D+14 months - "Let It Bleed" *

Part 1 - Tuesday 18th was Bone Marrow day....
.... and turned out to be a long day.  The platelets had fallen yet again, from 21 to 16 in the previous five days. They had two attempts at a Bone Marrow Aspirate in the morning but couldn't get anything out at all, what is called a 'dry tap'.

Over lunchtime, as planned, I was put on a nebuliser for Salbutamol and then an antibiotic, Pentamidine.

Meanwhile it was decided that I should have a BM Biopsy that same afternoon.  This involves a larger needle and the idea is to remove a core of bone marrow and bone.  A very experienced senior registrar who is a few months short of his first consultant post did the deed.  He was really excellent and didn't 'pin me to the wall' as my consultant had suggested might be the case!  It wasn't really very different to a BM Aspirate, brief pain only.  He tried an Aspirate first but this was another 'dry tap' so used the larger needle for a BMB which was successful thank goodness.  I now have four new holes in my backside and a little soreness to remind me what 's been going on!

A BM Biopsy is used to look at the structure of the bone marrow.  An Aspirate looks at the content.  So now it's a question of waiting for a result and keeping a close eye on the platelet level. The next clinic appointment is Thursday 20th and hopefully someone will have done the microscopy to see what is happening.  At the very least this will rule in or rule out various possibilities but may well not give a definitive answer.  The other tests on the BMB core sample will take a week or two.

Part 2 - Thursday 20th BM Transplant Clinic....
... but no results from the BMB.  The transfer of cells from the biopsy sample to a microscope slide didn't produce enough cells to interpret it.  There is a multidisciplinary meeting between the lab people and haematology next Wednesday so there will be a result when we go to clinic next Thursday.  The Cytogenetics will take a week or two after that.

Unfortunately the Haemoglobin has fallen back to 115.  The Chimerism in the blood which was 100% for a long time has fallen over the past month to 91%.  This is the mixture of donor cells and my original cells, the higher the percentage the better.  The platelets are unchanged at 16.  This all suggests that the bone marrow graft is struggling.  Whilst we are waiting for the results the steroids are being gradually reduced since they are suppressing the bone marrow graft and I'm to restart EPO injections to boost my haemoglobin.

The important question is why is the bone marrow struggling?  The answer could be anything from 'don't know' to infection to drugs to a full blown relapse.  Speculation is useless but pretty hard to avoid.

To this end Karine and I are away for a short break with our granddaughter Eden in the next few days so that will be a good distraction from the above.  She will keep us busy!  She is always full of enthusiasm and fun.  We took her round the National Tramway Museum yesterday and we all had a great time riding on trams and looking at all the old trams in the various exhibition halls.

* Rolling Stones "Let It Bleed" - track 5 off the album of the same name