Total Change of Direction x2 - Dr. Rich Calls an Audible

Yesterday I mentioned that my doctors and I were changing our direction today on our mission to get my platelets up to functional levels and keep them there. We ended up changing directions, twice.

I reported to Dr. Rich's lab this morning to start a new (to me) treatment called Rituxan (Rituximab). Rituxan is administered through an IV injection and used to treat certain types of non-Hodgkin's Lymphoma. In my (ITP) case, the plan was to use it to increase my platelet count because the plan I was on wasn't cuttin' the ketchup. I was excited and nervous at the same time. The side effects of Rituxan can be harsh, especially during and after the first dose.

Meet Dr. Rich's administrative staff, Kelly and Jamie. Both are the best in the biz!

Kelly and Jamie - There's Nothing They Can't Solve!
Reporting for Duty - December 2, 2011

Bad Bad Antibodies
Jayme - IV Expert and Super Nice
The first item of business was to set up my IV. Jayme, not to be confused with Jayme at the front desk, did the honors. I have to say, she's an expert. I didn't feel a thing. OK, maybe a slight pinch. Jayme took a blood sample, as is customary every time I step in the door, for a quick analysis. The results showed that my platelets had dropped to 26k from 43k where they were two days ago. My body just insists on destroying my platelets.

Dr. Rich Calls an Audible
With the platelets on a rapid decline, Dr. Rich went Peyton Manning on me - he called an audible. He took a look at the defense and audibleized. He changed the plan on the fly. I love that! Instead of an offensive strategy, a 5-hr infusion of Rituxan to increase platelets, he switched to a flanking strategy. Consulting with other cancer experts, he decided to target my evil antibodies.

Dr. Nathan Rich, Oncologist - Moments After He Called the Audible. Expert!

The New Plan
Let's get some WinRho in there to divert the antibodies' attention. WinRho's tagline is: Upward and Onward: Supporting Platelets and Patients for More Than 15 Years. I look for two things in taglines: Cheese and Buzzwords. WinRho delivers and makes me feel sooo good. I also like WinRho's administration instructions, WinRho SDF must be administered via the intravenous route for the treatment of ITP. Viva WinRho. Woot. I'm pumped already. Let's get it in!

Dear Ricky, What the Hell is WinRho?
Good question. From the Internets (so you know it's true): WinRho SDF is an immunoglobulin (Ig), which contains antibodies to the Rho(D) antigen. Exactly how it works is not known. Very consistent with me: Exactly how I work is not known. Dr. Rich explained it to me this way. WinRho is a blood product that will coat my [positive] red blood cells. The reason WinRho will behave this way is because it will be extracted from negative blood types. The negs don't like the pos and the pos don't like the negs. When my evil antibodies see that action, they will stop their feeding frenzy on my harmless platelets and go attack my red blood cells. See, my evil antibodies want to be heroes after all. Since my bone marrow factory is doing its job properly, cranking out platelets, and my now heroic antibodies are busy working my red blood cells, my platelet count will climb. Brilliant!

What About Your Red Blood Cells, Ricky? Don't You Need Those?
Yes, I do need my red blood cells - they carry oxygen, iron, and, uh zzz... and that's an equally important job. Dr. Rich explained the answer but my head and other parts were bumping so hard that I don't remember it. It's on my list of questions next to, When do I get my prescription for marijuana? and Does EPO come in pills because I'm really sick of needles?

WinRho Doesn't Feel Good
I finally got my WinRho injection at 8:30pm. It came straight out of the fridge and into my arm. It went down cold but smooth. In all, it took about 15 minutes to get it in. My nurse had to literally squeeze the bag with force to get it all in. I think this stuff has the viscosity of like Pennzoil 10W-40. I'm a Quaker State man myself. Because of the crazy list of potential side effects that come along with this "we don't know how it works" WinRho, I had an eight-hour observation period. I spent the night at Utah Valley. This place is starting to feel like Marriott to me. My side effects included hot and cold flashes, sore throat, slight back pain, really blurry vision, then extreme hot and cold flashes, followed by a laughing epidemic. Sounds like a normal day back in my office.

One other change to the game plan includes weening myself off of Prednisone because it's not doing anything for me and switching to Dexamethasone. Dex is 4-5 times stronger than Prednisone. We'll ramp it up though so I don't go too kooky too quickly, starting with 40MG. Prednisone's for kids. Wait, I really don't mean that. It's nasty!

Chad, High-end Photographer. Expert!
Other fun things today included a trip to the imaging studio for an exciting photo shoot. We took close-ups of my lungs, abdomen, and pelvis. I told them no Photoshopping me - I want to be all natural just like the celebs in mags. CT scans are always a pleasure because I get to drink the worst concoction ever invented designed to create internal contrast. You get better pictures that way. I went with the warm, delicious, and always gaggy "Berry Smoothie." Settle down, Jamba Juice, you don't need to call the bankruptcy lawyer yet. But if you don't bring your prices back down to reality, don't lose that number. Thank goodness Chad didn't make me drink the Avagard again. Kid's got a warped sense of humor.

The Gift That Keeps On Giving

Special Bonus...Affirmations
Now this is going to freak some of you out. Brace yourselves. Sitting down? Right before my 3:45am urine sample, my PCT, Nicolli, came in and whiteboarded some affirmations. Then she made me help her pound out some new ones...for me. They're on the board. Wow, this Dexamethasone rocks! Hey Stuart Smalley, I like you. I really like you. If I'm lucky, I'll get my chakras adjusted before I get out of here.

Nicolli. Expert PCT and Affirmation Maker
I Feel Better Already

Platelets: 26k
(down from 43k two days ago)
Meds: 40MG Dexamethasone (Steroid), 3.75MG WinRho


Persnickety Prints said...

Ricky- you are going to lose sympathy by making this whole adventure look like so much fun! Hope the new play can score some relief!

Skiing Entrepreneur said...

Dude, I love your writing almost as much as I love you! Almost...

keep it coming, we're listening.