Good Blood, Bad Blood

I drove to the hospital in town. Smoke billowed on the Washington shore of the Columbia River. Like a genie escaping from the bottle of dry forest, it swirled upwards in the morning breeze. 

I have a standing order for monthly labs through next February. With this bloodwork, we will assess my response to last December’s CAR-T procedure. For now, I can forego alternative diagnostics: bone marrow biopsies, MRIs, and PET/CT scans. It fits my mantra that, “less is more.” 

I checked in. A lab tech opened the door. My name was called. We greeted each other. The tech gathered seven color coded vials. Despite fifteen years of needles, hundreds of sticks, I need a bit of conversation to relax. I peppered her with questions, “How was her day? What time had she started? Where did she live?” 

The fire complicated her life. She lived across the river, adjacent to the blaze. She shared a home with a cat. She learned after coming to work the fire evacuation zone now included her residence. Her cat and I had something in common. It has special needs due to immune system deficiencies. And, she was worried.

The tech performed my blood draw with efficiency. The “stick” barely registered in the pain department. The vials loaded fast. She bandaged the crook of my elbow. I commiserated with her about the cat and the fire. I wished them both well.

Over the next several days, the fire’s drama unfolded as my lab results returned. They revealed a body healing from December’s intervention with CAR-T. Overall, the latest bloodwork is positive. Some results are perfect. They reflect a long sought balance in specific categories. That’s good. But, and there will forever be buts, there are questions about other relevant numbers. It’s been nearly seven months. Room for improvement exists. Is this indicative of remission or relapse?  I don’t know. I won’t label it either. It’s still wait and see.

So it goes for myeloma patients. Clarity is an illusory goal. I anticipate the diagnostics. I strive to remain detached from the results. I don’t worry much. But, I’m curious about what’s next. The treatment I underwent is not a cure. Yet, for the moment, I don’t have to make any decisions. I’m drug free. It’s a good result with no promise of durability.

Meanwhile, the temple of my body is cluttered with side effects. The inflammatory response from December’s treatment presents as joint stiffness: elbows, knees, shoulders, hips. My feet are troubled with neuropathy. A stubborn case of ONJ persists. Chemo brain translates into writer’s block. Hence, this post that tries to make something out of nothing. Mild word aphasia leads to stutter stepping conversations. I reorder my life with lists and exercise routines. I trust my body and mind to improve with stimuli that challenge the deficits. But it’s slow. Patience, patience, patience …

I keep things simple. I tend the garden. I fuss over the potted plants. A new tree, a cut leaf maple, needs nurturing. There’s weeding and watering. A cohort of bees, drunk with pollen, visit the poppies. My cat, Spanky, enjoys wildflower salads on the periphery of the beds. In the evening, he sleeps on the warm stepping stones of the garden path. They radiate heat from their day in the sun. I sit on a bench by the veggies. I serenade the cat, the birds, and the plants.

*****

My wife and I departed for seven days to attend a family reunion. The Tunnel 5 Fire in the Columbia River Gorge was far from contained when we left. The extraordinary danger of this blaze prompted an aggressive response.

The Gorge is a dynamic environment for wildfire. Prevailing breezes act as bellows. The cliffs are difficult to access. Large trees and dry grasslands provide volatile fuel. Some dwellings were lost in the early stage of the fire. However, suppression efforts from planes and helicopters minimized damage until ground crews arrived. Slowly, control on the steep terrain improved. Evacuation orders eased. My wishes for the lab tech and her cat were answered.

An updated graph in The Drill.

And, a song: If I Could Only Fly by Blaze Foley.