meds for the minor surgery. This kind of ticked me off. Why didn't they get this ahead of time? When he has this pain he tends to magnify everything bad and he tends to keep frustration too close. He's got four months of this. I wish I knew better how to keep his stress levels down. And mine, ha.

Deja vu all over again

He's baaaaack.

Same room. Same phone. If you need a refresher: 1013 and 713-778-7073. Clementine was again there to welcome us. Saw Andrea, who calls everybody "Mama" and "Daddy." She's always a delight. We got him moved in with much less stuff.

For the moment, he's bored. He's waiting for them to put in his central line, after which he can eat some lunch. (Or dinner as the case may be).

I came home to work. I plan to go back up tonight. I also want to finish the borscht he started. I've never made it, but I've gotten good instructions. I'll probably have to do the borscht this weekend, though.

Anyway, here we go ...

REMISSION!

Vlad is officially in remission!

We were at Conlon's this morning and got the good news. He said there had been no increase in blasts, which means it looks like he's in remission.

But it's not the end of the chemo. He's going back for four months of "consolidation" therapy, Part 2 of his chemo treatment. I am not familiar with this version of the consolidation, where he goes for 5.5 days of chemo in the hospital, then goes home for three weeks, and repeats this three more times. He would be taking a higher dose of the Ara-C than before, "like a booster," Conlon said, to knock out any more leukemia. During his three weeks of recuperation at home, he'll need to go in for transfusions. Also if he develops a fever, he'll have to check back in to the hospital.

So mid-August, with a little luck and a lot of prayers, this chapter may be over. Yes!

We took some Russian candy to the nurses while we were in the neighborhood. They are so amazing. They were thrilled about the remission. And crying. One was ribbing Vlad about the Rockets' horrible performance last night. Ah. We'll seem them Thursday. We ran into Dr. Mallick in the elevator, who was also happy to hear the news.

Must get back to work now. Vlad's making stuffed peppers for tonight. We've invited some people over to celebrate.

Busy weekend

I hit the farmer's market and Central Market Saturday morning. Got all kinds of healthy veggies and such. We met Pat and Carol at Phoenicia for lunch on Saturday. It was mondo yummy. Got more groceries there. Been working on and off all weekend. Vlad got a new laptop from eBay and has been playing with it for a few days.

Today we went to Galveston for lunch and to look at the ocean, say hi to the pelicans and get a gander at the cruise ships before they took off this evening on their weekly voyages. Carnival's Conquest and Royal Caribbean's Voyager were in port. Both are beasts. Crazy big ships. The weather was great but it was too windy to enjoy the beach. We went back through LaMarque and stopped at the sad little outlet mall there. There's a fantastic kitchen store in there. They have stuff I've seen at Central Market for a third of the price.

We came back home. Vlad grilled up some free Central Market salmon and I made a salad from hydroponic tomatoes and buffalo mozzarella with fresh purple basil and Italian parsley. It was pretty tasty. Vlad was watching the Rockets struggle with Denver a bit ago.

We were trying to talk about the future today. Where to go on vacation next year. Stuff like that. We found we had to stop. It's like it's too far behind the wall we've both put up. The wall that keeps out the bad thoughts and the crying. This situation is so incredibly complicated emotionally. But all things told, we're doing very well.

A week ago today ...

Vlad has been home a week today. He's doing really well. A little less hair, but back to his old self, if a tad weaker for the moment.

Thursday, April 10, was a day to celebrate. It's not only my sister's birthday, it's the day Valiya got her new car, which Vlad helped broker by phone in the hospital from "his" Lexus guy Art. This is the 5th Lexus he's made the deal with through Art. Making the deal is Vlad's passion, but, like Hyman Roth in "Godfather II," he always makes money for his partners. So Art is always glad to see him coming with another ex-Ukrainian needing a nice car.

Valiya's RX-350 is a 2009. Two weeks ago it was in Japan. It had 4 miles on it when she got in. It's beautiful. Matador red with a beige interior. It has little individual washers for the headlights. Hysterical. It's a beautiful car.

We went over to their house last night briefly for a light meal and to drink to the car and to her mother, who passed away three years ago April 10. They were close and her passing is still a hard thing for her to talk about. Vlad, I, Valiya and Sasha shared the dregs of the Nemiroff vodka, which they brought back in 2006, when we all were in Odessa. Barely one shot each. A gathering of Russians is almost always ceremonial.

Another big wait begins

Thanks everybody for the comments and phone calls! And congrats Ginny for going braceless!

Vlad indeed had his marrow biopsy today. And despite my calling him every hour before the appointment to assess whether he needed a chaperone, he went on his own. His white cells are 5.o, his hemoglobin is 13 and his platelets are 5,000. (Correction: Actually platelets are 500). Pretty close to normal if not normal. Conlon said the fact his mouth has healed so quickly is a sign his blood is rebounding quickly.

What we don't know yet is the number of leukemia cells that are still in his blood. That number will determine whether he's in remission post-chemo and will go directly to consolidation therapy, kind of the last stop on his AML chemotherapy train. If the leukemia cells' numbers are too high, he'll go through the induction therapy a second time. Then he would presumably go to the consolidation therapy after that.

This explains things better:

The first round of chemotherapy usually does not get rid of all the AML cells. Most patients will need more treatment. Usually the same drugs are used for more rounds of treatment to complete induction therapy.

More treatment is usually needed even after a patient with AML is in remission. This second part of treatment is called consolidation therapy. It is needed because some AML cells remain that are not found by common blood or marrow tests. Consolidation therapy is also done in the hospital. As with induction therarpy, patients may be in the hospital for three to four weeks, or sometimes longer. Consolidation therapy may include chemotherapy with or without an allogeneic stem cell transplant or autologous stem cell transplant.

He goes back Monday and should get the test results then. This will be a very big milestone.

All's quiet

Things have calmed down a bit. No double trips to the hospital. No frantic vacuuming. Less sneezing and coughing.

Vlad is doing well. He's weak. And he's tired of being weak. The hair is falling out slowly. He drove to the mailbox today and it tired him out briefly. He's got some numbness in his toes. Don't know whether that's circulation problems or some chemo side-effect. His fingertips still ache from a month of blood glucose tests in the hospital.

Tomorrow he goes to see Conlon. We think it's the marrow biopsy. I'm a little concerned about him driving himself down there and back, and walking through the maze of the med center. He assures me he'll be fine. Yikes.

Scott from McGrath Pest Control came to check the rat traps again today. No rats, dead or otherwise. He said he thinks we're ratless, but left the baited traps in the attic for good measure.

Vlad and I have kept everything very clean so far. Keeping fingers crossed.

Back to normalcy

Had a great weekend. Vlad is improving, feeling pretty good, eating everything in sight and overdoing things slightly. His mouth is much better. More hair falling out. He's starting to look a bit "fuzzy" on the head.

Mom cooked a pot roast Saturday night. We had some champagne to celebrate Vlad's homecoming and ate the meal on the china. We inhaled it all and we all were asleep by 10 p.m. Real party animals.

Mom left before 9 a.m. today and arrived safely home in Fort Worth. All were very happy to see her, none moreso than the family dog, Pepper. Bill left around 2 for Austin after we had a great fish feast at Goode's Seafood Co., on I-10.

I had psychotic fears the house would implode immediately into a huge dump of dust and clutter within hours of my mother's departure, but so far, so good. We've been relaxing and puttering to keep it clean and picked up most of the day.

My cough is 90% gone. Had more rest today than I've had in weeks, which helped.

Got lots of wonderful calls today from Aunt Katie, Sasha, Liliya, John among others.

Vlad has a doctor's appointment Wednesday. We think it's for the post-chemo bone marrow biopsy, but we're not sure yet.

Home sweet home

Vlad arrived home around 11:30 a.m. How sweet it is. Mom and Bill here tonight with us. John dropped by briefly with Anna. We're all going to bed early. We're exhausted and thrilled.

Going home

Conlon released Vlad this morning with a 2.0 white count. Whoo hoo! Sometime this later this morning I'll go pick him up. He had become quite ensconced there nearly a month's time, and Mom and I took two overnight bags of books, snacks, hats, cards, a radio and more out of there last night. I have another suitcase for today.

We are so happy!

Almost there

Vlad's white cells are 1.7! Platelets at 173 (isn't that X 1,000?), up from 120 yesterday. And hemoglobin is 9.6, up from 9.2 yesterday. We still do not have the all-important neutrophils number. But a white cell count over 1.5, I believe, means he's out of neutropenia. There was a lot of activity this morning at the hospital leading us to believe he may be checking out today, but it's after noon now with no official word, so I think it will be tomorrow.

Vlad ate a huge breakfast and is ready to get out. He said goodbye to Rafael, one of the patient assistants (my personal favorite), who's off till Monday.

I'm working from home, still hacking. Mom's doing better. Cleaning everything in sight.

Looking to the weekend

Vlad had a very good day. (And it's the first day I have not visited; hmm.) Valia and Sasha went by tonight with mashed potatoes and fish cutletas. He was so happy that he could actually chew again. Dr. Malick and the palliative care nurse, whose name escapes me, both visited today and congratulated Vlad on his impending Friday departure. That doesn't make it official, but it does lend credence to the rumor.

I worked from 8 to 4. From about 8 to 9 Jenny briefed me on what I missed. Oy vay. I did pretty well until about 2 pm, then started hacking like a smoker. Stuck it out till 4 and headed home instead of the hospital. Laid down for awhile, went to dinner at the grill around the corner with Mom and we went to buy a few groceries. Been resting since. Not a lot better. Never heard about the chest X-ray. Probably nothing.

Will be at the hospital in the morning to talk to Conlon, then to the office. I don't know what Friday will be like. I imagine they'll start the process of releasing him in the morning and he won't actually get to leave until late afternoon. I'll probably just go to work and hope I'm not needed until later in the day. We'll see.

Bill comes Friday evening and Mom's staying until Sunday morning. So there will be a full house this weekend. And there's still loads to do. But this place looks and breathes much better. Poor Mom's been hacking today. The dust finally getting to her.

Friday is D-Day

White count up to 1.4 and "a few neutrophils" coming on the scene. His platelets are way up, which is an indication the marrow is back in business. Conlon is all but promising a Friday release!

All about the numbers

White count up to 1.3 today! Vlad's feeling much better. They didn't do differential blood tests this morning so there's no neutrophil count to report. Platelets are up, however. Yay.

He ate more today than he's eaten in at least two days. His mouth sores are diminishing slightly. This first round appears to be abating. Hold that thought tight!

I'm going to work tomorrow for the first time in more than two weeks. It will be strange but I look forward to it. I feel better today. Felt great until about 4 p.m. when the cough returned. But doing better now. Vlad's room is a toasty 80 degrees these days, which may be part of that problem.

Cautionary tale du jour: Mom locked herself out of the house this morning for about an hour and a half. I was sleeping with vicodin cough medicine in my veins and plugs in my ears and couldn't hear her knocking or honking the car horn. A neighbor did and offered her a cup of coffee and to drill through the door knob, but Mom declined both kind offers. I felt horrible of course, especially because I hadn't told her where the spare key was kept. I told her it was OK if she went home today. She declined that offer also, and said we'd laugh about it one day.

You're asking why didn't she call? She didn't know the number. I don't know too many people's numbers myself anymore. My mother is "4" on my cell phone. My husband's cell is "2" on my cell, home is "17" and his work is "77." This doesn't help when you get locked out.