Dear friends,
Being a patient or a family member involved in today’s
medical world can be sometimes be uncertain and confusing. We returned to Mt
Sinai today where Bernice’s blood was again drawn and submitted to both the
automatic machines for analysis and studied by doctors under the microscope. On
our last visit on Thursday, Nov 17 we tried to absorb some disturbing news. It
appeared that there were 27% blasts. Her white blood cell count had risen to 209 (normal is 4.5 to
11) and the 27% is compared to this total. As I explained in the previous blog
this could be an indication of a transformation to leukemia. This news came at
the end of the day and Dr M indicated that the data would be scrutinized
carefully and the blood would also be analyzed by flow cytometry, where the
blood passes through tubes and each cell type is identified and counted. Today
we learned there were some discrepancies in the different measurement modes.
The 27% was the measure from an automatic machine. Three hematologists using a
microscope repeated this measurement and their result was about 12%. Better,
and half of what we heard at first, but still not so good. But the flow cytometry
registered a 2% value! This is not only confusing for us but, for now, is also
a bit of a mystery to the medical staff.
I relate all this, dear readers, not to educate anyone in
the art of blood analysis, but to help describe how difficult it sometimes is
to judge the status of situation from what may be superb medical information laden
with its own ambiguities.
Bernice might be close to being eliminated from the trial
but, since her next infusion is not scheduled until Dec 15, it is valuable and
necessary to continue to collect all medical data. Dr M noted that Bernice with
her fall, breaking her wrist, has not been the ideal trial candidate. The
medical investigator in a trial makes every effort to observe every side effect
and such changes make the task difficult.
One welcome change was recorded today but there is no
knowing if this could be due to the drug. Both Bernice and Boeta thought that
Bernice’s enlarged spleen had shrunk. I was asked and cautiously agreed.
Measurements proved it to be so: on Nov 10 it was 24x24 cm and today it was
22x20 cm.
Dr M wants Bernice to make an effort to exercise more for
her arm in a cast, has prevented her from taking walks with her wheelie. He
will arrange for a physical therapist to come to our home.
Boeta accompanied us today and was invaluable. There were no
problems with the parking lot. We are due to return to Mt Sinai on Wednesday.
On Thursday our plan is to leave in the morning on the
two-hour drive to Sandy and Harvey’s where we will see the family including our
darling three granddaughters and enjoy a Thanksgiving feast. Bernice will be
able to rest there between acts and we will return that night.
Happy Thanksgiving and love to everyone,
Merwin
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