Until yesterday, I'd been feeling pretty lucky. The blast count in my blood was a mere 5% when I got my diagnosis, and it didn't seem to be growing. I felt like I had just a "little" case of leukemia. And who knows, maybe it was all just a mistake. Maybe with a little more testing the doctors would finally realize this wasn't the big deal they thought it was, and sorry you did all that chemo for no reason. And then they would give me T-shirt and I would go home.
But they gave me a number yesterday that brought me back down to reality. When they tested my bone marrow the very first time, they found that 43 percent of the cells were leukemia cells. 43 percent. I asked how long it takes to get from one bad cell to 43 percent of the cells in my bone marrow. They couldn't say for sure, it depends on the individual. But it took months. Or possibly just weeks, depending on how aggressive the cancer is.
So I'm not a biologist, and I'm trying to piece together an understanding of what's going on in my bone marrow and my blood. Here's the nutshell. In the bone marrow, there are stem cells from which all blood cells are generated. Hematopoietic stem cells. They're like blood grandparents. As they grow and divide, some mature into either myeloid progenitors, or lymphoid progenitors. They are like blood parents. These progenitors, or blasts, further grow and divide and mature into regular blood cells. Myeloid type blasts will eventually become erythrocytes (red blood cells), basophils, neutrophils, eosinophils, or macrophages (these are all white blood cells), or platelets. The lymphoid type blasts will eventually mature into lymphocytes (B cells, T cells, natural killer cells). The mature blood cells leave the bone marrow and go out into the blood stream to live out their life's purpose.
When leukemia comes into play, it happens at the level of the blasts (blood parents). Leukemia is classified based on which blast type it's happening in, either myeloid or lymphoid. When one of these blast cells has certain types of genetic mutations, it starts growing and dividing out of control but cannot mature further to become a useful member of society. It does not eventually stop dividing the way a normal cell would, but keeps growing like, well, a cancer.
Eventually, the cancer cells start crowding the normal bone marrow cells. At some point, the overcrowding is so bad that blasts start popping out of the bones and into the bloodstream. In my case, at the point I could no longer tolerate my headaches and made the trip to the ER, the blasts that had been ejected into my bloodstream had reached 5%. But the little trolls had taken up residence in my bone marrow and would just not stop making babies. And they had now reached 43 percent. Still a minority. But a very powerful and demanding minority.
Drs. Patil and McDermott are optimistic about what they are seeing in my bone marrow these days. I guess the chemo had sort of a Hurricane Harvey effect. It looks like the leukemia has much less of a stronghold (though conclusive results won't be in for several days). It is likely I'll need at least one more round of chemo, but the chances I will get into remission, eventually, are looking pretty good.
Thanks, Niko, for the magic wand. I guess I probably need it.
But they gave me a number yesterday that brought me back down to reality. When they tested my bone marrow the very first time, they found that 43 percent of the cells were leukemia cells. 43 percent. I asked how long it takes to get from one bad cell to 43 percent of the cells in my bone marrow. They couldn't say for sure, it depends on the individual. But it took months. Or possibly just weeks, depending on how aggressive the cancer is.
So I'm not a biologist, and I'm trying to piece together an understanding of what's going on in my bone marrow and my blood. Here's the nutshell. In the bone marrow, there are stem cells from which all blood cells are generated. Hematopoietic stem cells. They're like blood grandparents. As they grow and divide, some mature into either myeloid progenitors, or lymphoid progenitors. They are like blood parents. These progenitors, or blasts, further grow and divide and mature into regular blood cells. Myeloid type blasts will eventually become erythrocytes (red blood cells), basophils, neutrophils, eosinophils, or macrophages (these are all white blood cells), or platelets. The lymphoid type blasts will eventually mature into lymphocytes (B cells, T cells, natural killer cells). The mature blood cells leave the bone marrow and go out into the blood stream to live out their life's purpose.
When leukemia comes into play, it happens at the level of the blasts (blood parents). Leukemia is classified based on which blast type it's happening in, either myeloid or lymphoid. When one of these blast cells has certain types of genetic mutations, it starts growing and dividing out of control but cannot mature further to become a useful member of society. It does not eventually stop dividing the way a normal cell would, but keeps growing like, well, a cancer.
Eventually, the cancer cells start crowding the normal bone marrow cells. At some point, the overcrowding is so bad that blasts start popping out of the bones and into the bloodstream. In my case, at the point I could no longer tolerate my headaches and made the trip to the ER, the blasts that had been ejected into my bloodstream had reached 5%. But the little trolls had taken up residence in my bone marrow and would just not stop making babies. And they had now reached 43 percent. Still a minority. But a very powerful and demanding minority.
Drs. Patil and McDermott are optimistic about what they are seeing in my bone marrow these days. I guess the chemo had sort of a Hurricane Harvey effect. It looks like the leukemia has much less of a stronghold (though conclusive results won't be in for several days). It is likely I'll need at least one more round of chemo, but the chances I will get into remission, eventually, are looking pretty good.
Thanks, Niko, for the magic wand. I guess I probably need it.
Somehow you made Hurricane Harvey sound like a good thing, so props! Fingers crossed for continued natural disasters on your bone marrow?
ReplyDeleteAh, I see -- sounds like you had yourself a classic bunny-pit situation, just on a bonal-level, to use medical terms
ReplyDeletehttp://pbfcomics.com/comics/bunny-pit/
The field is still in its infancy, but the literature suggests a strong effect for mogwai-gremlin rules on rampantly amorous behavior in blood-bunnies. Just store your marrow in a cool, dark, dry receptacle, and avoid midnight snacks, and they'll settle down.
Of course, there are other, less conservative theories and treatment plans for your consideration.
http://pbfcomics.com/comics/christmas-surgery-2/
http://pbfcomics.com/comics/the-last-unicorns/
http://pbfcomics.com/comics/evolving-to-fly/
http://pbfcomics.com/comics/keep-on-truckin/
In my first or second week at work I heard someone whisting a Christmas song; I want to say it was "Sleigh Ride"? It freaked me out so much I had to pop my head around the corner to see who it was. It was you and it freaked me out because it's one of MY favorite whistling songs to belt out, especially in Summer! I knew at that moment there was something special about you. Life is so cruel sometimes, often to the most undeserving. Your recovery is in my, and and everybody at work's thoughts. A sense of humor has got me through many of my life's roughest punches and I'm glad you're keeping yours flowing. Sometimes we have to throw our hands up and laugh at the absurdity of difficult situations. So please keep whistling and beat this nonsense. You are missed. Stay strong and keep blogging. I look forward to them. Bad UX on this feedburner app and can't seem to change my name to Edward. Kidding!! - Michael K
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