Trying Not to Think of the Elephant in the Room

I had several tests on Monday: pulmonary function, blood counts, and a bone marrow biopsy.

My pulmonary function test results are very good. Volume, diffusion... all indicate that my lungs are doing well and that my blood is taking up oxygen as it should.

My blood counts are not so positive. My platelets continue their steady decline, and for the first time in months my white counts have also slipped below normal. The hemoglobin counts are fine, which is consistent with my pulmonary function results. The neutrophil count is good, providing decent infection protection. The low platelet numbers are not a surprise, since my legs are covered with tiny red dots and larger red spots, both signs that capillaries just below the surface of the skin are leaking.

Why are the counts dropping? We don't know. The last time I visited my doctor, she said she didn't know. My doctor is currently on vacation, so I was seeing an APN, and she wasn't inclined to make a guess. She did say that she didn't think sirolimus was a likely culprit, an earlier hypothesis, since it has been quite a while since I stopped taking it.

What other explanations are there? GVHD, though my symptoms have been receding. Or an autoimmune response that targets platelets, which is supported by positive tests for platelet antibodies. Or the return of leukemia.

I don't want to think about the last possibility, but I can't help it. It is not my doctor's style to hide bad news, but maybe she has chosen to spare me a disturbing suspicion until she has actual news to talk about. I'm disturbed anyway.

I would be on edge even without the negative blood counts, since I am waiting for biopsy results. The edge has been sharpened by the last few blood counts and the recent don't-know-what's-going-on stance of my caregivers.

I have another blood test tomorrow, and I may get preliminary biopsy results today or tomorrow. Depending on the results, I will either be tentatively relieved (while awaiting the more comprehensive results in early July) or forced to think about what I am unsuccessfully trying to not think about.