Day +8

It is amazing how little it takes to make for a good day--essentially just the absence of anything truly yucky.

Today, with the help of my transfusion, my platelets were 34K, so no Benadryl sleepies. With the modified magnesium levels, I didn't need supplementation, so no upset stomach from that. And I'm still rocking the one-armed tank top, so no hospital gown!

The mucositis is perhaps a little bit worse, although not terrible. Dr. Chhabra (this week's rounding doctor) did tell me to expect it to get worse after my fourth methotrexate on Saturday, though. I was surprised, as I didn't notice much with the others, but the effects are apparently cumulative.

My counts (other than platelets) continue to drop, exactly as they should. I have very few WBCs and neutrophils, which means that any mucositis will be difficult to repair. But Dr. Chhabra also said that, on average, we should expect my counts to begin to go up next week. I clarified that I had marrow and he said that on average peripheral stem cells begin to increase on Day 12, and bone marrow on Day 14. That is earlier than I'd been led to believe before, and he stressed that it is, of course, an average and it could be later. (But then again, being an average, it could be earlier, right?) At any rate, since I like to chunk things, I have now chunked the rest of this week (through Saturday) to be just steadily getting a little worse, then lots worse Sunday until maybe Wednesday of next week, if I'm lucky. That is a much more manageable chunk in my mind.

The other thing we're trying has to do with the magnesium supplements. Tacrolimus (the anti-rejection drug that I'll be on for about 6 months) eats up magnesium, so I'll likely be needing the supplements that whole time. Right now I get it as an IV infusion and it upsets my stomach a LOT after I get it. The other option is to take giant magnesium supplement pills--and lots of them. They are going to let me try to take the oral supplements and see if I do better on them and if I'm able to maintain an adequate level. Fingers crossed, because I'm convinced that's the issue right now.

My appetite continues to decline, but I'm still eating solid food. I have to chew very carefully and swallowing hurts some. I am expecting that my diet will soon change to only soft, cold things. I'm going to try to keep eating regular food as long as I can, but at least there are plenty of options here that are high protein and soft or liquid.