Day +91

Photos make blogs more fun. Today, I didn't have a good photo to post, so I dug up a silly and random photo from the past especially for your entertainment.

We went to the hospital today, and aren't due to go back until Friday. Joe's rash - the main issue we've been focusing on for quite some time now - seriously seems to be getting better now. Although, it is still pretty severe. Joe is being kept on the same amount of steroids for now. The doctor fears that tapering too soon will cause the GVHD to flare up again. If that were to happen, the doctors would look to other drugs for treatment. In fact, even if Joe's rash continues as is for too long, other treatment options may be implemented - and they don't sound like fun. So please, let's pray that the rash stays in control, and in fact, continues to get better. We are indeed grateful for some GVHD, and we are very thankful that the GVHD has limited itself to the skin, but I think that it has worn out its welcome. I'm sure Joe would be quick to agree.

Other than that, and the fact that Joe constantly looks like he has an atrocious case of dandruff (despite having very few hairs) Joe is doing well. All of that hemorrhagic cystitis business has gone away, Joe's feet and ankles are back to looking svelte, and I'm seeing more of his smile!

Oh yes, Joe's blood draw. His WBC was a whopping 0.8 k/mcL (normal range= [4.4-11.0] k/mcL.) So Joe had another Neupogen (filgrastim) injection today. The lowness of the count may be connected to GVHD. It also could be due to a relapse - although everyone is pretty confident that is not the case. Just two weeks ago, Joe's chimerism test showed 99% donor. He did get another chimerism draw today, so we'll find out later this week how female Joe is now. Think 100%! On the positive side, Joe's hemoglobin continues to be good, and his platelets keep creeping up ve-ry sl-ow-ly.

One more thing. Over the weekend, Joe did a lot of sleeping. The thing is, most of his sleep happened during the day. The steroids seemed to work their magic at night when most people are sleeping peacefully and dreaming of vacationing in Fiji. Yeah, when he should have been sleeping, Joe was unable to. Not having to go to the hospital made it that much easier for Joe to sleep straight through the morning. I kept joking that I needed to ship him to Taiwan where the time difference would make his sleeping pattern normal! Thankfully, Joe fell asleep at a regular hour last night, so I think I might be able to keep him in the States for a bit longer.
~~~
Happy happy belated birthday to Shelley!!!!!!! Hope you had fun celebrating your Easter birthday.

I waited patiently for the Lord; he turned to me and heard my cry. He lifted me out of the slimy pit, out of the mud and mire; he set my feet on a rock and gave me a firm place to stand. He put a new song in my mouth, a hymn of praise to our God. Many will see and fear and put their trust in the Lord.
~Psalm 40:1-3

How sweet it is...

First, the not so fun stuff. Joe's rash became increasingly worse over the weekend. Yesterday, his body was covered with red patches and spots, and his skin was flaking more than ever. Joe actually looked like he had a white beard because the peeling was so bad. Several times a day Joe goes through the ritual of slathering himself with lotion. I get the privilege of getting his back. Over the weekend, we resorted to good old petroleum jelly. It is working better than any lotion, but the effect still wears off within a few hours. It is really amazing. If I used a quarter of the amount Joe uses on myself, I'd look like an oil slick and then completely break out. Or, I'd look like a wannabe body builder. Last night it became pretty unbearable. Joe contacted the doctor who further increased Joe's steroids. Again, the increase is hopefully very temporary. Please pray that as Joe's GVHD is treated that he continues to test negative for CMV! (Friday's draw did test negative. Yay!) The increase did seem to help. Joe's rash was bearable today.

Joe's WBC continues to be low. We're hoping to see it go up by the end of the week. Joe got a Neupogen (filgrastim) shot today. That usually boosts his WBC for a couple days. Joe's platelets are creeping up ever so slowly. I consider that a good sign. The hemorrhagic cystitis is much better now, and the edema in his feet and ankle area seems to be better too.

We were not scheduled to go back to the hospital until Thursday. But then the doctors decided Wednesday would be better...and then they changed their minds again, so we'll be back tomorrow. That is okay. We did have the whole weekend away from the hospital!

Now for the more fun part. Our weekend was lovely. We got to spend some time with Joe's parents on Friday evening. Then on Saturday my parents and my brother joined us for lunch. It is always nice to spend time with our families. Saturday night, Joe was glued to the TV, thanks to college basketball.

On Sunday, Joe slept the day away. He was not awake for more than 30 minutes at a time until 6:30pm. Poor babe was absolutely exhausted. He finally woke up and promised to stay awake for at least three hours. Later in the evening, the doorbell rang. I was absolutely shocked to discover six of our friends from fellowship grinning from ear to ear outside our door. They brought us a beautiful cake. They didn't even complain when we made them stay huddled by the door since Joe's counts are still low. It was a great surprise to see them, and Joe was thrilled to see some familiar faces outside of the family. By this time, Joe was a bit wired from his steroids, and the two of us ended up reminiscing about our wedding day and other fun things until close to 3am. Ooops. That's okay, when we got to the hospital, we discovered that the doctor forgot to write orders for Joe to go to short stay, so we had to wait extra long. Joe got a little cat nap in the waiting room!

Today we did sappy squishy anniversary things like look at all of our photos and videos, and eat cake! The shirt Joe wore was my gift to him. It makes me smile!

Congratulations to Michael and Judy who got married on Saturday!

Thank you to Nancy, Bill, Evan, and Elijah for the gift. You guys put a huge smile on our faces! (Happy belated anniversary to you!)

Thank you to my Taichung Aunts, Uncles, and cousins for the card. And special thanks to my 3rd auntie for the handmade bear charm (so cute!) and generous gift.

Thank you to Caryn and Roia for serenading us over the weekend. You two are too funny.

Thank you to Eric, Vivian, Louis, Sha, Crystal, and Patrick for the big surprise! You guys are wonderful!

Thank you to Sha for the thoughtful gift and always treating us like royalty!

Thank you Joy, Jerry, and Alex for the very sweet card. We miss you and can't wait to see how much Alex has changed!

Many waters cannot quench love; rivers cannot wash it away.
~Song of Songs 7:7a

Day +79

Yesterday's visit to the hospital was relatively quick and painless. Our friend Marcus is doing a rotation at the hospital, so he provided some entertainment while we were there. Joe tested negative for CMV again. Yay! This is really wonderful news. With Joe's counts and the drugs he is on, the doctors would have preferred to keep Joe on Foscarnet, at least a few times a week until Day 100. Since Joe developed a side effect, the doctors are keeping him off everything used to treat CMV for now. If Joe were to test positive again (and we know that he will NOT), there is a third drug (after Ganciclovir and Foscarnet) that would be used as treatment.

The not so fun parts of this week are that Joe's GVHD rash seems to be getting worse again. As you might recall, his skin was peeling like crazy, but the rash seemed to be healing. The peeling continued in waves, and the rash continued to look better. As the rash got better, the steroids were tapered more and more. Over the weekend, the rash started to look more pink again. Now, it seems that the rash is back with a vengeance, and Joe is itching like crazy. He calls it alligator skin. Yesterday, the steroids were increased slightly. Hopefully that helps. To make things even more fun Joe is experiencing some edema. It is not too much of a concern right now, but Joe's usually slender and sleek ankles and feet now look like they belong to Miss Piggy. Joe is not really feeling like himself right now. And finally, because the rash and edema are not enough to procur sympathy from others, the Hemorrhagic Cystitis which Joe so eloquently described in a previous post has returned.

Joe isn't exactly enjoying all of this. How could he? But he is being tougher than can be expected under the circumstances. Tomorrow we'll be returning to the hospital. We'll keep our faithful readers updated!

The Lord will sustain him on his sickbed and restore him from his bed of illness.
~Psalm 41:3

Hallelujah! Generous contribution!

I have recently been informed that marrowtrek.org has received its first generous contribution from an Anonymous donor I will refer to only as W.H. Gates (HIPAA regulations prohibit me from revealing full names) in the amount of one hundred million dollars! This unexpected windfall dwarfs our measly goal. Since we at marrowtrek.org are now unbelievably rich beyond our wildest dreams, we are immediately closing the website. So everything I posted previously, disregard.

Haha! Of course, that whole preceding paragraph was completely fabricated (e.g. LIES). Just wanted to show you what we might achieve collectively with a little elbow grease / ga you / chutzpah. If only life were as easy as above. Do you think Pittsburgh's David L. Lawrence Convention Center was built in a day?! (Apparently the answer to that is "yes"). marrowtrek.org operators (i.e. internet trolls) are eagerly standing by for your generous donations. You say that you don't have one hundred million dollars to spare? Well, we'll gladly take one hundred million pennies.

Now, I went to Stanford and have a medical degree from another prestigious university, so math isn't exactly my strong suit. But let's just suppose that you decide to make a sorta generous donation of $3 per mile of trek. Assuming Jim and Jesse accomplish their trek, your total pledge is less than $10,000! If you think about it, that's mere pennies a day for the next 50 years or so: you can share this gift of giving with your grandchildren and probably your grandchildren's grandchildren. I know that it's quite difficult to part with hard earned moulah. Take me for instance. Do you think it's easy sitting around all day collecting disability checks?! Heck no! (I'll let you in on a little secret to being rich like me- I am easily a thousand-aire. All you have to do is contract a life-threatening bone marrow cancer and undergo intense chemo treatments followed by a bone marrow transplant and the inherent 6-12 months of follow up and lifetime check-ups. Piece of cake!) Getting back to the topic at hand, enter the beauty of second mortgages and home equity lines of credit! Free money! No really, I'm not saying you have to or even should bankrupt yourself to contribute to this cause but maybe the kids could go without that 10th Wii-Box-PS5 gaming console brought to you by the MicroSonyTendo conglomerate. I say, let's you and I bring back a wooden toys movement. Better yet, homemade wooden toys.

Incidentally, if W.H. Gates or perhaps M. Jordan or O. Winfrey happen upon this blog and are really bored cleaning the trophy case with $1000 bills or lining their rare Sumatran white-tailed endangered hamster cages with Benjamins, please pinch us off a little sump'n sump'n. I'm sure y'all have a couple mil stuck in the lint trap of your dryers.

Okay... as you can see steroids is good stuff! Seriously, please check out marrowtrek.org. There's not much to the website right now, but since it's early, we are trying to get the word out about this. My people are in contact with people who might know Katie Couric and Stone Phillips as of this writing. In my last blog entry, I so casually slipped in that Jim and Jesse are trekking 3,100 miles over four months. If you really stop to think about this, that's 3,100 freakin' miles over four months! They did this sorta thing once, which makes them manly men. But to do it again takes some degree of brain damage. So if my urgings don't make you feel compelled to contribute, do it for these two poor souls... Man, if I can just get every one of my friends and acquaintances to contribute a grand total of just a single dollar, our project wouldn't even get off the ground since I've counted about 5 friends, and that's including Karen. But you, you can really make a difference.

Alright, I promise not to bombard you too much about the Marrow Trek (at least, not until it gets closer to "go" time). A little update on me... the hemorrhagic cystitis issue is improving, meaning I run around the house pantsless only about once an hour instead of two or three. The skin rash I've had from graft-versus-host disease has gotten a little worse as they have been decreasing my immunosuppression in the name of more effectively treating the CMV. Bloodwork for CMV was drawn again today and I should know the results by tomorrow. We're all praying really hard that it's finally going to be negative. Otherwise, I'll have to switch to a different IV drug which has to be monitored even more carefully.

That's it.

Joe

Hemorrhagic cystitis?!

Hey everybody!

Tomorrow will be Day 50 post-transplant! Unfortunately, as you probably know by now, I got my first semi-serious complication last week with a CMV infection. The good news is I still feel good overall and I've been getting to come home in the afternoon/evenings the past few days. The bad news is that the CMV has not been completely eradicated and the virus was still detected in my bloodstream as of yesterday's blood draw. So for now, I have to continue with the twice a day IV ganciclovir and my next blood test for CMV will be Thursday. So please pray that this will be negative on Thursday. Ganciclovir is supposed to be very effective in treating CMV but has the bad side effect of decreasing my white blood cell counts, so ideally, I don't want to be on the medication for too long.

Now, we'll play scenario games again. Imagine this time that as a reward for a long, hard week at the office, you and your lovely wife enjoy Belgian chocolate dipped strawberries and mimosas on late Saturday morning after which you hop in your fire red Lamborghini and motor to the day spa. There you enjoy couples total body massage/facial/wax/manicure/pedicure/body wrap treatments given by Angelina Jolie and Brad Pitt (in my case, either one would suffice... you know, Brad and I would talk politics and sports). Then, you take your private jet to partake of a late lunch at, let's say, Spago, prepared by your personal chef, Iron Chef. You do some shopping on Rodeo Drive and buy a couple Rolexes or Pateks and consider buying a poodle to go with those fabulous Manolos. Now it's time to enjoy a romantic dinner at your favorite restaurant on Mars with an incredible view of Earth. You make it back just in time for courtside seats at the Super Bowl/World Series/Stanley Cup finals topped off with a private performance by the "All-Stars" of the world's greatest symphonies including a world premiere of a ballad written and performed in your honor by Luciano Pavarotti.

Now, let's change the scenario a little. Instead of chocolate and alcoholic beverages on a Saturday morning, imagine that you have to urinate; instead of a Lamborghini, you have to urinate; instead of total body treatments, you have to urinate; yep, instead of Angelina and Brad, urinate; instead of private jet, Spago, Iron chef: urinate. I think you're starting to get the picture. Welcome to the world of hemorrhagic cystitis!! Sounds fancy and complicated doesn't it?! It's really about urinating, and on top of that, there's some blood involved. Really I'll be sitting there minding my own business happily picking my nose or something as intellectual as that and suddenly, without appropriate warning, my urinary apparatus and brain will shout "You better find a toilet for me in the next three seconds or I'm going all over your pants buddy! One... two..." This happens every 20-30 minutes. In all seriousness, this hemorrhagic cystitis thing is supposed to be a fairly common complication after a bone marrow transplant. It involves inflammation of the bladder and can lead to urgency (feeling the need to pee all the time), frequency (going all the time), burning and pain (not fun), and hematuria (peeing blood... yikes!). It's rather disconcerting seeing blood come out, but fortunately, this whole thing is supposed to be self-limited. So for now, I'm told to drink lots of fluids and ride it out. Unfortunately, this thing can last up to six months (!) which would be a worse case scenario. Again, let's just hope and pray that my doctors don't have to end up putting instruments up my you know what and do "bladder irrigation."

So my advice to you: try to avoid getting hemorrhagic cystitis. And if you see me whizzing by you (pun intended), it's not because I'm being rude. Just get outta the way, okay?!

Joe