Week 46 – Evidence based decisions

Last week I was concerned the blood counts had dropped dramatically and the doctors were in two minds as to how to go forward – one option was to increase the drugs and the other was to lower the dosage.

After looking at the evidence and the options the decision was made to keep everything as it was – no changes were made to dosage rates at all!

So what has this meant for this week?

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I received two units of blood last Wednesday which has bumped my Haemoglobin levels up to 93 with all other results being very similar. The doctors tell me that things are still on track and I have no need to worry – it is just taking some time for the bone marrow to kick into action.  I need to be patient.

The Leukaemia Foundation have a range of services they offer patients and one of these is a ‘blood buddy’ service where they match you up with a survivor for a phone conversation.

I was matched with a person of similar age, George, who has now survived 5 years post his Bone Marrow Transplant.  We spoke for an hour on the phone about his experience and the issues he has faced along the way.  Although everyone is different in how they respond to treatment there were plenty of similarities with his treatment and progress along the way.

What became evident during our conversation was the need for patience and to realise that the recovery process is likely to take years rather than months.  George was back to work 6 weeks post his transplant but has since retired.  He found that fatigue and other issues prevented him wanting to continue with work.

He did say that his fitness is now back to being better than pre-leukaemia and he is pretty happy with his current lifestyle.  This gives me great hope!

Due to feeling a little better each day we have now started to plan some business trips and other longer trips out of Melbourne.

 

 

Last week we flew over to Whyalla in South Australia to catch up with our caravan park managers, Peter and Deb Dawson.  They have been doing a fabulous job with our park and it is really hitting its straps at present being booked out most nights at present.

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We met up with Nick and Sue Clarke again to see a great play last week, Oscar Wilde’s Ideal Husband.  We had a great night together.

 

 

And on Thursday after my re-habitation session at the Epworth we headed off on our biggest trip this year – a four day trip up the NSW coast to catch up with my brother Tony and Katy who have recently purchased a fabulous ‘retirement’ home at Rosedale on the NSW south coast near Moruya.  Their house is on top of the ridge line overlooking the sea (and as it happens the migrating whales!) through a stand of spotted gums. Their daughter Amy and boyfriend Phim arrived for Friday night.

We managed a fantastic drive across the mountains from Bega to Bairnsdale via Bombala and McKillops Bridge on Sunday and stayed with Jan’s brother Andrew on Sunday night before returning to Melbourne.

Jan even managed to get on a horse for a nice ride!

This was a big trip for both of us but one we managed and thoroughly enjoyed.  It has given me confidence to venture out from Melbourne knowing that even with my current health status it is possible to travel.

 

Week 45 – Blood counts drop

Haematology is an interesting medical area.  One minute my blood counts are doing really well and the next things seem to take a turn for the worse.

Today’s blood counts were all down on last week.

Hb is now 80 – I will require a blood transfusion this week.

My White Cells WCC are down to 2.4 which is just outside the ‘normal’ range but not low enough to be of concern.

And Platelets have dropped to 24 which is quite low and these may need a top up as well.

Neutrophils have dropped to 1.1 which is now outside the normal range and something to keep an eye on.

The question is what has caused this drop in blood counts in just one week?

And this is where the haematology gets fascinating. It may be because I am weaning off the steroids resulting in a drop in Stem cell production (Steroids can boost the stem cell production of red blood cells and platelets). Or it could be that the cyclosporin levels are too low or too high.  These things seem to be at opposite ends of the spectrum!!

On the one hand they tell me that it might be because I have another different presentation of Graft vs Host Disease and my immune cells may be attacking my red blood cells but on the other hand it might be that the immunosuppressant drug Cyclosporin is causing breakdown of the red blood cells. They are going to look at my blood under the microscope to see if there is any signs of haemolysis (red blood cell destruction) which will allow them to make a decision regarding the ongoing doses of Cyclosporin, it will either be increased or deceased depending on what is causing the drop in my red blood cell (Hb level) and platelet count.

There is a possibility that the graft which has taken is not functioning correctly in terms of the bone marrow production but more tests will have to be conducted to confirm this.

This is a puzzle for the haematology team and one I am hoping they can work through over the next few days.

Either way I expect to find out more on Wednesday when I go back in for a blood transfusion. I haven’t needed one of these for a month or more so it is a little step backwards but hopefully not too much of a set back.

IMG_2516On the weekend we spent some time with Jan’s brother and family taking  in a kids show at the Arts Centre – Hunting the Snark.

We also managed to see the Alice in Wonderland exhibition at ACMI which the kids loved.

We (Jan and I) also saw a film called “Terror Nullius” at ACMI- the jury is still out on this one.

 

 

 

 

And on Sunday we caught up with Nick Middendorp and his lovely wife Jo for lunch at the Royal Brighton Yacht Club. Nick is a keen sailor but is smart enough to crew on a mate’s boat rather than own one!  Nick is the man behind “Middy’s” Electrical and they have just opened up a new shop in Wagga next to Signarama.  They have a fantastic business model offering all sorts of sustainable solutions for power usage in businesses and households.  They now have outlets all over Australia with about 400 plus staff – a big business indeed.

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Week 44 – Quick trip to Tassie

Jan was keen to travel down to Tassie for a meeting with Tassie Irrigation, in relation to the dam and water supply on our farm.

Having just received some good results from the Doctor and with everything fairly stable I decided to join her.  What an adventure!

We flew down commercially with Virgin on Tuesday night, stayed at the brand new (and very sharp) Peppers Silo hotel in Launny.

While Jan was at her meeting I met up with Miles Kendell (son of aviation pioneer Don Kendell) to check out my hangar at the airport (Miles keeps his Piper Cub there).  Miles invited me to join him  for a local flight which I couldn’t resist.

It was a beautiful day and we headed over to Ben Lomond and then our farm for a quick aerial.  Miles had to fly to Melbourne as he is a Captain with China Southern and was due to fly out to China that night.

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We drove through to Campbell Town to quickly catch up with my GP, Myrle Grey to let her know how my recovery was coming along.  In the afternoon we headed down to the farm to check out how things looked.  Everything was fantastic – the house looked like we’d only left a few weeks ago (thanks to our fantastic cleaner Cherry) and the garden was in top order thanks to Scotty, our gardener who helps out every few weeks

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Week 44 – How do you stay sane?

As I write this blog it is obvious that I am slowly getting better as my mind now turns to activities and things to do to keep me sane!

Can you imagine a life changing event that not only renders you in hospital for many weeks but leaves you with a loss of confidence and energy when you are discharged?

For me the biggest challenge has been to keep my mind and body active during the recovery process.

It has taken me many weeks (months in fact) to get a feeling of some normal level of energy and during this time I have had to make many adjustments to my ‘normal lifestyle’.  The most noticeable is that I am still very weak and lack any sort of muscle mass.  Apparently it takes 6 weeks to replace what you can lose in just two days of lying in bed.

I am now involved in a Rehab program at the Epworth hospital where the Sports Physiologist is putting me through my paces, measuring everything and  letting me know not only how unfit I am but also how bad my posture has become!  It is a long way back but my aim  is have some sort of fitness and muscle mass by the end of the year!

In the meantime the question for me is how to keep sane on a day to day basis.  There are only so many jigsaw puzzles one can do and of course reading is an option – the local library is getting regular visits.  I have started to make a pom pom rug which is a craft activity that tends to take up plenty of time.

And in what is perhaps a good sign I have now started to spend some time thinking about our various businesses that we are involved in.  Jan has been taking the front running on this since my diagnosis and luckily I have not had to think much about this.

We are also venturing out from Melbourne on small day and overnight excursions.  I have now had just two nights sleeping out of Melbourne this year so far.

Blood counts

My blood counts for this week are again stable which is good news.  Hb 87, Wcc 4.1, Platelets 32, Neutrophils 2.5 and Creatinine 85.

I had another Bone Marrow Biopsy last week and results show I am all clear of Leukaemia which is again a big relief.

And a Chimerism test also showed that for both my blood and immune system I have a 100% take up of my brother’s cells.  Another good result.

I am happy with progress.

Family and Friends

We had a lovely dinner with Susan and Stuart Nicolson last Thursday.  Susan sits on the GGS board with Jan and they have become good friends over the years. Stuart works in the Retirement Development industry and has some interesting stories to tell.

Lachy and Hanna headed off to Bali to start their new adventure on Saturday, having sold up their ‘life’ in Melbourne over the past few weeks.

And Claire was back in Melbourne for the weekend from Brisbane where she is training for her new role with Shell as a Gas Analyst!

Tassie for a Day

In light of the good blood tests and my feeling relatively well we have arranged a quick visit to Tassie this week for Jan to attend an Irrigation meeting and for us to see our farm and house for the first time in 10 months.  Scary but also a step closer to relocating back home.

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Week 43 – Stable blood counts

This week’s visit to hospital for blood tests revealed that the blood counts are still tracking along pretty well.

Hb 89, Wcc 4.5, Platelets 34 (have dropped a little) and Neutrophils 3.0.  As expected Creatinine has crept up to 106, largely due to the side effect of the higher dose of Valaciclovir.  And the CMV result from last week was down a little from the previous at 487.

All in all the doctors are still happy with progress and are keeping me on a weekly schedule of monitoring.

I must admit I wake up every day and remind myself how grateful I am that I am not in hospital, I am feeling pretty good and my overall progress back to health seems to be well on track.  What more could I ask for!

Claire flew back into town on Friday night and travelled up to Wagga for a party with her friend Toby.  She has now finished her old job in Perth and is off to Brisbane for some training in the new role with Shell before returning to work from Melbourne early in August.  She will be a gas analyst for Shell.

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We are now starting to plan a few trips out of town to visit friends and do things other than walks around Docklands.  This has been a little confronting for me as we had our second night sleeping out of Melbourne on the weekend – a long way from the  hospital but all went well.

We stayed over with Richard and Zara Brookes at the weekend on the Bellarine Peninsula, near Port Arlington.  We also had a great dinner party (late one for me at midnight) with George and Serena Chirnside and Lyndsay and David Sharp – who run a group of vineyards, restaurants and a golf course on the Peninsula.

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I’ve said this before but the simple act of catching up with some friends for a coffee or lunch has been stimulating and very rewarding for us both.  There is nothing like staying connected with old friends and family and the support this has given me has certainly helped with my recovery.

Knox and Cate Heggaton dropped in Sunday afternoon on their way to Europe for a well earned holiday.  We managed to catch up on news of our farm in Tassie  – all is going well.

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Matt Kibble, a childcare centre builder and friend from way back is a great tea drinker!

A bunch of Wagga people including David Foster, Mark  Hillis, Peter Clucas, David Hodge, Col  Duff, John Smith and David and Cathy Pyke made the trip down to Melbourne for the Swans- Tigers match on Thursday night.  What a great night out at Etihad Stadium just next door!  Note Clucs dressed me up in Swans gear and is proudly wearing the beanie I knitted him.

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Smithy flew his Mooney down with Col so I couldn’t resist popping out to Essendon for my aviation fix!
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Lunch with hospital pals James and Victoria Watson. James is now one year on from initial diagnosis of Leukaemia and happy to celebrate being alive and well.

Lachy heads out of Melbourne to Bali with his girl friend Hanna next week to work from Bali!  Hanna has a job transfer and Lachy has decided to go along – indefinitely.  He has convinced his boss that he can work flexibly from Bali with a return to Oz every few months for client meetings and so forth.  He has sold everything up and is about to start a new chapter in his life!

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Sparky on a pub crawl with Fi Davidson who will be looking after her while Lachy is away.