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Thursday, July 3, 2008

Day +176 Good Numbers, Phlebotomy

All my blood line counts are up from last month! See the blog page. Even my white cell counts are up a tenth. At today's appointment Dr. Andrey said the whites always come up slower because T-cells have to get 'educated' by the lymphatic system, Lymphatic U., so to speak. Dr. Andrey was very positive about my progress. He did say, for the first time, that he thinks I am definitely experiencing some minor, chronic, GVHD symptoms. These are: dry eyes, dry mouth, some facial rash, and some skin itching (without rashes). This means he wants to keep me on Tacrolimus for the time being. Supposedly, if I were not taking Tacrolimus, these GVHD symptoms would be more pronounced. These kind of symptoms generally disappear as the new immune system becomes accustomed to it's new surroundings. So I am to drink lots of fluids, use the 'Tears II' solution in my eyes from time to time, and occasionally employ the bamboo back scratcher that I obtained in a tropical drink years ago in Waikiki. The GVHD symptoms are very minor so I feel very lucky. However, even light symptoms are considered a problem because it does not take much to cause the new immune system to overreact in unpredictable ways. That is the reason SCT patients are told to stay out of the sun. A common sunburn can cause the new immune system to go bonkers, to start mistaking good skin cells for alien invaders. It's kind of a a tight rope for the first year after a SCT. The new immune system is kept mellow by the Tacrolimus and eventually learns to discern friends from foes on it's own.
My Ferritin level tested out at 3132 ng/mL. Normal range is 10 to 291. All those blood transfusions the last 2 years loaded up my system with iron (Fe). The body has no way of getting rid of iron once it enters the vascular system. The excess iron gets stored in places where it doesnt belong, eventually damaging organs. With my newly functioning red blood cell system able to make lots of blood now, the way they get rid of excess iron is to perform a phlebotomy, not to be confused with 'lobotomy' where they snip the connection between the prefrontal cortex and the rest of the brain. In the phlebotomy procedure a nurse inserts a needle into a vein in your arm and drains a quantity of blood. Starting today I will have this done weekly for around 16 weeks. Each pint of blood removed will eliminate 1/4 gram of iron. The blood, of course, is useless and cannot be donated. It is thrown away. How strange. I went from needing blood for 2 years to now needing to get rid of it. In 16 weeks I should lose around 4 grams of iron, bringing my Ferritin level down to normal. The 1 pint drained each week represents only about 6% of my circulating blood, so I will only feel slightly fatigued during the period. Not to worry, I am used to feeling much more fatigued because of the chronic anemia I experienced for more than 2 years.
With all your help and support I will continue to try to beat the odds and stick around a while longer! Thank You!

3 comments:

Mike B said...

I guess you never know how those drinks in Hawai will pay off.

I am so happy for your continued good progress. Those blood counts look great.

Loosing a 1/4 gram of iron in one pint of blood--wow.

Keep up the good work.

Mike

Katy & Larry said...

Well hey, it comes and goes, ebbs and flows, etc, etc, what can I say it's the circle of life! I guess you've just found a detour and taken a new route. Good news on the other blood counts, can't wait to see you for ourselves at the end of the month.
K&L

Anonymous said...

JIM... I love hearing that things are going well! Your counts are great! I know you can overcome those little pests along the way! Love you and cant wait to see you soon!!
Shelli