Yesterday I got some info on the blood bank at the Clearlake MD Anderson in case anyone was interested in giving blood around this area. That way you wouldn't have to go all the way to the medical center. So the center is right by St. John's Hospital on NASA Road 1. Go into the MD Anderson building. The lab is in Suite 380. The phone number is 713-834-6668. The hours are:
Monday: 8am-4:30pm
Tues/Thurs: 11:30am-8pm
Wed/Fri: 6:30am-3pm
You need to call and make an appointment if you are giving platelets and the last platelet appointment is 2 hours before they close. Also, you will need a picture id to donate.
Hope this info helps.
*For those that don't live in Houston, read my mom's comment from this entry. It will direct you to how you can donate in your area.
Tuesday, August 28, 2007
Monday, August 27, 2007
Meeting with the New Doctor at Clearlake MD Anderson
So I had the meeting with the doctor at the new Clearlake Campus of MD Anderson this morning. He is very nice and I really like him. He seemed to be on the same page with our thinking and wants to make everything easier for us by doing everything we can locally instead of going all the way to the medical center. The facility itself was very nice and everyone was very friendly. It looks like I'll be able to do most of my labs there, as well as any transfusions I need. I cannot do chemo there, but that's ok. The labs are our biggest concern at the moment. The doctor is supposed to coordinate with my chemo doctor and the study doctor and see if we can consolidate some of the labs they require. I'm supposed to get a call sometime this afternoon about that.
Anyway, I love the new facility and I'm excited to be able to go there. I'm feeling pretty good health wise. Tired as usual, but still able to get around pretty good. Not much of an appetite, but still eating like I should. That's all for now. More later...
Anyway, I love the new facility and I'm excited to be able to go there. I'm feeling pretty good health wise. Tired as usual, but still able to get around pretty good. Not much of an appetite, but still eating like I should. That's all for now. More later...
Thursday, August 23, 2007
Chemo Round 5, Day 4
Lauri finished her fourth day of chemo round 5 today. She is feeling alright, just really tired at times. Some of that fatigue is due to early appointments at MD Anderson. She gets her Mesna and Adriamycin pumps unhooked tomorrow. She is really excited for that to happen!
Once Lauri gets unhooked tomorrow, then we just take it easy and try not to catch a fever. We never found out why Lauri ran a fever during the last round. We only hope that whatever caused it is gone now. At the end of this cycle, Lauri will have another CT scan to help us determine if the old "stuff" in the left lung has finally disappeared, as well as a status on her other tumors. As always, we'll keep you posted...
Once Lauri gets unhooked tomorrow, then we just take it easy and try not to catch a fever. We never found out why Lauri ran a fever during the last round. We only hope that whatever caused it is gone now. At the end of this cycle, Lauri will have another CT scan to help us determine if the old "stuff" in the left lung has finally disappeared, as well as a status on her other tumors. As always, we'll keep you posted...
Monday, August 20, 2007
Chemo Round 5 - Day 1
Lauri finished day 1 of the 5th round of her chemotherapy today. She is feeling fine, but she isn't very thrilled about her "baggage." As you may remember, Lauri is now being given her Adriamycin over a 72 hour continuous infusion. They put her Adriamycin, along with her Mesna, in her backpack, along with pumps for both medicines. It adds a little weight to the bag, but she carries it just fine, even though she will say otherwise...
At our appointment with our Oncologist last week we arranged to have Lauri's blood work done at the new MD Anderson wing at Christus St. John's Hospital in Clear Lake (right next to NASA = close to home). Our Oncologist knows the two doctors stationed at the new wing, and she called to arrange an appointment for us next week. Hopefully, we can begin getting Lauri's blood work done at the new wing immediately after the appointment. It will be a lot closer for us, and a greatly reduced impact on the car and our schedule.
Also, for the record, I found out today that I have a blood type of A+. I told Lauri that she should be proud that I have the best blood around! You can't get anything better than an A+, right?!? Needless to say, she was not impressed. Geez...
At our appointment with our Oncologist last week we arranged to have Lauri's blood work done at the new MD Anderson wing at Christus St. John's Hospital in Clear Lake (right next to NASA = close to home). Our Oncologist knows the two doctors stationed at the new wing, and she called to arrange an appointment for us next week. Hopefully, we can begin getting Lauri's blood work done at the new wing immediately after the appointment. It will be a lot closer for us, and a greatly reduced impact on the car and our schedule.
Also, for the record, I found out today that I have a blood type of A+. I told Lauri that she should be proud that I have the best blood around! You can't get anything better than an A+, right?!? Needless to say, she was not impressed. Geez...
Thursday, August 16, 2007
River Rafting at MD Anderson
Lauri and I returned to MD Anderson for our standard blood tests, chest x-ray, and meeting with the study doctor. Lauri's counts look good, so it looks like we are set for continuing chemotherapy with round 5 beginning on Monday. Our Oncologist will give the final word at our meeting tomorrow.
How they will administer the chemotherapy drugs to Lauri for the next two rounds will be changing. As you may remember from past notes, Lauri takes two chemotherapy drugs: Ifosfamide and Adriamycin. Up to now, Lauri receives Adriamycin via a "bolus", which is basically an IV bag given over 1 hour or so, on the first day only. She receives Ifosfamide over 3 hours for 4 consecutive days. The change is that Lauri will now receive Adriamycin via a "continuous infusion" over 72 hours. What does this mean to people who speak english? Instead of receiving Adriamycin via IV on day 1, she will instead get a fanny pack with the Adriamycin and a small pump that will infuse the medication much more slowly (over 72 hours instead of 1 hour). Administration of the Ifosfamide will not change.
Providing Adriamycin via continuous infusion translates to a greatly reduced risk to the heart, meaning we will no longer require the Zinicard medication. There is a greater risk of mouth sores, however, we take the study drug Palifermin to counteract that side effect. The change to the fanny pack was made to bring our medication process more in line with the study we are on. Some studies require Adriamycin to be given via bolus, while others require continuous infusion. Either way, Lauri will receive the same dose of Adriamycin, just with more "baggage" this time...
The really interesting part of our visit to the hospital was the ride home. It took us 1 1/2 hours to get home today due to extensive flooding in the downtown and Medical Center areas of Houston. We got our money's worth out of the navigation system in our car! We tried all kinds of ways of getting out of Houston, with just about all of them being blocked due to high water. We eventually weaved through subdivisions and roads we had never been on before, through the ghetto, to get to the interstate. We got home, though. Trouble is, we have to go back tomorrow, with more rain expected later today. Hopefully the water levels will fall...
How they will administer the chemotherapy drugs to Lauri for the next two rounds will be changing. As you may remember from past notes, Lauri takes two chemotherapy drugs: Ifosfamide and Adriamycin. Up to now, Lauri receives Adriamycin via a "bolus", which is basically an IV bag given over 1 hour or so, on the first day only. She receives Ifosfamide over 3 hours for 4 consecutive days. The change is that Lauri will now receive Adriamycin via a "continuous infusion" over 72 hours. What does this mean to people who speak english? Instead of receiving Adriamycin via IV on day 1, she will instead get a fanny pack with the Adriamycin and a small pump that will infuse the medication much more slowly (over 72 hours instead of 1 hour). Administration of the Ifosfamide will not change.
Providing Adriamycin via continuous infusion translates to a greatly reduced risk to the heart, meaning we will no longer require the Zinicard medication. There is a greater risk of mouth sores, however, we take the study drug Palifermin to counteract that side effect. The change to the fanny pack was made to bring our medication process more in line with the study we are on. Some studies require Adriamycin to be given via bolus, while others require continuous infusion. Either way, Lauri will receive the same dose of Adriamycin, just with more "baggage" this time...
The really interesting part of our visit to the hospital was the ride home. It took us 1 1/2 hours to get home today due to extensive flooding in the downtown and Medical Center areas of Houston. We got our money's worth out of the navigation system in our car! We tried all kinds of ways of getting out of Houston, with just about all of them being blocked due to high water. We eventually weaved through subdivisions and roads we had never been on before, through the ghetto, to get to the interstate. We got home, though. Trouble is, we have to go back tomorrow, with more rain expected later today. Hopefully the water levels will fall...
Wednesday, August 15, 2007
Home Sweet Home
Well, we finally checked out of Ritz Anderson and arrived home around 12:30ish. It's going to be a short visit home because we have to go back tomorrow for more lab work, chest xray and doctor's visit with the study doctor. Friday back again for another doctor's visit and the Pallifermin. Fun, fun. Overall I feel really good. My counts are all in a good range. I feel a little sleepy because of the terrible sleep you get in a hospital. I'm sure Jeff and I will both sleep well tonight in our own bed. He says sleeping on the "chair which folds out into a bed" was not very comfortable and he felt like he had been camping for the last 4 nights in a tent that was pitched on rocks. He'll sleep like a baby tonight, I'm sure!
Just wanted to thank everyone for the phone calls and well wishes while I was in the hospital. It helped the time fly right on by (wink, wink). Anyway, glad to be home and not attached to the iv pole. That's all for now.
PS. Chemo is still on for next week as of right now. We'll keep you posted if that changes.
Just wanted to thank everyone for the phone calls and well wishes while I was in the hospital. It helped the time fly right on by (wink, wink). Anyway, glad to be home and not attached to the iv pole. That's all for now.
PS. Chemo is still on for next week as of right now. We'll keep you posted if that changes.
Tuesday, August 14, 2007
Still Vacationing at MD Anderson
We finally got to talk with our Oncologist today (she was out yesterday). She told us that Lauri will need to stay in the hospital through Wednesday, possibly as long as Thursday. Lauri's start date for Round 5 of chemotherapy will be pushed back about a week to allow Lauri's health to return. It's not so much that Lauri is feeling bad right now, it is more that the doctors want to give her body additional time to counteract whatever it is that put her in the hospital. No medicine can compare to the body's natural ability to fight infection, specifically those white blood cells. Stepping directly into another round of chemo will obliterate those white cells again, leaving the door open for further proliferation of infection.
The decision was made to no longer provide Lauri with any Tylenol beginning on Sunday afternoon. Tylenol would only be administered if her fever had risen above 101 deg for four hours or more. Instead, Lauri's temperature was managed with ice packs. She did have a temperature of around 102 on Sunday evening, but it has since fallen and she has had no fever since Sunday evening. She must remain without fever for at least 48 hours before our Oncologist will allow her to leave the hospital. They decided to stop providing Tylenol in order to better track the behavior and magnitude of the fever. Tylenol masks the fever, giving the doctors no insight into its actual value, and how it is effected by blood counts, antibiotic medication, etc. Relieving the fever is merely relieving a symptom of the problem, not the problem itself...
We also spoke with our Oncologist about the maximum number of chemo rounds we should expect, and what the path forward from here would be. She told us that we will complete 6 rounds (we have finished 4 to date), and then re-evaluate. At this point, she has neither ruled in nor ruled out surgery. In order for surgery to take place, our doctor must be satisfied that the disease is under control and that surgery would be able to remove 100% of the tumors. At this point, she is not sold that either criteria is met.
Her concern arises from the "stuff" that had shown up in Lauri's left lung. She is not going to proceed with surgery if the stuff remains, or grows, meaning the disease is not under control. As we saw in the previous CT scan, it looks like this "stuff" is going away, and was likely due to infection. Until it is totally gone, though, it will continue to be a roadblock. The next CT scan should provide more information on this front.
So the path forward is that we will continue with two more rounds of chemo, and then take a look at where we are. If the tumors have been controlled (no growth, perhaps shrinkage) and the stuff in the left lung is gone, then we will meet with the surgeons to determine if the remaining tumors are operable. If the tumors have not been controlled, or if the stuff in the left lung persists, then changes to the chemo dosage, drug type, and/or frequency will be made, and additional rounds will be required.
In the meantime, Lauri remains at the hospital, relaxing and trying to "be cool". Keep posting comments, she reads them all the time. Thanks for all of your support!
The decision was made to no longer provide Lauri with any Tylenol beginning on Sunday afternoon. Tylenol would only be administered if her fever had risen above 101 deg for four hours or more. Instead, Lauri's temperature was managed with ice packs. She did have a temperature of around 102 on Sunday evening, but it has since fallen and she has had no fever since Sunday evening. She must remain without fever for at least 48 hours before our Oncologist will allow her to leave the hospital. They decided to stop providing Tylenol in order to better track the behavior and magnitude of the fever. Tylenol masks the fever, giving the doctors no insight into its actual value, and how it is effected by blood counts, antibiotic medication, etc. Relieving the fever is merely relieving a symptom of the problem, not the problem itself...
We also spoke with our Oncologist about the maximum number of chemo rounds we should expect, and what the path forward from here would be. She told us that we will complete 6 rounds (we have finished 4 to date), and then re-evaluate. At this point, she has neither ruled in nor ruled out surgery. In order for surgery to take place, our doctor must be satisfied that the disease is under control and that surgery would be able to remove 100% of the tumors. At this point, she is not sold that either criteria is met.
Her concern arises from the "stuff" that had shown up in Lauri's left lung. She is not going to proceed with surgery if the stuff remains, or grows, meaning the disease is not under control. As we saw in the previous CT scan, it looks like this "stuff" is going away, and was likely due to infection. Until it is totally gone, though, it will continue to be a roadblock. The next CT scan should provide more information on this front.
So the path forward is that we will continue with two more rounds of chemo, and then take a look at where we are. If the tumors have been controlled (no growth, perhaps shrinkage) and the stuff in the left lung is gone, then we will meet with the surgeons to determine if the remaining tumors are operable. If the tumors have not been controlled, or if the stuff in the left lung persists, then changes to the chemo dosage, drug type, and/or frequency will be made, and additional rounds will be required.
In the meantime, Lauri remains at the hospital, relaxing and trying to "be cool". Keep posting comments, she reads them all the time. Thanks for all of your support!
Sunday, August 12, 2007
Extended Stay
Lauri's fever persists, so we have been admitted to MD Anderson Hospital for the next few days. We arrived at the MD Anderson Emergency Center last night around 9pm, and the doctors there thought Lauri had a "Neutropenic" fever, basically a fever in patients with extremly low blood counts, especially low white blood cell counts.
They called our Oncologist, and she decided to admit us to the hospital for further tests and observation. Her reasoning is that Lauri was already on preventative antibiotics when the fever spiked yesterday. She is not sure at this point why the fever is here now, and what we need to do to get it back down. We were admitted to the hospital at around 2 or 3 am this morning (long night)...
We talked to the Sarcoma Oncologist on call, who turned out to be the chairman of the Sarcoma Center. Interesting that the chairman has to work the weekend!?! I guess it's not as good as it used to be to be the king.... Anyway, the on call doctor visits patients during weekend hours in the hospital; we should see our personal Oncologist on Monday.
The On Call doctor agreed that Lauri seems completely healthy except for the fever. Her fever this morning had risen as high as 103.3 deg, before being dropped again with tylenol. The blood cultures so far are negative for infection, as is the chest x-ray. The doctor said the fever is not due to the blood transfusion because there has been too much time since the transfusion took place. He agrees with the Emergency Center doctor that the fever is likely due to low blood counts. Lauri's white blood cell count last night, around 12:00am, was 1.0, and had risen to 1.5 this morning. Normal range for white blood cells is 4-10.
He added that fever due to problems with the transfusion would occur within the first few hours, not 24 hours + afterwards. He also clarified that Lauri received two units of red blood cells, not whole blood (MD Anderson does not transfuse whole blood). Whole blood includes white blood cells and antibodies from the donor that can sometimes negatively interact with the patient receiving the blood.
We have been told that we will remain in the hospital until the fever is under control. We should have more definitive direction once we speak to our Oncologist on Monday. We anticipate remaining in the hospital until at least Tuesday or Wednesday, depending on how her fever behaves today. We hope to see improvement in Lauri's temperature as her white blood cells continue to increase. In the meantime, Lauri is resting comfortably at Ritz Anderson, feasting on jello and thoroughly investigating the assortment of TV stations available in the room...
I will provide updates as soon as I can...
They called our Oncologist, and she decided to admit us to the hospital for further tests and observation. Her reasoning is that Lauri was already on preventative antibiotics when the fever spiked yesterday. She is not sure at this point why the fever is here now, and what we need to do to get it back down. We were admitted to the hospital at around 2 or 3 am this morning (long night)...
We talked to the Sarcoma Oncologist on call, who turned out to be the chairman of the Sarcoma Center. Interesting that the chairman has to work the weekend!?! I guess it's not as good as it used to be to be the king.... Anyway, the on call doctor visits patients during weekend hours in the hospital; we should see our personal Oncologist on Monday.
The On Call doctor agreed that Lauri seems completely healthy except for the fever. Her fever this morning had risen as high as 103.3 deg, before being dropped again with tylenol. The blood cultures so far are negative for infection, as is the chest x-ray. The doctor said the fever is not due to the blood transfusion because there has been too much time since the transfusion took place. He agrees with the Emergency Center doctor that the fever is likely due to low blood counts. Lauri's white blood cell count last night, around 12:00am, was 1.0, and had risen to 1.5 this morning. Normal range for white blood cells is 4-10.
He added that fever due to problems with the transfusion would occur within the first few hours, not 24 hours + afterwards. He also clarified that Lauri received two units of red blood cells, not whole blood (MD Anderson does not transfuse whole blood). Whole blood includes white blood cells and antibodies from the donor that can sometimes negatively interact with the patient receiving the blood.
We have been told that we will remain in the hospital until the fever is under control. We should have more definitive direction once we speak to our Oncologist on Monday. We anticipate remaining in the hospital until at least Tuesday or Wednesday, depending on how her fever behaves today. We hope to see improvement in Lauri's temperature as her white blood cells continue to increase. In the meantime, Lauri is resting comfortably at Ritz Anderson, feasting on jello and thoroughly investigating the assortment of TV stations available in the room...
I will provide updates as soon as I can...
Saturday, August 11, 2007
Back to MD Anderson
Lauri's temperature has risen to 102 deg F within the last few hours (as of 8:00pm), and we are now heading back to MD Anderson to see what's wrong. Lauri is feeling fine, just her temperature is the problem. We believe the problem is related to the blood transfusion, but we are not sure at this point. Will provide more info when we have it...and have access to the internet...
Friday, August 10, 2007
She will (did) have a Blood Transfusion...
We just got back from a very long day at MD Anderson. As Lauri mentioned yesterday, we had to go in this morning to have her blood work done again. The results came back well below the threshold for a blood transfusion. For those interested, the white blood cell count was 0.2, Hemoglobin was 6.6 (considered critical), and Platelet count was 5,000 (also critically low). We had the results of the blood work by 11:00am, and orders for 2 units of red blood cells and 6 units of platelets were put in immediately.
They first did a "type and cross" on Lauri (another blood test, second of the morning) to determine her blood type and match it to their inventory in the blood bank. The results of the type and cross took about 2 hours, followed by a 3 hour wait to get into the blood transfusion unit. We decided to wait to be worked in because our appointment was set for 7:00pm, which was later than we wanted to stick around. Once we finally got in, it took about 6 hours to infuse the blood. We finally left MD Anderson at around 10:00pm.
Lauri is feeling much better now, but must return for blood tests for the next four days. We had never done a blood transfusion before, so we learned a lot. We found that MD Anderson has a critical shortage of O+, both whole blood and platelets. O+ is the universal donor, meaning everyone can receive O+ blood. However, those who have a blood type of O+ can ONLY receive O+ blood. Lauri is O+. The shortage is so critical that they are turning away people who need blood. We weren't turned away, though. In fact, the nurses were surprised we got as much O+ blood as we got. Sounds like our Oncologists have some pull... Lauri thinks it is because she was "just that critical..." I'm sticking with the "our doctors are the best, better than yours..." cuz it makes me feel better...
I have no idea what my blood type is, but I went ahead and donated blood anyway, since it sounded like they needed it. They were happy to oblige, and even gave me a free T-shirt! (My sister would be thrilled...) They also give you $5 off your parking if you donate at MD Anderson. (I am thrilled...)
Anyway, off to bed, then back to MD Anderson. Have a good night!
They first did a "type and cross" on Lauri (another blood test, second of the morning) to determine her blood type and match it to their inventory in the blood bank. The results of the type and cross took about 2 hours, followed by a 3 hour wait to get into the blood transfusion unit. We decided to wait to be worked in because our appointment was set for 7:00pm, which was later than we wanted to stick around. Once we finally got in, it took about 6 hours to infuse the blood. We finally left MD Anderson at around 10:00pm.
Lauri is feeling much better now, but must return for blood tests for the next four days. We had never done a blood transfusion before, so we learned a lot. We found that MD Anderson has a critical shortage of O+, both whole blood and platelets. O+ is the universal donor, meaning everyone can receive O+ blood. However, those who have a blood type of O+ can ONLY receive O+ blood. Lauri is O+. The shortage is so critical that they are turning away people who need blood. We weren't turned away, though. In fact, the nurses were surprised we got as much O+ blood as we got. Sounds like our Oncologists have some pull... Lauri thinks it is because she was "just that critical..." I'm sticking with the "our doctors are the best, better than yours..." cuz it makes me feel better...
I have no idea what my blood type is, but I went ahead and donated blood anyway, since it sounded like they needed it. They were happy to oblige, and even gave me a free T-shirt! (My sister would be thrilled...) They also give you $5 off your parking if you donate at MD Anderson. (I am thrilled...)
Anyway, off to bed, then back to MD Anderson. Have a good night!
Thursday, August 9, 2007
Lab results...
I made it by the hair of my chiny, chin chin...
No transfusion today, but if my counts drop any further, I'll have to be transfused tomorrow. Which is fine with me, I'll already be at the hospital and I know it will make me feel better. I'm really tired and a blood transfusion would do me a world of good right now. But we'll see tomorrow. In case your interested, my WBC's were 0.3, hemoglobin was 7.2 (7.0 or less and I get blood) and platelets 12,000 (less than 10,000 and I get platelets). So I just scraped by today. Keep checking for the next posting of "Will she or won't she need a transfusion". I know you are all just hanging by the computer waiting with bated breath. Ha!
No transfusion today, but if my counts drop any further, I'll have to be transfused tomorrow. Which is fine with me, I'll already be at the hospital and I know it will make me feel better. I'm really tired and a blood transfusion would do me a world of good right now. But we'll see tomorrow. In case your interested, my WBC's were 0.3, hemoglobin was 7.2 (7.0 or less and I get blood) and platelets 12,000 (less than 10,000 and I get platelets). So I just scraped by today. Keep checking for the next posting of "Will she or won't she need a transfusion". I know you are all just hanging by the computer waiting with bated breath. Ha!
Wednesday, August 8, 2007
Lab results and Space Shuttle Launch
I have a bad feeling that I'm going to have to get blood or platelets in the next couple of days. My lab results have been sinking further and further down to transfusion levels. Oh well, it won't be the end of the world. I'll probably feel a lot better after getting one anyway. I will keep you posted.
Also, if your head has been in the sand, the Space Shuttle Endeavor is going to launch tonight at 5:30 central time. It'll be on NASA TV or most probably the news if you don't live in Texas. Check it out, it'll be cool!
Also, if your head has been in the sand, the Space Shuttle Endeavor is going to launch tonight at 5:30 central time. It'll be on NASA TV or most probably the news if you don't live in Texas. Check it out, it'll be cool!
Comments
Some of you are very familiar with the whole "blogging" thing, but I know most of my family is not. But everyone is allowed to submit comments to the blogs we post. Underneath each post is a link that says " 0 comments" or "1 comment" depending on if someone has posted a comment or not. I encourage everyone to submit comments. Not only so I can read them, but also so I know people are actually reading what I write. Ha ha! Anyway, start commenting!
Tuesday, August 7, 2007
Get well wishes
I just wanted to thank everyone who has been sending me get well cards. I have kept them all and I have been putting them in my kitchen so I can see them everyday. I really appreciate all the loving words and wishes. It helps me get through the hard times knowing I have a lot of support from all my friends and family. So here is what I have so far...
Keep them coming! I love getting stuff in the mail!
Monday, August 6, 2007
Not much going on...
Just a little update even though not much is going on right now. All the family has left and Jeff and I are surviving on our own quite well. This round was much better than the last one and I'm doing a lot better. I had some lab work today and now I'm going to rest. I've found a very good smoothie at Smoothie King. It's called "The Hulk". No joke. It's designed for cancer patients (or so they tell me) to help them bulk up. It taste like strawberry-banana and it's got a very good flavor. I'm definitely going to get it again. So anyway, that's about all.
Lab results just got in, WBC-0.7, Hg-8.7, platelets-75. Not too bad, just the wbc's are really low but that's normal. Laying low, till next time...
Lab results just got in, WBC-0.7, Hg-8.7, platelets-75. Not too bad, just the wbc's are really low but that's normal. Laying low, till next time...
Wednesday, August 1, 2007
Chemo 4, Day 2
Yesterday was chemo day 2. We got in almost on time, which is good. We were out of there by 6:45. Got to come home and eat a good meal at a decent hour. Today I'm feeling pretty good. Not much fatigue, which has been a problem in the past. No appetite, but that's to be expected. And my tongue is completely white. I'll spare y'all another picture! Anyway, that's all the news to report for now. More to come later on.
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