Friday, January 15, 2010

Monday, January 11, 2010

Day +13 (Hospital discharge)

Today's video message. . . .

And final blood count upon check-out today (although I will have a final blood check 8:30am Thursday morning followed by a final consultation with Dr. Raab) (click to enlarge). . . .

And barring snow or security related issues, this schedule is completely on track (click to enlarge). . .

Sunday, January 10, 2010

Day +12 (Last Day in Hospital + Urticaria)

Video message for today. . . .

George's Urticarica due to allergic reaction to one of the previously administered antibiotics [ceftazidime]. Should (hopefully) resolve soon [post transplant note: it did resolve in about a week] . . . .

Thanks to everyone for your postive thought and support!

- George

Saturday, January 9, 2010

Day +11

Video message for today followed by blood count graph. . . . .

Blood count history including today's numbers. Bottom line. . . leukocytes recovering quickly, and well. And although you can't really tell from the graph, the platelets are slowly rising. That's the absolute right trend and they will likely be good enough for Monday's hospital discharge. Still gotta remain vigilant against hemorage risk for a while though . . .

Picture outside the hospial room of the snow. Doesn't appear to be much but it is more than Heidelberg is accustomed. . . .

Friday, January 8, 2010

Day +10 (Recovery well underway)

Video message for today. . . . .

Blood count progress (click to enlarge). . . .

Thursday, January 7, 2010

Day +9 (Leukocyte recovery!)

Sorry, too tired to say anything more about today. But the good news is that my leukocyte levels rose today for the first time! [Post ransplant note: This initial indication of leukocyte recovery happened just about as early as is normally possible. An excellent indicator of a very good recovery timeframe. Coincident with this I quickly started feeling much better which is evident on the following day's video posting.] Should be on track for hospital discharge early next week.

Schedule, attached (click to enlarge). . .

And the special woman that is helping me through this, of which I would not be able to survive. . .

Wednesday, January 6, 2010

Day +8

***BREAKING NEWS 8:10PM Heidelberg***George tested negative for H1N1 and no longer required to follow quarantine protocol.

By the way. . . I forgot to mention in the attached video that my leukocyte levels are unchanged from yesterday. Which means that I am still neutropenic. Professor Dreger and Dr. McClanahan said that I would likely have to wait until day +11 to see any significant rise in my blood counts. So right now my immune recovery is in a race with my fever. I just gotta hang in there for a few more days.

Tuesday, January 5, 2010

Day +7

It was too soon for me to tell a couple of people that George would post today... but it's Yuko again. .. sorry. I am gonna give you just a quick update for today.

Not really a big change as far as his condition. He makes a painful face because of a pain due to, we think, the mucositis in his esophagus and nausea. Still he has a fever 38.6C (101.5F). He's still neutropenic but Dr. McClanahan told him his leukocyte counts are "slightly" increased. Although it is possible this is just a variation in the [measured] data, we hope this will be a good sign .... George and I are praying this is a sign of successful engraftment and we will see an upward trend of the counts tomorrow.

Platelets are very low still. I saw many bruise on his arm and legs, especially the area for the blood drawing on his arm is bad, which makes me feel terrible. When I visited this evening, he said he got infusion of platelet. Hope it helps.

He started to take a nutrition IV. It is a bag filled with white solution/emulsion, the nurse practitioner explained it's because of fat contained. Then he asked . . . . . "omega-3?"

... ... Just to make sure it's made of fish oil, not .... lard or something :D

And of course, shedding...
It seems like there is a dog on the bed. A dog is not supposed to be in a hospital :-)
One of the nurse practitioner, [nurse] Frau Diana, kindly helped him to shave his head.
Thank you very much... he looks good.

Big news today is that Tateishi san, George's Japanese roommate, was discharged. Fantastic!... even though we miss him. We hope he and his family will visit us in California some time!

And for the last of today's posting... Heros in Heidelberg.

These 4 doctors take care of George and see him every morning.

And he gives George a physiotherapy.

Ciao ciao!

Monday, January 4, 2010

Day +6

Hi, it's Yuko again. Sorry, but no luck for George being up a new posting today... he needs more rest. I just came back from the afternoon/evening visit with him.

His vitals this morning was BP 120/80, pulse rate 100 (a little fast), body weight 63kg/139lbs (his normal is 68kg/150lbs). Body temperature is around 38 - 38.4 C (100.4- 101.1F). No blood test results available yet, but most likely still in neutropenic condition. Dr. Ho mentioned hopefully from this Wednesday the leukocyte level will be going up. This is very good to know and encouraging. It should help him a lot to feel better, mentally and physically for sure.

He has not ingested any food for five days now.Even if he drinks a small amount of Sprite, he feels nausia and throws up, but his stomach is basically empty so looks like just bile comes out ..(o oh, sorry, that's too much detailed information...)

His hair starts falling off, I could actually see his shedding. (click to enlarge)

He said he would shave his hair using a clipper tomorrow. Also he said he feels very weak and like "loopy" because he thinks he has not eaten but taken a lot of drugs through IV; antibiotics and anti-emetic medications... all legal drugs, just so you know :)

So I just tried....I tried to pull hair on his legs, but no hair comes off, so asked him "what about your nose hair???"

... o oops, not funny at all....

So I stopped joking around with him, but just pray for him to be back to the "George" who we know :-)

Today is January 4th, the day I have to get back to work. So I worked from here. I completed more training which was overdue, somewhat releived. I did laundry (yeah!), which sometime takes forever with the dryer here. (it's not a complaint.... yes a little bit complaint...) Working maybe keeps me well-balanced.

No picture today. Hope everybody has a very good morning/day/evening whereever you are.

- Yuko

Sunday, January 3, 2010

Day +5

Hello, this is Yuko. It is snowing here in Heidelberg.
Very sorry, but George is too sick to post today. He wants me to give you an update, so here I am.

Just a quick update. His leukocyte level is 40 today, he's been in neutropenic condition for 4 days already. Platelet level is very low, too. Dr. McClanahan told him to let them know as soon as he feels severe headache, it should be a sign of bleeding in his head... scary.

He still has fever about 38C (100.4 F) when I visited this morning, and he continues to take an antibiotic medication through IV. No mucositis in his mouth, but maybe in the esophagus, therefore he complains pain and discomfort and could not eat anything. Yogurt was left unopen on the side table. I hope he could take pills supposed to be taken "Morgen", though. He takes anti-acid and a painkiller (both are syrup or liquid type) for this pain.

He also wanted me to update other side, what I did, etc...
I didn't do much today, Sunday is a rest day. I read books in most of my free time, or listening 80's music on "Deluxe Music" channel. I guess German people really love 80's, right Judy?

My sister gave me an update about Riki. He and his grandma took a bullet train (shinkansen) to visit my sister's family in Tokyo. He was so excited on taking a shinkansen, which I can easily imagine. Seems like he adjusted to new environment very well, thanks to my mother and all of my family there, and enjoys playing with his cousins (shown in picture). One of my good coworkers said to me before. . . . Everything has a good(positive) side and a bad (negative) side, so you should look at both sides. One of the positive sides in this current situation may be [that it is] a good chance for Riki to bond to my side of family. Now he knows he has a very good extended family in Japan.

I really hope George will be getting better tomorrow so he can say hi to you all.
Let's see...

- Yuko

Saturday, January 2, 2010

Day +4 (Neulasta administration)

Today my leukocytes dropped to 140 and the platelets are at 68. The numbers are now scraping the bottom (click to enlarge). . . .

Today I had my Neulasta injection. An important event for getting back on the road to recovery. Should start to show improvement in blood counts by next weekend. I really hope.

I still feel sick as a dog. I have to force myself to eat even the most minimal amount of yogurt. Understandably I'm losing weight. I'm down to 63kg (normal weight 68kg) and based upon my (lack of) eating it is likely to drop a lot more. The nurse told me that they'll start me on a nutrition IV if I remain this way.

Also, my temperature has risen to 38.8C, a fever. The standard procedure as a precaution is to start people on IV antibiotics if this happens (90% of people fall into this category and are nearly always given IV anti-infective agents). I have been fitted with an IV cannula in my forearm and am being administered the antibiotic Ceftazidime at regular intervals around the clock. It's a third generation broad-spectrum anti-bacterial agent known as a cephalosporin and is commonly given to those that are febrile neutropenic. This is just a precaution to help gaurd against the possibility of an underlying infection that would be very dangerous with my current state of having no functional immune system. But for the vast majority of people that get a fever during this phase of HSCT, there is usually no specific identifiable cause of the fever. Hence it is an idiopathic (cause unknown) fever, which is quite common in this situation and is why nearly all people receive IV antibiotics at this time during hospitalization. The fever normally resolves by the time successful engraftment manifests. [Post transplant note: My immune system showed initial signs of successful engraftment coincident with fever reduction by day +9. So in the end, everything worked out fine with no unexpected complications (except for a temporary skin rash/urticaria).]

Sorry. I feel sick as a dog right now and can't write anymore.

Friday, January 1, 2010

Day +3 (New Year Day)

Akemashite Omedetou Gozaimasu!! (For those that don't speak Japanese that means Happy New Year!)

Also, Dr. Thalheimer stopped by for a few minutes to wish me a happy New Year. Very nice to see him. Such a great doctor and wonderful human being!

I'm not going to waste any time today and just cut right to the chase. . . I feel like crap. Tired, lathargic, run down and most of all my GI tract is telling me NO FOOD, NO WAY! Saying that I feel like I've been through-the-wringer would probably be a fairly representative expression. My lack of desire for food is similar to the time in college when you get horribly sick from drinking [name your own alcohol] and never want to drink the same stuff for the rest of your life. Based on my mindset right now I think I could swear off solid food for the rest of my life. I'm told that this is because the epithelial tissue layer of my entire GI tract is coming off from the chemo. At least I know that this should resolve in another week-to-ten days. I have to remind myself of my own maxim. . . . "No situation is so bad that it cannot get worse." It's nice to have the nurses here providing some moral support and reassurance that they are here to help me through it and that this too shall pass.

This morning my leukocytes measured at 222 and platelets at 102. In this setting that is essentially zero. My immune system is gone (and also "reset" from the standpoint of my MS). Detail history (click to enlarge). . . .

Last night Yuko and Frank went to Old Town Heidelberg to ring in the New year. I'm very glad they had an enjoyable time, loving to see the images and video. I'll take watching it from a distance and am glad to be here in Heidelberg. If I never had the opportunity to see Frank again, I would be glad to know this is my last image of him. . .

They went over to the bridge entrance into old town to join the throngs of other New Year revelers. I think the following video requires no further explanation. At least now I know where all the German socer hooligans migrated to. . . . . . .