October 21, 2006

Well the hard and heavy stuff has started. I was admitted into Sunnyside Hospital last night to begin chemotherapy today. I will be getting a total of 3 doses of Idarubicin which is infused into a new PICC line they inserted in my left arm yesterday. I will also be getting 7 doses of Cytarabine infused into the same PICC line over the next 7 days. The Idarubicin is infused over 20 minutes and the Cytarabine infuses in the same PICC line continuously over 24 hours for the next 7 days.

Of course I can’t do things normally. I will be continuing the Dasatinib during the chemo phase. No one has done this yet in the Kaiser or OHSU systems. The theory is that the Dasatinib will be helpful in getting a good remission from the chemo with little or no additional side effects. This is theoretical since there is no data to prove that. The only likely additive side effect is the buildup of liquid in the chest cavity, which can be threatening to heart function. Excess water is very easy to detect and they are watching that side effect closely.

Here’s a list of some milestones for the next few weeks according to the plan of the doctors.

1. Within 2-4 days I’ll be neutropenic (easily susceptible to viruses, bacteria and fungi infections). All chemo has a Nadir time which is where the blood counts are lowest. Since the Dasatinib has suppressed the counts already, My Nadir time is from day 2-4 until day 7-9, instead of from days 5-9.

2. My chemo regime will stop in 7 days.

3. A bone marrow biopsy will be done on the 14th day to see the effectiveness of reducing the leukemia in the marrow. Normally there is a 50% chance of good, controlled remission. Since I’m also continuing the Dasatinib during the chemo phase, the 50% should be higher but there is no data to support that.

4. My hair will probably fall out between days 17-20. Apparently it comes out all at once on this stuff.

5. My marrow will be rebuilding during weeks 2-3. Hopefully my strength will improve somewhat during that time. The additional strength will be helpful during the stem cell transplant.

6. I will start the chemo that prepares me for the transplant in 3 ½ weeks. From what I understand there will be 2 days of chemo then that will totally clear (kill off) my marrow and any remaining leukemia.

7. The stem cell transplant is tentatively scheduled for 4 weeks from today. The donor has been contacted to see if that time is OK for him. By the way, the donor is a male in his 40s, I think from Great Brittan. That’s all I know about him other than by his weight he is probably in good shape (or he has to be really short to be overweight.)

The schedule can change for a lot of reasons. The donor may be on holiday (vacation), side effects may cause the chemo to be temporarily stopped, or many other reasons.

If anyone wants to visit they should do so very soon or wait for a while. Please call me on my cell to see what’s going on before you come. No sick people please.

I sure would appreciate any prayers to get through this process. As I’ve said before, my first and highest desire is to be in God’s will. I don’t have a lot of clarity about what that exactly is right now, but I’m sure He has. I do know that I’ve been able to share my faith in and knowledge about Jesus Christ to a number of people in the medical community. That has been very rewarding.

I’ll let you all know if there are any changes. I’ll also try to continue the updates regularly as my strength (or lack thereof) permits.

I love you guys.