Sunday, July 19, 2009

Guest Blog: Moving in the Right Direction

Your faithful reporter and Gil's personal nurse extraordinaire (Karen) has earned herself a day off, so this post comes courtesy of Evan, the curly-haired youngster (lower left) in the picture of Gil, Adam and yours truly, circa 1989.

Upon arriving from Los Angeles on Friday I was pleased to find my dad in good spirits with his condition slowly improving after a few tough days resulting from the side effects of his Neupogen treatment. Fortunately, he is feeling "much better" and his face was bright once more when Marika and I burst into his hospital room on Saturday morning armed with smiles for him and a plateful of freshly baked blueberry muffins for the hardworking nurses on his floor.

We have been anxiously waiting for an improvement in Gil's neutrophil count and an increase in his albumin level. A rise in his neutrophil count would be a sign that his bone marrow has begun to once again produce cells after the trauma from his first round of chemotherapy. And according to his oncologist it would also significantly improve the aches, pains, and other side effects he has been dealing with recently. Albumin is a soluble protein that is critical for osmotic pressure balance. An increase in Gil's albumin would help with the edema in his lower legs, which at this point is more of an annoyance than a medical emergency.

The irony of chemotherapy treatment is that much of my dad's efforts to aid in his own healing have been staunched by the very therapy he is being given. For example, it's hard to increase your daily calorie intake when your tongue is sore (another apparent Neupogen side effect), nevertheless he is persevering to eat as much as he can to supplement the TPN.

Today, however, we got some promising news: Gil's neutrophils levels have increased steadily, if not slightly, from 0.1 to 0.2 to 0.3 (UPDATE: 0.6!) over the past three days. (For reference, normal values range between 2.5 - 7.5 x 10^9/L). In addition, while his albumin levels are still low, the albumin precursors in his blood were increasing, indicating that the edema he has been experiencing in his legs may soon improve.

While this progress can seem excruciatingly slow, it feels that we are finally moving in the right direction. Finding the joy in these "small wins" keeps our spirits up and our resolve determined.

In spite of everything, this experience has been a blessing in one regard: It has been a real treat to spend some quality time with my dad. Despite what he may think, sitting alone with my old man in his hospital room, quietly reading and talking about life has been tremendously enjoyable. Rarely do our two busy schedules permit us such unrestricted time to relax together and reflect on issues both significant and trivial.

For me, it's an opportunity to absorb some wisdom from the old sage himself. (Although it isn't a complete tragedy that his tongue is sore; I can finally get a word in edgewise). For Gil, I like to think that we help distract him from the annoying side effects of treatment and keep him connected to the outside world, even if just to report that Michael Jackson had died. (Yes, Gil was perhaps the LAST person on earth to hear the news a few weeks ago when we belatedly informed him the morning following the passing of the King of Pop).

So after perhaps the longest blog entry in recorded history (so says Marika) I am headed to bed. Tomorrow is another day where we look forward to the morning neutrophil report. Stay tuned!


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