99%

Three lovely photos have been posted for your entertainment. First, we have Joe smiling because his mind is far away from the Mepron he will soon be taking. The second is a photo of the Mepron. Didn't I tell you that it looks like bright yellow paint? The third photo needs little or no explanation - but it is Joe's reaction to taking Mepron. Apparently though, things could be worse. Poor Baby Livi has to take a medication that smells like skunk.

We went to see the doctor yesterday. Joe's rash is definitely looking better and better each day. He is not shedding as much skin, and his skin is not as red. Joe was given permission to taper his steroids slightly. Today was the first day of the taper; so far so good.

The results from the chimerism test earlier in the week show that Joe is 99% female. Yay! Those donor cells are doing just what they are supposed to be doing. The fact that they are doing what they are supposed to be doing largely contributes to why Joe's rash was so ugly. High price to pay, but in the end it should all prove to have been worth it.


Joe got another Neupogen shot on Friday because his WBC are still stubbornly low. The positive CMV result isn't helping either. Praise God though, because Joe is feeling well overall. Monday we return to the hospital. Mostly just a routine check. Thursday will be round two of the Cidofovir.
~~~
I keep forgetting...thank you Susan H. for the lovely card! It was really fun to read.

Great is the Lord, and most worthy of praise, in city of our God, his holy mountain. ~Psalm 48:1

Day +93

Joe received his first dose of Cidofovir today. This means I can share more factual information on how it is administered, unlike yesterday. :) Joe was given fluid (Saline) over three hours, and some Probenecid. After that, the Cidofovir ran over one hour. Then Joe was given more fluid over two hours. Then some more Probenecid...and then he was to take one more dose of Probenecid six hours after the second dose. Such a complicated drug. And unlike what we thought yesterday, each Thursday will be the same routine. It wasn't so bad - says me, the girl who wasn't hooked up to an IV pole for six hours. The huge blessing of today was that Joe's rash looked even better than it did yesterday, and it was even less itchy. This made hanging out at the hospital less miserable. Coming out from the agony of constant itchy, dry, rashy skin makes everything seem more pleasant! Joe definitely is looking brighter and has renewed energy to fight this stupid MDS stuff.

Tomorrow we go back to the BMT office for another blood draw and rash assessment. We're hoping for a taper in the steroids soon. As mentioned before, a high dose of steroids makes it very difficult to treat CMV. A high dose of steroids can also mask infection by inhibiting the ability to get a fever. Infection is increased when WBC (and neutrophils and lymphocytes) are low as they have been with Joe. Surely Joe won't develop any infections, but we need to be prepared for the possibility so we know what to look for.

Thank you for continued prayers, good vibes, virtual germ-free hugs and kisses, and warm fuzzies!

~~~~
Happy happy birthday Rachel U. We love you!!!!!!

The Lord you God is with you, he is mighty to save. He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing.
~Zephaniah 3:15

itchy, itchy, itch, itch...

Joe continues to itch from his rash. I keep threatening to cover his hands with socks to keep him from scratching. I suppose, I need to just do it! The problem would be figuring out a way to Joe proof them, so that he can't take them off! Joe is still taking steroids at the increased level, which is actually the same amount he took the very first time the GVHD began to appear. Joe was also prescribed a steroid cream. Both help some, but not enough. I think that the itchiness is counteracting the loopiness that Joe would normally be experiencing by now from the steroids. Oh, but the steroids have been providing Joe with some very vivid dreams. Last night was the best one yet. Joe had a dream that scratching fairies were giving him permission, in fact encouraging, him to scratch. Great. Go away fairies, go away!

Because Joe's rash is being so ugly and stubborn, we are now scheduled to go to the hospital every day this week. This way the doctors are able to keep an eye on the rash and act accordingly. The good news is that the daily visits no longer mean daily blood draws. As originally planned, Joe will only have a total of two blood draws this week. One down, one to go!

The photo doesn't even come close to doing it justice. But I had to share the beautiful card that our friend Patrick made for us. It is just too cool!

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

About Joe.

Last Tuesday, as I was ending a brief and tumultuous affair with Mr. Stomach Flu, Joe was having trouble escaping the grasp of the evil temptress Ms. CMV. Although Mr. Ganciclovir tried time and time again to intervene on our behalf, Ms. CMV refused to let go (who could blame her?) We ended up firing Mr. Ganciclovir and hiring Mr. Foscarnet. It still took some time, but being meaner and tougher , Mr. Foscarnet with his twice a day interventions seems to have scared Ms. CMV into submission. As of this past Monday, Ms. CMV has gone into hiding. Just to be sure that she won’t be bothering Joe anymore, Mr. Foscarnet will continue to intervene twice a day. If Ms. CMV behaves tomorrow and Monday, then Mr. Foscarnet has agreed to only visit once a day for a week or so. As for me, my relationship with Mr. Stomach Flu is completely over. Affairs are bad. Falling under the spell of an evil temptress is also bad.

Meanwhile, Joe started to develop cold/flu symptoms. Last week, it was mostly some coughing and sniffling in the mornings and evenings. The coughing and sniffling steadily increased until Saturday evening when Joe started to feel chills. On Sunday, he felt a bit better, but his WBC had fallen to only 0.7k/mcL. The doctor wanted to be sure that Joe wasn’t developing pneumonia. He also wanted to confirm that Joe ‘s counts were dropping due to the CMV, and not something else. So on Sunday, Joe was admitted to the hospital. Joe was given all kinds of antibiotics to ensure he was armed against all kinds of infections. A chest x-ray showed no signs of pneumonia.

By Monday, Joe was feeling a bit better. A bone marrow biopsy was scheduled for the afternoon. Joe was introduced to the wonders of morphine for the very first time. It is a amazing that it was never offered before. It made the biopsy so much more pleasant. It still wasn’t fun of course. But it was far better than the extreme torture Joe has endured in the past. Tuesday was better yet, although the cough was worse. What made Tuesday even better was that the CMV results came back negative. By evening, the doctors decided that there was no reason for Joe to be in the hospital anymore. We left the hospital sometime after 9pm last night. Of course we still have to return every single day.

That brings us to today. It was a long day. Joe’s rash from GVHD now covers about 90% of his body. Many areas are starting to peel. Joe’s eyes have become puffy and dry. This is either due to the GVHD, or water retention from the steroids. The coughing continues. And since Joe has had his line in for nine weeks now, the area under and around his dressing has become very sensitive. It peels and bleeds, and the dressings start to look ratty before his weekly dressing changes. Still, Joe remains strong and says he doesn’t feel too bad. The first thing today was that one of Joe’s lumens was clogged. This is an easy fix with Retavase. Today however, it took longer than usual. More of a nuisance than anything else. Then Joe’s magnesium results took an unusually long time to return. Of course that was the one thing that Joe ended up needing more of, which further extended our day. Finally, Joe received a call from one of the doctors. The results from his bone marrow biopsy showed that the graft went from 98% to 89%. Still, there is no room for worrying around here. The doctors said that it is not uncommon to see fluctuations this early. Also, they are encouraged that this was caught early. Joe is at day 64, and his next biopsy originally was not going to be until day 100. The plan is that Joe will be getting five days of Vidaza starting tomorrow. Hopefully, this will scare Joe’s cells into going away, and his donor's cells will be able to fight harder. This time, the dosage of Vidaza will be lower, and it will be administered IV rather than with injections. No worries. Only prayers, hugs, and positive thoughts are welcome.

That concludes this update on Joe.

Pressin' On.

Hello, hello! It's Karen. I've temporarily regained control of the blog. It has been an interesting couple of days in our household. On Sunday evening, I developed some pains in my stomach. From then until now, I have experienced something quite similar to what Joe was experiencing post-transplant. As you may recall, he had little appetite, and pretty much everything that entered his body would proceed to exit in a most unpleasant matter. Yes, it is my turn...although I managed to skip the life-threatening diagnosis, chemotherapy, and transplant. Okay, I guess it is totally different. Apparently, I'm just one of those lucky people who managed to contract that Stomach Flu that seems to be everywhere. I was so frustrated, because I've been able to avoid getting sick for so long. The timing was awful too, because both of Joe's parents are also very sick. Joe started joking around that even though he is rightfully the "sickest" one of us all, he feels the greatest.

Joe traveled to and from the hospital by himself yesterday and today, which worked out okay. I've been wearing a mask, walking around with Purell in my pocket, and wiping down everything I touch with alcohol. Joe and I spend little time in the same room. It feels very weird, because we have been together almost 24/7 for months now, and I've gotten used to being the caretaker...or at least doing a decent job pretending to be a caretaker. And yet, this evening Joe made me congee/jook/rice porridge/mue/okayu/lugao/pick your favorite name... Seems a little backwards! I think I might finally be feeling better. I hope so anyway. What this short two days of a common stomach flu has taught me though is how incredibly tough Joe and others like him are. Two days and I feel like a miserable, useless, whining blob of blahness. Joe has been through so much more for so much longer, and yet he is still able to be the king of silliness and find humor in every step of his journey. Do I have the coolest most amazing husband, or what? I think the answer is that I have the coolest most amazing husband!

Enough about me, more about Joe. Unfortunately, the results of Joe's CMV test from yesterday were still positive. Today, they switched him to Foscarnet. It is not as well-tolerated as Ganciclovir, and can cause un-fun things like kidney problems and a decrease in Calcium. But Joe will be closely monitored, and this should definitely take care of the CMV. The problem with the Ganciclovir is that it doesn't work so well against steroids and FK5O6. While the doctors attempted to lower Joe's steroid dosage, it apparently wasn't enough. Joe can't be taken off the steroids completely yet because they are what make his blog entries so funny. I mean, because of the rash caused by the GVH. Even as the dosage was tapered, we could see that the rash was spreading. So far this hasn't bothered Joe too much though. His head has been spared, so Joe is still able to admire his reflection in the mirror. :) And of course Joe needs to take FK5O6, so little could be done with that. Today was Joe's first dose of the Foscarnet. He did notice that it makes him feel a bit nauseated, and very tired. Also, his taste buds seem to be acting funny again. We are confident though that Joe will be CMV negative by Thursday...and then he'll just need to take the Foscarnet for another week or so...and then we'll be done with it!

Well, we're still pressin' on.

Thank you so much to the Jou's for bringing us so much food last night! It was so appreciated. And thank you to Gordon and Julie for the sweet gift!

But as for me, I will always have hope; I will praise you more and more. My mouth will tell of your righteousness, of your salvation all day long, though I know not its measure.
~Psalm 71:14-15

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

Ganciclovir

As of Thursday, Joe still tested positive for CMV. We're going to pray and pray and pray that the results from Monday's draw will be negative! If Joe was not still taking steroids for his GVHD and FK5O6, the Ganciclovir would have worked its magic by now. Unfortunately, he can't be taken off those meds completely, but the dosages have been lowered. Let's just keep praying!

I posted a photo of Joe getting his evening dose of Ganciclovir. It looks like a little baby bottle. It is as cute as anything medical related could possibly be. You know we'll find entertainment any way we can!

That's it from me today. I'm hoping Joe will post again soon, because his posts are so entertaining!

A very Happy Birthday to my 1st Auntie! She hasn't been exempted from getting older each year, but somehow she has managed to get exempt from looking older each year. It is truly amazing.

And Congratulations to Nancy and Bill who are the proud parents of a second baby boy!!!!

Happy Valentine's Day!!!

Traveling is really exausting. Especially when you are going from Fiji to Narnia to Outer Space in a matter of days. Fortunately, I have a very wonderful and loving husband who is on steroids. So while he has been merrily blogging away extremely silly things, I've been granted the opportunity to bask in the sun, get pampered at the spa, and gorge myself on turkish delight and astronaut ice cream. (Hey, Joe isn't the only one with a vivid imagination! Or to be more clear, all of the above, with the exception of the wonderful and loving husband on steroids part, is just in my head.)

Joe has been making me laugh and making me crazy all at once. He has really been loopy this week, as you can see from his blogs. It has been so entertaining, I'd allow him to completely take over the blog if he wanted! Then there is the behind the scenes stuff. He hinted at it in his last entry. Joe has gotten major re-organization fever. We knew it would happen once the steroids started. We didn't know it would take a few days for the craziness to begin! As soon as I leave a room, to shovel massive amounts of snow (bundle up, stay warm, and drive safely everyone!), or get groceries, or brush my teeth, Joe gets busy. And he doesn't stop. Nothing is safe. Just when I tell him that something looks great, I turn around to find that it has moved again. It is a good thing that Joe has a good eye, or I'd really have a headache!

Right after Joe's transplant, he would sleep at least 16 hours a day. Now he is like Mr. Busy Beaver meets the Energizer Bunny. He keeps going, and going, and going... Before, even before the transplant business, when Joe would go to bed, he would fall asleep instantly. Now, he gets all chatty and tells me long epic stories until I fall asleep. I am not sure what will happen when the steroids are tapered to nothing and the effects wear off. I imagine the house will be more peaceful. :)

Well, I am extremely grateful this Happy Hearts Day to have such an amazing husband. It is truly incredible that after all he has been through and continues to experience he is still able to remain positive and make others laugh! He is quite a guy. And let it be known that he is all MINE! Woohoooo!

Happy Valentine's Day everyone! Even if you believe that today is an overhyped, sappy, squishy day used by Hallmark and flower companies to earn massive amounts of money - at the very least make it an excuse to let your family and friends know you love them. I mean, even if you let them know every single day, it doesn't hurt to tell them one more time. It's more fun than boycotting a day to celebrate love, right?

And speaking of Valentine's Day. A very happy birthday to two Valentine's Day babies!!!!!!!
Happy Birthday Albert! You are a super little brother!

Happy Birthday, beautiful cousin Pei-chen!!!! You have been so sweet and wonderful.

Very encouraging news

Hey there,

I think I'm breaking my own record here with the blogging. Now with this weather we're having, nobody can go out! Ha! Welcome to my world! Might as well enjoy my ramblings, right?!

I feel like I have to make a MAJOR DISCLAIMER here. It appears that there is mass confusion about Karen and I actually being in Fiji at the moment. I guess I had a lot of people going on that one. If only life were that simple. To make things clear, we are NOT vacationing on an island. On the contrary, I am firmly planted in Allison Park, so much so that roots are actually sprouting forth from my feet. If it were not for my bi-weekly visits with my parole officers (aka BMT doctors and nurses), I am going nowhere any time soon. But, this of course does not prohibit me from traveling anywhere I want (in my HEAD), like say the surface of the Sun or Narnia.

Today marks another BMT office visit and more encouraging news. My prednisone is getting further tapered since I am not having very much skin symptoms anymore. And results so far from the bone marrow biopsy have been quite promising... there are no detectable blast cells in the flow cytometry and the actual biopsy info so far looks "normal". There are still more tests to be completed on those samples, so I should have more information later in the week.

I have felt better these last few days than I have in a while. I now have very little physical pain (of course, this is not inclusive of the psychological and moral anguish... I've got Edgar Snyder on speed dial... the touch of a button I tell you...) Just kidding, please do not leak any info to Monsieur Snyder as he would probably be knocking on my door even through sub-zero blizzard conditions. In all seriousness, I am getting great care and TLC by all. The steroids have been making me a little wired, so God bless Karen, who has been putting up with me "re-organizing" the house. It's really more like relocating bunches of junk from upstairs to downstairs and vice versa.

Well, that's it for now. I'll keep you posted on what life is like from outer space.

God's love,
Joe

Bone marrow biospy: a cautionary tale

Hey folks,

Greetings from Fiji! The weather is great. There's nothing like hanging out at the beach soaking in the rays. If you haven't done so, you have to indulge in the suckling pig. I am currently exploring the depths of and finding new meaning to the term "cabin fever". My life right now should be titled a la Dr. Seuss "Oh the Places You'll Go! (in your HEAD)." Actually, it's not quite that bad. Through the miracle of books, TV, and the internet, I am becoming a world traveler at fractions of the cost of actual traveling.

Thanks to the awesome power of steroids, I get to experience mild euphoria, greatly improved appetite, and insomnia. So this gives me loads of time to think. Lest you think that this whole transplant process as been one honky dory moonlit beach walk through a bed of roses (or something like that), I wanted to ponder the bone marrow biopsy, since I still have the residual soreness from a few days ago. I want you to picture lying on a beach in the Caribbean on pristine white sand under the shade of an umbrella overlooking impossibly blue seas and crystal clear skies. You are, of course, sipping on a daiquiri while thumbing through some trashy, inconsequential novel. Now, picture the exact opposite of that. That's what getting a bone marrow biopsy is like. I think at most centers, they sedate children when they do these biopsies. But, oh no, not so for the "adults". I'm saying, where's the love man?! Slip me some of the juice! I'm pretty sure that Hollywood movie producers somehow slipped into the oncology exam rooms and parlayed their knowledge of bone marrow biopsy into mega-blockbuster hits like Saw, Saw II, Saw III, the Texas Chainsaw Massacres. But really... it's not that bad. :) But, like the title, this a cautionary tale, so the next time your doctor mentions in passing "We'll probably need a bone marrow biopsy" in the same tone of voice as if he were saying "Don't forget to get your parking validated on the way out", be aware. Be very aware...

That is my random rambling of the day. I continue to do very well. Of course, I am anxious to find out the biopsy results. We should have some info this coming week. This weekend had been very nice so far. Karen and I were able to spend time with my parents in Monroeville for dinner last night, and my in-laws came and had lunch with us this afternoon. Always good to spend time with family.

As always, thank you all for the support, love, and prayers. And do me a favor, go rent Saw this weekend. (I've actually never seen it).

God's love,
Joe

Happy Super Bowl Sunday!!!!!

Go COLTS!!!!!! I'm so happy for the team. And I'm so happy I wasn't out in that rain. :) Joe and I had a nice quiet Super Bowl Sunday, perched on our big red couch, in front of our big television. Next year, we should be back to partying!

Joe is still doing well, despite still being itchy. The steroids definitely do help. But the steroids also make Joe loopy! Before the steroids, Joe was sleeping at least 16 hours a day. The transplant, drugs, and aftermath of the chemo really made him tired. But now that Joe is taking some steroids, he is finding himself awake until four in the morning! He does sleep well once he is able to fall asleep. His schedule is just a little out of whack. Hopefully, he won't need to be on the steroids for very long. We shall see.

Tomorrow we'll be going back to see the doctor. Thursday will make Day 30 of the transplant process. Joe should be getting a bone marrow biopsy then to see where he is in terms of engrafting. Speaking of bone marrow biopsy, I gained newfound respect for Joe's strength and pain tolerance. While at the doctor's on Friday, we were apparently next door to a young gentleman getting a bone marrow biopsy. He was screaming in pain, and it just broke my heart. This week will be Joe's 5th bone marrow biopsy. I can not even imagine. Joe did admit that in his experience as a doctor, women are the strongest. (I know you women aren't surprised!) Young, big, burly men apparently turn into big babies when encountering the least bit of pain. All I know is that I'm really glad that Joe doesn't scream in agony during his biopsies, I wouldn't be able to handle it! He's tough.

Friday was a very special day! Our dear friends Van & Rune are now the proud parents of their second child - a baby boy!!!!!!!! Congratulations!

Monday is a very special day. My beautiful and sweet 3rd Auntie will be celebrating the anniversary of her birth! She has been so amazing in loving us and supporting us, even though she has yet to meet Joe.
Our dear friend Jomei is also celebrating her birthday on Monday!!!!! Yay!
Happy Birthday ladies. :)