February 25, 2012

the best laid plans, part I

     Scientists love protocols.  It insures that one's particular experiment is carried out the way it's supposed.  Doctors aren't too different.  And so there's a temptation that the protocol is supposed to unfold according to plan.  Basically, it's like a script for a play.  It's real tempting for the patient to believe, too.  After all, who wants to go into a life or death situation and expect that it will be utter chaos?  Not exactly reassuring.  Regardless, that analogy falls apart real quick in the real world of medicine.  The beginning of my dad's experience is a prime example and we're not even at the beginning yet.  Diseases don't read the textbook or protocols so things rarely go according to plan.

     A meeting with the doc but I'm not there since I have an exam (of course exams have to coincide with my dad's stem cell transplant, how could it be any other way).  The CT of the head and neck picked up a node on the neck.  I assume that it's a lymph node, feel my dad's neck and think "that node doesn't feel any bigger than it usually does".  Couple that with the fact that it didn't not light up with the PET scan and it doesn't seem like a big deal to me.
    The preliminary pathology report of the bone marrow biopsy shows minimal disease that has been stable since the previous biopsies.  That's wonderful, wonderful news.  On average, his type of CLL starts to rear its ugly head by 6 months after chemo.  We're pushing 8 months now so I was starting to get nervous.  Plus, my dad has had fatigue come roaring back the past month.  I presumed it was due to the cancer coming back but it wouldn't appear so based on these results.  But the biggest reason this is good news as that the probability of a successful stem cell transplant goes up substantially when the cancer is stable and minimal.  Active disease is very, very bad so Wednesday ends with an air of cautious optimism.

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