Day 9 – Immune System Returning   October 15th, 2011

My hopes for a start to the recovery of my immune system have been fulfilled. Yesterday my white blood cell count was hovering between zero and 50 lymphocytes (4000-6000 is normal), and this morning I was at 130, and by evening up to 330.

I may or may not have any countable neutrophils, but with the WBC lymphocyte count increasing, I will start having them soon – tomorrow or Monday for sure. The neutrophils tend to be in proportion (70% or so) to the white blood cells (lymphocytes), but not necessarily when the numbers are small.

In order to be discharged I need to have three days in a row where my neutrophils number 1000 or more, or one day where they are 5000. And my platelet count needs to be steady above 20. I may be out as soon as Wednesday, but it could also be next Saturday, depending on how things go.

While I had a couple requisite naps, my energy levels were definitely a bit better today, and I even got to go outside (with sterile mask on) to enjoy a bit of the sunshine. Haven’t experienced any part of the outdoors in over two weeks at this point. I was pretty wiped out after both my slow walks with the girls (hence the naps).

After my afternoon blood work, I ended up with another 6 unites of platelets, as I was back down to 17,000 (from 23,000 this morning). And I was given magnesium via IV to compensate for a small deficiency earlier in the day.

I still am maintaining a mostly mild fever (99.0-100.6F/37.2-38.1C), which appears to not be unusual for someone who went through the TIL/TBI treatment (and is even considered a likely sign that the TIL are hard at work).

Several of you had asked question about broths and food in general with respect to my mouth dryness and soreness. I am finding I am having an easier time with warm liquids than with room temperature or cold. And thinner liquids create less of a mucous issue than creamy or thick ones. So clear broths with added material (meat protein, maybe some noodles) work pretty well as does warm tea (room temperature tea is not bearable). Solids outside the broths are not very good at this point because they get stuck in my mouth and require lots of water and gagging to get them down.

Linda had me try a thin butternut squash soup today, and I managed to get a fair bit down, but it was still too thick to do again in the next couple of days. We also experimented with apple juice. I couldn’t stand the bitterness and acidity of cold apple juice when I tried it this morning, but after Linda heated it up in a microwave, and it became more more palatable. Go figure.

The respiration department here at NIH also dropped off a new toy which might make sleep easier – it’s a vaporizer that uses oxygen to mist sterile water into a tube and attached mask. It’s very loud, but I have high hopes for it working tonight now that I understand how it works (although I think I look a little alien with the mask on). Would be great to maintain moisture in my mouth and nasal passages while I sleep.

I will leave you all with a webcam capture of the latest evolution of my Mr. Clean look. And no, no plans for any earrings (sorry Dara) :-)

Going for the Mr. Clean look, sans earring

Going for the Mr. Clean look, sans earring