Sunday, June 28, 2009

Looking at the blood, but not the bones

While I never really leave the world of CLL behind, as everyday I read some article or talk to a friend or read and write a few emails, and of course peruse and occasional post to one of the various CLL websites, I don't spend much time thinking about the cancer in my life. What a sweet change that is.

Not to belabor the point, but it is always the 800 pound gorilla in the room. One swipe, one wrap of its knuckles, and my reality would be reoriented again. But for right now it seems to be sleeping deeply, and I am doing my best to avoid anything jarring that might disturb its slumbers. Hence my organic vegan lifestyle, my regular exercise, my detoxifying Zeolite, and my beloved Japanese Sencha green tea.

I am drawn back into the world of personal vigilance by doctors' visits and waiting for lab results. It never gets easy, but it does get easier. I had my blood work done late last week in anticipation of my doctor's visit next week.

CBC was normal except for a low lymphocyte count. Is that the ghost of Rituxan I sense? (I just watched Kenneth Branagh's Hamlet- WOW- Rent this very long movie! -so ghosts are on my mind). Platelets remain stable. In fact it is all pleasantly boring. A nearly normal CBC. How divine.

My B2M is a meager 1.4 something and falling. This tumor marker is never been this low. At MDACC, they put much credence in this inexpensive test as a strong predictor of the future. By their figuring, my future is bright. (In the world of CLL, there is no agreement, and other experts dismiss the value of this prognostic indicator after any treatment.)

LDH is another cheap test that hints at breakdown of cells. The higher, the worse, but maybe not. Mine is still very normal, but up a bit. I tell my patients normal is normal, and not to pay attention to small changes in levels, especially in the normal range. Follow the trend. But I don't listen to my own advice. I think instead that maybe my diet and detox is cleaning up those pesky nodes, and the higher LDH is the battlefield litter.

The only slightly high reading is my uric acid, of gout fame. This is certainly not from sneaking beer and organ meats, so it might reflect increased cell kill.  I'm OK with that. The green tea may also play a factor. Plenty of fluids will keep this from being a problem.

My blood chemistries are all otherwise well, but my immunoglobins, no surprise here, are dismal. My IGG, the most important, is miserably stable at 377, less than 1/2  normal and my IGA and IGM remain missing in action.  Immunoglobulins rarely recover in CLL. even in remission which stinks.

This raises the whole IVIG question again. 

Now my chance to boast. Total cholesterol in the low 140s, LDL in the 70s and HDL well over 40. The rewards of clean living.

A few weird tests are pending: Vit. D levels, zinc and selenium. I am not expecting any earthquakes.

Overall, I have to be very grateful for another good set of lab results.  If I can keep this up only four more years, I could be sneaking up on a cure.

The critical questions for Dr. Forman will be: When to image my nodes and when to do the next bone marrow biopsy. More on that later, right now I will bask in my continuing good news.



Blogger Judy Cleri said...

OH how we love good news. See you did have good news on the horizon.

Does good news come in 3's?

June 29, 2009 at 7:50 AM  
Blogger pkenn said...

Welcome to the world of boring! Boring is sooooo good in medicine!


June 29, 2009 at 5:05 PM  
Blogger Marcia said...

So glad to hear you are boring -- in the right ways, of course...
I'm wishing you a long, long bore...

June 29, 2009 at 10:21 PM  
Anonymous Jama said...

I DO like reading "near normal" lab values - Does that make me wierd, too? These numbers somehow rule our lives (directly or indirectly) so those of us with the gorilla in the room HAVE to be attentive to its "droppings". Brian, I very much value your blog and reading how a physician views his own case. How "normal" you are as a patient is shown by the fact that you have the same worries and concerns as "Joe Average Patient" - but with the twist that you have a better understanding of how your body works. Keep on keeping on and sharing with me.
Jama in Chincoteague Island, VA

June 30, 2009 at 5:44 AM  
Anonymous Deb Light said...

Wow Dr. Brian,I didn't know you were so normal!Keep up the good work!!

God Bless,
Deb Light

June 30, 2009 at 8:03 PM  
Anonymous Anonymous said...

I've read, but cannot put my hands on it, a paper which asserts that cholesterol tests are not to be relied upon in CLL patients. It may be that cholesterol is used in CLL. I know of one person who had very low total cholesterol, but had heart problems nevertheless.

Your numbers, though, indicate that you are one of the lucky ones in CLL, at least so far.

July 10, 2009 at 5:10 PM  
Anonymous Anonymous said...

Would you comment on Zeolite? Many people says this does nothing. Then why do you take it? I'm interested in what you have to say.

July 14, 2009 at 7:40 AM  

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