Step by Step

I am successfully navigating the current path, getting infections under control before the leukemia gets out of control.

I have been running low-grade fevers every few days, which the infectious disease team has decided are not important. The ID team also suspected a surface infection of my Hickman triple lumen (the port into my chest for putting in stuff and taking our blood samples) as the source of the fevers. Yesterday, I got a PICC (peripherally inserted central catheter) line into my arm, which allowed the removal of the Hickman. So far, no fevers since the Hickman came out.

The fungus is no longer considered an issue. Fungal infections take a long time to be completely eradicated, especially with a weak immune system. But there is no sign of an active infection.

This morning, ENT removed splints and packing from my nose. It sounded worse than it turned out to be. I still can't breathe through my nose, because the nasal passages are blocked with clotted blood and some stuff they put in there to encourage clotting, but I'm getting closer. I still wear a gauze mustache to catch bloody drainage out the front. Several times a day, I now spray saline solution into my nostrils to help break up the crud in there. I also got a great tip from the ENT folks which is going to save me a small amount of grief as long as I'm wearing the gauze mustache. Instead of taping the gauze under my nose —which leads to repeated removal of tape from my face, which hurts — the ENT folks just use a folded face mask that hooks over the ears. I wish they had passed that tip along nine days ago, but better late than never.

Here is the current treatment plan, subject to change (as always):

1. Continue to have a quiet (infection-free) weekend, and maybe Monday and Tuesday, too.
2. Start another round of chemotherapy, using a different class of chemicals than we have tried before. Instead of induction chemotherapy, which is what we did in October, this will be a bridge chemotherapy, used to buy time after one chemo treatment in preparation for transplant.
3. Twelve days after that chemo starts, do a biopsy. Again, we need to see barely any leukemia at that point.
4. If we don't see what we want to not see, do a conditioning round of chemotherapy (clear out the marrow) and then do a transplant.

My dad was visiting the last couple of days. He is down in Champaign now, doing a few home maintenance tasks and providing an adult presence while Jan is up visiting me for the weekend.