November 29, 2007
Yesterday’s visit with the oncologist was different from all the others. This time, the information given was that a clone of cells has figured out how to grow around the Vidaza. Vidaza and the other therapies that control my form of MDS work in the same way; the evil protein is pulled away from the undeveloped white cells, thus permitting them to mature and provide immunities. When these cancer cells become resistant, there is not another known approach that can stop their proliferation. The Revlimid would possibly address the issue in a different manner, however, the side effects are very daunting, and we all agreed that the therapy would be a long shot with no guarantees of any success. The doctor said that he brought it up because he wanted us to know of its existence should we wish to try it. He is going to a large conference where blood cancers will be specifically addressed, and he said he would be checking out all information in hopes of finding anything that might work for me.
The plan going forward is to keep checking the blood every two weeks and to treat symptoms as they occur. If and when the red blood counts drop below the acceptable level, there are orders for blood transfusions. My ANC (absolute neutrophil count) is presently at 0.8, and at 0.5 or lower, neutropenia becomes an issue. This can be treated by the Neupogen injections, however, it appears that my stem cells are not replicating themselves either, and in the absence of healthy stem cells, the Neupogen doesn’t have anything to work with in calling forth more white blood cells.
Written out like this, the whole condition looks daunting but there are always possibilities in the future. It could be that on this very day, a breakthrough has taken place; I feel quite confident that Christmas and New Year’s will have my physical presence in this house – on my walk this morning I contemplated miracles and I thought, “Why not?” Perhaps there will be many days before me here in this beautiful place, or perhaps not. Every living thing must die and humanity is no exception. All those words and thoughts about God and creation and salvation and grace that have been woven into my life from my earliest remembering shape and inform how I think about what happens after death. My heaven still evokes images of a clear day in southern California under old growth trees and viewing the ocean.
This morning when we came back past the pond toward the house, I heard the cry of a red tail hawk sounding quite near, but not as loud as usual. I stopped and looked for the source, and a blue jay was sitting in the cedar doing a fine job of imitating the far larger bird. I have no idea how or why, but it added an interesting footnote to the morning. So it is. . . always, I return to the “now”. Alphie lies here next to me hopeful that I will soon take him out to walk around Sanctuary and Charles just came back from teaching to announce that it is time to check out a Christmas tree and decorations. C’est la vive.