More chemo in my future

Today was a day of a little bad, but mostly good.

Starting with the bad:

• I was not surprised to hear that the cytogenetics show that my bone marrow is still messed up genetically. What that means is that I need to do another round of the Vidaza, and also will need to add the Venclexta in.

Good stuff:

• My blood counts are awesome (for me).
• WBC: 1.5 (had been 0.4-0.8; normal is 3.9-11.2)
• Absolute neutrophils: 0.44 (had been too low to count; normal is 1.9-7.8)
• Hemoglobin: 8.4 (maintaining and gaining w/o transfusions; normal is 11.3-15.1; transfusion at 7.0)
• Platelets: 61K (maintaining w/o transfusions; normal is 165-366K; transfusion at 10K)
• Dr. Atallah called me "in recovery." This is good because my bone marrow is working toward doing what it should, and I'm also recovered enough to be hit with the next round of chemo.
• I will start Vidaza and Venclexta on Monday, giving me a "free" weekend. 
• Although my cytogenetics are still messed up, fewer chromosomes this time tested "messed up" (technical term).

Dr. Atallah said this was still "great" news, just not "excellent news." I said, "kind of like getting a B in grad school when you'd gotten all A's?" and he said, "no--it's an A instead of an A+." (Dr. Atallah is awesome!)

Greg and I asked about next steps and timing of additional bone marrow biopsies and the transplant. Dr. Atallah explained that it's a balance of timing. Ideally, I'd be in remission without any cytogenetic changes and a donor would be secured. However, the longer in remission w/o a transplant, the more likely that the leukemia will relapse and the longer I'm at risk for regular infections. So if a donor is found and there are still cytogenetic changes at my next biopsy (in 4-5 weeks), they might proceed with the transplant and continue chemo after.

I'm still waiting for the appointments to be scheduled, but I will receive chemo at Froedtert Monday 1/27/20 daily through Sunday 2/2/20. Most days will also have labs, and the first three days they'll give me extra IV fluids since I'll be starting the oral med, too. Some days may have transfusions (although I didn't need my first transfusion until day 7 the first go-arounds; not sure if starting lower will mean I'll need transfusions sooner...). I'll update the google drive as soon as my appointments are scheduled. Thank you all again for volunteering.

More good:

• I got the most perfect fuzzy blanket today from my friend Holly (who also drove me to my appointment). Look:

• This is a big of a brag, but I'm sharing anyway. Today I was supposed to present at a Preparedness Conference in Stevens Point. I ended up hospitalized, dropped the ball, and my supervisor had to do it all on her own (much guilt). But at this conference today, my colleagues accepted an award that I won--the Public Health Emergency Preparedness (PHEP) Coordinator of the Year award. It brought me to tears for several reasons. First, I was nominated by an amazing colleague. Second, I took my current job with no experience in Emergency Preparedness over four years ago. Though I struggled initially to understand this field which I'd learned nothing about in school, I grew to love the work--primarily because of the people who do it. I really wanted to be at the Conference! And finally, I'm not sure when (or if) I will get back to "doing preparedness," and that makes me really sad. So receiving this award was extremely bittersweet.

My plans are to enjoy this weekend while my neutrophils and hemoglobin are (relatively) high. (And I need to get out and fat bike when my platelets and energy are both up!) I will take what next week brings when it gets here--no need to worry now. :)