Last day of March

Our son Matt wins the contest to find a mnemonic for Walter Reed: a wooden replica of a tiny bird: a wren mimic (WReNMiMiC).

David slept quite a bit until late afternoon, received blood and plasma through his port, and hosted a raft of doctors and med students and nurses. Dr. Wanko expects him to start the downhill part of this chemo cycle and hit bottom in about two weeks. They will decide on further treatment when they get the final lab results on the bone marrow biopsy.

 In other news, today it finally felt like I had driven seven hours south of Lexington. Sunny, blue skies, high 64°. I walked to the CVS in Bethesda center; it felt wonderful to leave my coat at home. Unfortunately, just as the weather turns, David is confined to the unit, since he is getting neutropenic, i.e. possessing an abnormally low white blood cell count and thus susceptible to infection. The chemo is killing off the leukemic white blood cells, but also every other type, hence the intravenous blood transfusions, and antibiotic, anti-fungal, and anti-viral medication.

Peaceful Sabbath

Peter, Xiomara, and 11 month-old Andrew drove down to Bethesda from the Bronx Saturday evening. We all visited David Sunday morning, then went to the ward (Mormon congregation) for young single adults in Chevy Chase, MD. Jim and I introduced David by proxy to the congregation during the sacrament meeting. I was deeply touched by our reception, as members gathered around us, offering friendship and support. Many young Mormon singles are in training at Walter Reed Medical Center or work and live nearby. David will get quite a few visitors this week. By the time we arrived at his room after church, three of them were sitting on his couch chatting and a fourth year medical student dropped by later.

David looks good, is not in pain, and laughs and talks freely. His anti-nausea medication works well. He enjoyed Andrew’s visit, although Andrew stayed near his mother and kept a safe four to six feet away. The subject heading of a recent family email by Army Specialist Johnston read “Having leukemia in the army does have its positives”. Inside were two selfies of the bearded Army medic and this further commentary: “Unfortunately, I just took a massive hit of chemotherapy, which may or may not cause all good things to end in this department.”

Rainy Saturday

Another quiet day at Walter Reed. My brother Steve, Jim, and I spent a few hours with David. He’s doing well and enjoyed some phone conversations. Last night Jim noticed that the hefty machine that registers blood pressure and temperature was pulling away from the wall. He helped detach it and position it on the floor. It had never been attached to a stud and would have fallen right onto the bed soon. Today they moved David to a room down the hall to avoid the plaster dust. His new room is nearer the end of the building, with a bigger couch, two chairs, and a nicer view.

Speaking of views, from the hallway window near the fifth floor elevator, I can see the LDS Washington Temple, where Jim and I were married 35 years ago. The white and gold spires rise above the trees. It’s especially lovely at night.

Day Three at WRMMC

Another boring day (oh how I love boring days in a military hospital) at Walter Reed. David had a port installed in his chest early this morning, so that the chemo drugs can be delivered into the superior vena cava, the vein that goes directly to the heart. This sounds alarming, but this large vein can handle the chemo much better than the smaller wrist veins.

There was a rumor that the chemo would start late morning, but it actually got going at 4:30 p.m. For those of you with a score card, he will receive daunorubicin over 10-15 minutes, once a day for 3 days. At the same time he is receiving cytarabine continuously for 7 days.

He’s in excellent spirits right now. He’s only been back from Korea for 53 hours, so his sleep cycles are still off. We had a videochat with Peter, Matt, and Sam, with cameos by Xiomara and wee baby Andrew, who just turned 11 months old on Tuesday.

Prize to whomever comes up with a word that uses WRMMC, in that order. Extra points for English. Linguists are eligible to enter.

Day Two at Walter Reed Military Medical Center Bethesda

I didn’t have web access at Walter Reed today, so I’m starting this blog by pasting Jim’s email update here:

David had a wonderfully boring day today. He slept well last night. We were with him all day as he and the medical staff prepared for what is to come. They did another bone marrow biopsy (the first was in Korea), and measured everything about him in order to have a baseline before the start of chemo. He had breakfast, lunch, and dinner. He took a nap in the afternoon. He felt well all day, though he spent most of his time lying down and moved slowly when he was on his feet. At 6:30 p.m. we took a walk around the hospital and found a Subway and had supper.

David has two main doctors (Dr. Sam Wanko, an oncologist, and Dr. Eric Schofield, a hematologist), an internal medicine doctor (Dr. Michael McMahon), and a resident (Dr. Ben Vipler). Also, each shift has a nurse, a charge nurse, and a tech. They have preliminary results of today’s biopsy, confirming the Korea finding that the cancer is acute myeloid leukemia (AML). There is still more to know from both biopsies that could be quite important, but this will not be known for one to two more weeks. They know enough to begin chemo.

Tomorrow morning a port will be installed to give direct access to the superior vena cava vein near the heart, and then chemo will begin. It will continue daily for seven days.