Day 16 - Dr. Han Myint Appointment - September 29 2011

Jan Martin drove me to my first out-patient appointment since the Stem Cell Transplant with Dr. Han Myint on September 29 2011. My appointment was scheduled for 3 PM and they actually had us in an exam room right at 3 PM.

However, we sat and sat in the exam room for more than hour before Nurse Practitioner Denise came and showed me the lab work results from this morning and asked me a few questions. Denise noted my serum protein and albumin levels and was impressed that Jani had maintained my diet so well since discharge - making sure I was eating adequate levels of protein each day despite my continued nausea. If you look at the values over time chart below, you can see, I never ate enough protein while I was hospitalized with the Protein value ranging between 4.8 and 5.1. Now 2 days post hospital discharge, my protein level still is not in the normal range of 6.4 to 8.3, but much closer at 6.2.

Around 4:30 PM, Dr. Myint came in and said I was doing fine. He decided to give me a Neupogen injection to stimulate my new bone marrow into action since my white blood cell count had dropped from 2.8 on Day 14 to 1.3 on Day 16.

I'm scheduled for a bone marrow biopsy on November 2 2011, just prior to my Day 60 when the decision will be made on whether I will require a tandem (2nd) stem cell transplant. If that bone marrow biopsy shows any abnormal cytogenetic (DNA changes), I will need the tandem transplant. If the cytogenetics are normal and I'm in the top 3 categories of remission, then I would not require the tandem stem cell transplant. If I need the tandem transplant, it would be done right after all of the bone marrow biopsy results are done and finalized. My insurance company, Anthem, has already approved the tandem stem cell transplant.

We were still waiting for the neupogen injection when the nurse poked her head in the room and said they were waiting for insurance approval. Neupogen costs about $250 per one 300 g dose. Not long after, an obviously pregnant nurse came in the room with the neupogen and I asked her if there was a another nurse who could give the injection. The nurse looked so hurt and said, "Yes, there is." I quickly told the pregnant nurse that I had shingles and then she understood. The 2nd nurse came and gave me the injection and I took a Claritin tablet that I brought with me.

Now 5:00 PM, we went downstairs to schedule future appointments. Jan Martin waited at the desk with the scheduler and I went through a door to the Apheresis Department which has temporarily moved to the 1st Floor while the new space is being remodeled. Jessica Jones from Apheresis was there and we had a good visit.

With appointments in hand by 5:35 PM, Jan Martin drove us back to The Timbers. I told Jan that if I had to wait all afternoon by myself at the University of Colorado Hospital Outpatient Cancer Clinic - it would have been miserable - but visiting with Jan was wonderful and the 2 1/2 hour appointment didn't seem that LONG~

I collapsed into the bed for a 2 1/2 hour nap. Jan Martin made me mashed potatoes, fried chicken, and canned spinach for dinner and I ate it all - so yummy and loaded with protein.