Blasts Are Back

            I knew it was going to be bad news when Faye at Cox 1 in Mass General called at 10:45 a.m. to ask if we could come an hour early for another echocardiogram. Back in August, when they discovered the relapse, Dr. Fathi told us that David wasn’t eligible for any clinical trials because of his low heart ejection fraction. (One of the first chemo drugs he was given, daunorubicin, probably damaged his heart.) So, the only reason he would order another test right now would be if the latest round of conventional chemo and the DLI (donor lymphocyte infusion) had not been successful. Well, they weren’t.

            The October 6^th bone marrow biopsy showed 16% blasts.

            So, today, instead of seeing the transplant doctor, Dr. Chen for news about the DLI, we’re back to Dr. Fathi, the cancer doctor. He was very sympathetic when he delivered the news. He outlined the current options, both conventional treatments and clinical trials. He sent us home with two thick packets of description of and consent forms for two possible clinical trials. Jim, David, and I will meet with him on Wednesday to discuss the matter, once the latest EF (heart ejection fraction) is known.

            The good news is that most likely the treatments would be outpatient, requiring two office visits a week, after a 9 hour initial screening. The bad news is that the potential side effects are very serious, and the expected success rate not high.

            Our New England Railroads trip was a complete success. Jim and I thoroughly enjoyed all the interesting people we met and the classic railroads we road, including a dinner train ride in Lincoln, NH and a luncheon aboard the Cape Cod Central Railroad. Both featured delicious meals, white tablecloths, and beautiful fall scenery.

            The greatly anticipated ride along the famous White Mountain Kancamagus Highway did not disappoint. The fall colors were at their peak, the coach ride smooth and relaxing. I felt a bit of anxiety on the Cog Railroad ride up the steep, stark landscape to the summit of Mount Washington, but kept myself entertained on the way down by watching the steel roller between the engine and the passenger car. They aren’t connected at all. The operator explained that we did not want to be pulled downhill by a runaway engine. He expressed great confidence in the car’s braking system, and I decided to marvel at the engineering wonder and enjoy the ride.