Tuesday, 21 February 2012

Sharp Practices

A couple of weeks ago I had my first follow-up haematology appointment since before Christmas and also since my small op. Was disappointed and not a little puzzled that my haemoglobin had dipped down again, this time to 12.3. The consultant was reassuring though, commenting that my overall blood counts were not showing anything concerning and that recovery after such chemo as I had last summer can show peaks and troughs along the way. Odd itchy patches and occasional digestive disturbances were also consistent with an immune system building itself up again but not quite there yet. She does not want to see me in clinic for another three months in any event and I continue to feel very well, January’s operation seeming also to have been a success.

Last week it was time to go back to work. I will be going into the office three days a week and working at home the other two days. My sudden departure back in September 2010 and prolonged absences thereafter were the catalyst for recruiting an excellent part-time administrator who, with another colleague, has made great strides in dealing efficiently with vital day-to-day tasks. This will leave me freer to concentrate on projects, which I really welcome. It was wonderful to be back in the City, although by the end of the week I was pretty tired.

Having started back I then had to take some more time off last Tuesday morning to be poked with yet more needles, as it was time for my third bone marrow biopsy, aimed at assessing how successful last year’s stem cell autograft has been at clearing my system of wonky cells and beating back the disease. BMBs have their moments of unpleasantness and apprehension as, even with generous quantities of local anaesthetic, there are twinges of nervy pain and feelings of bruising when all is over that last for a few days. It is key to the success of the procedure from the patient’s point of view that the person performing it has a calm and communicative approach. Conversation helps the whole thing go much better and there was plenty of that on this occasion, as there were two nurses present, one of whom was there to learn the ropes, or rather the needles. Glad to say that this particular biopsy went as well as possible and I was soon striding down Tottenham Court Road to catch the Tube to work, pausing briefly to drool over cameras and computers in the windows of the high-tech shops that line that particular street.

The results of the biopsy should be through later this week, but in the meantime here are some pictures. There is a good description of the procedure and its aims here

I got to look at this colourful picture of exotic birds as the BMB was  carried out

The first part of the procedure is the obtaining of bone marrow "aspirate", semi-liquid bone marrow, which is drawn up into a syringe and then smeared onto glass slides for analysis by various tests and clever people.
The blobs you can see show that good samples have been obtained, I was told.

Bone marrow trephine, a core sample of bone marrow, not as painful to obtain as the aspirate.
The purpose of biopsy is to test the makeup of the bone marrow and the relative concentrations of the different groups of blood component cells that are produced there.
When I was diagnosed in September 2010 the concentration of malignant B-cells was 85%. At my second biopsy in February 2011, my bone marrow was clear of the little blighters.