Wednesday, February 4, 2009

2 month checkup on Gleevec

Today was my 2 month checkup. This has been the longest duration I've gone so far without any blood drawn or reviewing numbers, so I was naturally a little apprehensive. Leukemia is such a silent illness, that changes in your counts can change with no noticeable symptoms, until they get severe. This explains why some people only learn about their condition, when going to have some other injury or illness checked.
The good news is that I'm officially in Hematological remission  ! Given that 98% get there in a timely fashion it's not such a remarkable milestone, but it's great that it probably took me only 30 days since dx to get there. Dr P was expecting me to reach that by the 3rd month, so I'm ahead of the curve as he put it.
Those 90 blasts from last month’s tests were gone, Dr P said they were probably gone shortly after I left the building after my last appointment. I was slightly anemic before, but that was also back in normal range. Pretty much all my blood numbers were within range. My vitals were also great, blood pressure 120/70 and resting heart rate of 56. Lorraine the nurse said I was perfect, something I made sure to mention to Cynthia   Speaking of, Cynthia has simply been wonderful through these past 2 months. She has simply been amazing, and I can't imagine being able to get through the past 2 months without her. Her support during this period has been just the way she plays defense on the soccer field, solid as a rock. In fact, her nickname on the defense is 'the wall'.
Dr. P and I did discuss the next 4 months and testing, and what to expect. At my next visit in early March, we are going to conduct a  PCR test (quantitive test) that shows what percentage of cells out of a sample of 1 million, are considered Leukemia cells. This one is done on the blood, and will be our first look at how my cells are reacting to Gleevec. Our next milestone is to get to Cytogenetic remission, a test where they sample 20-30 cells, and none of them show Leukemia. After that, PCR starts telling us at a much more granular level. You'll start hearing mentions of Log - 3 in the blog, a major milestone for people with CML. That is where the PCR test shows less than 0.1% Leukemia cells for me (since my start point was 100%). 
At my 6 month checkup in June, we'll do another Bone Marrow Aspiration (BMA), which will show the level of Leukemia in the marrow as well. This will be another PCR test, so we’ll start seeing any progress at the lowest level possible.
This is all within normal treatment of CML. I think Dr. P is doing the 3 month PCR since I'm the type of person that needs data, and simply looking at the blood counts won't tell us much more going forward. I felt today was a very good discussion with Dr. P, and getting some insight into his own experience with treating CML. He's only had 1 patient out of more than 100 that he has had go to a bone marrow transplant. I've always known Tyler is special, I just never wanted him to be special in this way. Turns out that it's very seldom in CML these days to require a transplant, of course all this isn't doing anything for my friend.
Speaking of Tyler, all I know is what the Sunday entry had, they are just waiting for his numbers to start climbing, which will be a sign of Scott's marrow being integrated into Tyler’s body and going to work for him. I am looking forward to seeing him when it's possible, and look at him and know that he's cured of CML. As all of us, all I can do now is continue to pray and hope for that day to come as soon as possible.
For every 1 person that has to go through something as invasive as a transplant, there are 90 or more people, who continue to live normal lives and just have to take their pills each day. Lot of my information is from the internet, and he pointed out that it's a dangerous source since much of it is dated, and it's mostly the more serious situations that people open up to talk about. I guess he's right, if you the reader come back reading my blog in 12 months to find out that I took my pills that day, and other than a bad back from lifting Christian, I'm doing ok, I would expect you to stop reading past "today I ....".
I also played soccer again tonight, definately feeling the difference, and it's reassuring that part of my life has returned to a normal status. Now I just need to get into game shape, and shape in general, since I agreed to run the St. Patty day dash with our friends.