ggt!!!--part 4

i was admitted to the world renown juravinski cancer centre on oct. 24 after having my first bone marrow test the day before at the oakville-trafalgar hospital, and getting my diagnosis that evening (oct. 23). upon admission i met alix duck, the wonderful nurse practitioner whose daily care i have been under since the 24th. she's the closest one can be to being a dr without being a dr...and she's wonderful! so confident and compassionate and caring. her confidence in my care makes it impossible to feel anything other than safe and cared for. in fact, that's the kind of care i've received from every nurse and dr and nurse's aide and environmental aide...everyone is sooo positive and encouraging and accommodating! bottom line, everyone here at the juravinski goes out of their way to administer top notch care; attention is never divided and you're made to feel that you're the only patient in their care.

upon admission, alix asked me what i knew about my admission here. i told her i knew i was here to receive 30 days of chemo treatment and monitoring for infection. she elaborated by explaining that my chemo treatment would begin the next evening once tests had been done to see what kind of treatment i could handle. over the next 24 hours they would determine that my chemo treatment would be 24 hours a day, for 7 days. for 3 days for 30 minutes i would receive a drug called daunorubicin. i would also be receiving the drug cytarabine 24 hours a day for 7 days. because i have youth and health on my side, they felt strongly that i could handle aggressive treatment. the evening of my admission i also met my hematology oncologist, dr. brian leber--a soft spoken, brilliant man of medicine doing world renown cancer research and treatment. with every meeting and every person, i had the recurring feeling that i was in good hands...not to mention the fact that i feel strongly that God's hand is guiding everyone here :-) after all, this time in my life is in His hand :-)

a little more than 48 hours after receiving my diagnosis of acute myeloid leukemia my treatment began. i got chemo for 24/7. my side effects were minimal. i didn't suffer from the very common nausea side effect and i didn't throw up once--in fact, my appetite really only got a bit smaller, but i still got hungry and had cravings :-) i eventually lost my hair, i had some bowel issues, i lost my sense of taste, and i had a touch of mucositis, but i came through the treatment largely unscathed compared to some people.

like my oncology team predicted, my numbers went up and down and i occasionally required blood and platelet transfusions, and occasionally they would give me something to lower my phosphorus or raise my potassium, for instance, but after my numbers dropped they started to come back up. on day 18 the dr came in my room at 11:30 in the morning to give me the results of my second bone marrow test and he said my numbers were coming up days earlier than usual. i was showing increases on day 18 that they normally don't start seeing until day 22. he said my body was beginning to reproduce healthy white cells which was the goal since my body was previously only producing useless, baby white cells called blasts (which don't do anything except take up space in the bone marrow, forcing healthy red blood cells and platelets out into my blood stream). he also said that they don't typically see post inductive chemo patients eating greasy chicken wings from kfc at 11:30 am like i was that morning :-) he said, "you are motoring through this," and he knocked on wood. this was on nov. 11. what he may or may not know--or be willing to admit--is that God has got this :-)

around the middle of november, i did spike a fever which required some antibiotics. unfortunately, over the course of a week or a bit less, i had 2 bad reactions to 2 antibiotics--meropenem and cipro--so bad that i had 3 different rashes and because my platelets were so low i also bled into the rashes--something called petechial hemorrhaging. it was pretty ugly looking. i created some interest and had a couple infectious disease doctors in to see me, and they came with some pharmacists...and they asked to take pictures :-) pretty sure my backside is going to end up in a medical journal somewhere :-) during this time, arrangements were also made for an allergist to come in and test me for the family of antibiotics i wa reacting to, as well as for penicillin since we didn't know for sure where i stood with that allergy. we found out that i am not allergic to the family of drugs that meropenem is from, nor am i allergic to penicillin any longer, opening up the antibiotic possibilities for the team caring for me. a third attempt at an antibiotic proved a charm; i successfully responded to tazocin and over the next couple of weeks the side effects of my reaction gradually went away--with the help of lots of benedryl to minimize the itch :-)

i was due to get out friday, nov. 23, but on tuesday evening, nov. 20, dr. walker--the head of hematology here--came into my room and said, "how do you feel about getting out tomorrow? there's no reason for you to be here any longer." he explained that they were confident they had gotten 99% of my cancer cells and explained how the next few months would play out as they go after the remaining 1%; about every 30 days i would come in for a 5 day cycle of chemo treatment, then would be released. each time my numbers would be expected to drop again and i might possibly have to come in for more transfusions, or if i spike a fever...but at this point i could go home because everything was going so well.

the next day, before i was discharged, alix came to do a third bone marrow test (let me interject to say that they don't get any easier physically...i think psychologically they get worse because you know what's coming, but they are a necessary part of assessment and treatment). this would provide valuable results that would be made available to me the following week as i would be coming in to see dr. leber for follow up and to confirm my consolidation therapy. at the time of my follow up appointment, dr. leber explained that i was in the highest bracket possible for excellent prognosis. blood work from that morning also indicated that in less than a week my white cell count had gone from 3.4 to 5.1, hemoglobin had gone from 84 to 106, absolute neutrophils had gone from 1.3 to 2.6, platelets had gone from 315 to 587, and all my chemistries and bone marrow test came back normal. another bone marrow test was scheduled for thursday, nov. 29, and i would also be admitted for a 5 day cycle of chemo--phase 1 of my consolidation therapy--and would receive chemo on days 1, 3, and 5. the bone marrow test was being conducted this time so they could extract a sample for the purposes of pinpointing a molecular disorder they had detected, and for which they required a fresh marrow sample to study. the results of this test are still pending but once known, my team feels they will know the cause of my leukemia and will be able to fully complete my treatment.

i know this has been a long entry, but i just want to complete this post by adding that in the 8 days i was discharged, i was able to enjoy time at the house with my sister and niece who had come to visit, go out to the grocery store and walmart with my mom, do some christmas decorating, and visit with people in a non-hospital setting...in other words, i was able to live pretty normally :-) i also went to see the walk-in clinic dr (who was instrumental in getting me in the hospital initially) to secure her as my family dr. she remembered me and gave me a big hug and said she would love to have me as a patient and that she was relieved i was ok and looking so well :-)

i am blessed to be on this journey because i am learning to trust...God and people. i am learning to lean...something i have never been inclined to do because i have always been so fiercely independent...but i have come to the awareness that doctors and nurses and medicine and hospitals aren't scary after all :-) i'm learning that i need to sometimes shut up and accept help and things from family and friends. i'm learning that God really won't give me more than i can bear. i am the wimpiest person on the face of the earth, with no pain tolerance or stomach for anything, and yet somehow i am bearing this :-) maybe not always silently or graciously (yes, i have been sometimes vocal and have had choice words during a bone marrow test--ask my mom :-) ), but i am bearing it with God's help and with the help of all the prayers and encouraging words and thoughts from family and friends and even strangers.

after all, it's just cancer...

and God's got this!