Thursday, August 16, 2012

Chemo Fingerprints and Tapering Again

Rather than start with something serious, let's have a little fun at my expense.

I'm bald again.

Why? Well, this has a lot to do with it:

Need a clearer view?

I decided that I had little enough hair that I could just trim it myself with the beard trimmer. It looks okay with a modern-style crew cut, so that's what I was going to do.

I forgot, however, to check the charge on my beard trimmer before I began, and it was completely dead by the time I was done with one side of my head.


My trimmer doesn't run plugged in. Plugging it in is just for recharging.

We were one our way to Freed Hardeman University to finish enrolling Caleb,  and I really didn't want to show up there as a punk rocker. On the spur of the moment, all I could think of to do was to use the razor that doesn't require batteries. My good ol', three-blade, disposable razor.

It took a little while, but I got it. My disposable razor doesn't have a setting for "3-day beard" or anything like that, so bald seemed to be the only choice.

Everyone seems to agree that I look ten years younger bald, so I like that, but I'm not staying bald. Here's a picture in better light. I'm not mad; I'm just squinting at the sun and trying to hurry because I'm not supposed to be out in the sun ... especially with all that forehead exposed!

Resolving Last Week's "Seizure of Persons"

I was trying to think of a Christian way to deal with the events of last week. My arrest was not a big deal. I brought that on myself. My son's arrest, however, was ridiculous and leaving the issue alone so that it could happen to the next person did not seem like an option to me.

A couple days ago, I was struck by what should have been obvious. Just go talk to the sheriff, and see if he'll do something about the situation!

So yesterday I dropped in to make an appointment. He was in, and he saw me immediately.

I added this picture just to
have something pretty to contrast
all the pictures of me.
We went back and forth a little bit, but in the end, I think I have to acknowledge that there is no way for the sheriff's office to double check the warrants that are issued to them. He offered to show me the stack of warrants that they have outstanding.

They do have to be double checked, though, and some attempt needs to be made to contact those, like my son, that obviously don't need to be picked up in the middle of the night. Protection against unreasonable warrants is a right that the constitution says "shall not be violated."

The place that needs to happen, however, is in the county clerk's office, where the warrants are issued. As it turned out, the sheriff had already talked to my lawyer, and both of them had already talked to the county clerk's office. They are already putting a system in place so that appeals, which happen at the circuit court in the middle of town, are registered with the justice center, which is on the bypass on the edge of town.

I think they were embarrassed that no system was already in place, and they're rectifying that as fast as possible.

Does no one appeal decisions in this county? Is this really the first time this has ever come up? Maybe there's just not much reason to appeal a general sessions court ruling, and it happens very rarely.

I also talked to him about the condition of the jail cell, and the sheriff told me it's already their policy to clean the cells between prisoners. He promised to leave his office and go straight in to check on the condition of the cell I was in and ask about what happened last week.

So overall I was pretty happy with that. Our lawyer is involved in the discussions with the county clerk's office, so I'm confident he'll make sure the system they set in place will never again put him in the position of having one of his clients arrested while the case is on appeal.

Chemo Fingerprints

One thing I forgot to tell you was the great difficulty they had fingerprinting me last week. Fingerprinting has come a long way since I was fingerprinted every time I moved in the military in the 80's. No ink is involved now. There's a scanner, and it puts a picture up on a computer monitor.

The computer kept rejecting my fingerprints. Finally, the guy doing the fingerprinting asked to see my hands. Then he showed me the crevices running the length of my fingers, including right across my fingerprints. After he showed me those, he turned the monitor my way so that I could see that not only did I have these crevices running the length of my fingers, but I had tinier ones crossing my fingertips as well. We couldn't see them, but the scanner was picking them up. It looked like someone had made a checkerboard with tiny squares all over my fingertips. Behind that checkerboard, we could see the whorls, loops, and arches that are supposed to make up my fingerprint. It was like they were covered in a mesh net on the screen.

Can you see the lines on my fingers and the web design on my index finger? The computer could see them, too; better than it could see my fingerprints.
Here's a closer view. There's a lot more lines too small to see that the computer picked up.

So we took 7 or 8 prints of each finger, and then he picked the best one. The computer itself only approved one or two.

The Taper

After the rough month of July, I was scared on Monday when we dropped back to 7.5 mg of steroids instead of 10.

Worse, on Tuesday I was very sick. I was exhausted, had diarrhea, and I was constantly nauseous. I slept a good 7 hours over three naps during the day besides what I had slept the night before, and I went to bed at 9 pm.

Wednesday, I woke up feeling as well as I've felt since I left the hospital. I got up, took one of my cars to the repair shop at 7 a.m., then walked a mile to a different repair shop to pick up our other car. It was after that I went to see the sheriff.

I guess I really was sick on Tuesday, not just reacting to the steroid taper.

We'll see. We're not tapering any further until the doctors see me again, and that won't be until September 13.

Saturday, August 4, 2012

Chemo Lines Revisited

I'm doing remarkably better now that I'm back on the steroids. I do need to repeat my note of self-justification that the amount of steroids that I am on is no more than what your body is making every day.

I am still fascinated by the "chemo line" effect. I wrote a couple months ago about the chemo lines on my fingernails. Those have grown out, but now I'm dealing with the chemo lines on my toenails, as seen below:

See that big line down the middle of my big toenail. All my toenails have lines like that. Some have grown to the end, and the closer to the end the chemo line gets, the more the nail separates at the line. You can probably see how one edge of my left big toe is separating already.

I didn't take the clearest photo. I just couldn't get the right lighting. Anyway, the chemo line on the toenail of the second toe has reached the end and half of it is loose, so I cut most of that half off.

It's not really a problem on my toes like it was on my fingers. The nails get real jagged and catch on every bit of fabric there is, especially socks, but I can just tape my toes up. Then there's no problem. I couldn't do that with my fingers because I have to wash my hands all day, use my fingers to do things, etc. Toes are mostly useless except for being stubbed and for a place for bees to survive and sting when you step on them barefoot.

Notice how crowded those right toes are? I have just one bunion. I'm going to give free bunion advice to anyone who wants it. First, mine's not bad (nor is it related to chemo, but to kicking a football in jr. high school), so if you have a severe bunion, my solution may not work. Here's what a bunion looks like:

See how big the knuckle of the big toe is? That's what's meant by a bunion. Calcium builds up in the knuckle, driving the big toe towards the other toes. It crowds your toes, and it can cause pain both inside the damaged knuckle and on the side of the knuckle from rubbing on shoes.

I never had the shoe problem, but the knuckle used to ache pretty much every evening unless I was off my feet all day.

The solution? I got some MSM/Glucosamine cream from Nature's Sunshine. (You can buy it all over the internet.) I used it topically on the knuckle once or twice a day, and within a week my toe joint didn't ache at all. That continued for a few months, then I quit for a couple weeks just to make sure the cream was the source of the improvement. It was. The pain came back in a few days.

Over the next two years I tried that experiment several times, quitting for a couple weeks, and the pain always came back in 3 or 4 days.

After about four years, I hit a point where I either forgot to restock or just got lazy and quit using it, and the pain has never come back. I haven't used the cream in six years, and my bunion hasn't hurt me the entire time.

If you have a painful bunion, I hope that works for you, too.

Oh, my daughter has a bunion. It works for her as well. She uses the MSM/Glucosamine cream for a while, then quits a while until the bunion starts aching again. Then I'll get her another tube. We probably only buy one tube every two years for her.

Weird post, I know, but I am just fascinated by the chemo lines. They are caused, by the way, by chemo killing the fingernail and toenail cells, then the nails going back to growing once the chemo wears off.

Thursday, August 2, 2012

Graft Versus Host Disease (GVHD) and Steroids

On July 31, I was supposed to drop completely off the steroids I was taking. I had been tapering all month. I contacted Vanderbilt, told them how things have been, and they told me to go back up to 10mg per day, which is where I was at in mid-June.

In two days, I felt like I'd been born again. Mood jumped, appetite increased, and all the intestinal warfare stopped.

And warfare is the right word. Graft-versus-Host Disease (GVHD) is my new immune system attacking my body, in this case my gut, because it doesn't recognize it as a friend. Going back up to 10mg Prednisone got my immune system off my gut.

So today we asked about when we might be able to taper off the steroids safely. (I saw "we" because my wife, who is my caretaker, goes through all this with me and handles my medications.) I learned some things about steroids I didn't know, or at least about Prednisone, this specific steroid. I also learned some things about stem cells and about transplants being rejected.


Your body (but not mine), produces about 7 milligrams of steroids on its own everyday. The nurse tells me that because I've received so much steroids over the last year, my adrenal glands have "gone to sleep" figuring they're not needed. The taper, going off the steroids bit by bit, is to get my body to wake up and start producing its own steroids. Until then, when we may have to settle in at 7.5 mg and give my body what it's not producing. The 10 mg that I'm getting now I will only get for two weeks, then we'll stay at 7.5 for a while until we're ready to test my body again.

Transplants and Stem Cells

When a person receives a kidney, liver, or heart transplant, he or she must stay on immunosuppressive medicines all their life. Their immune system, if given full reign, will attack the new organ as foreign, and that will be as true 30 years from the transplant as it is on the day of the transplant.

Stem cells are not so.

Stem cells are more "plastic." They can be trained. So today my immune system (which is the real foreigner here), will begin attacking my gut and skin if it is given full reign. But because I have the stem cells that produced the blood system (and thus the immune system), the stem cells are learning. While the immune system is on a leash, the cells are learning whom they can live with and whom they can't live with.

Eventually, sometimes its three, four, or five years down the road, bone marrow transplant recipients can let their immune systems off the leash, it will have learned to recognize the patient's original DNA as not harmful.

Until then, the doctors let the immune system loose a little at a time, chain it back up when it snarls and bites, then let it off again later; testing ... testing ... until they get the patient off all immunosuppressives.

I'm on very minor amounts, and the stem cells I got were really stem cells. People with adult donors get "hematopoietic" stem cells, which are cells that can become any blood cell. I got cells from an infant's umbilical cord (no, not an aborted infant; donated by a wonderful set of parents after a live, healthy birth). They're completely naive, untrained stem cells, ready to make blood and learn how to take on the world.

People like me who get cord blood are in more danger the first 30 days after transplant because engrafting goes slowly, so we're completely without an immune system longer than those with an adult donor (or who are self-donors). But after 90 days, our new immune system usually gives us less problems than those who have adult donors. Wow, that would be nice. I made it past the "sorry, you're much more likely to die during these 30 days than those with adult donors" so I'm happy to try to reap the benefit of those little thriving baby cells.

This is just like being a parent. Getting those children to behave can sometimes be a real challenge.

Have a great day. Conquer every obstacle. Roar a lot when the going gets difficult. Trust God, and there's nothing you can't overcome.