Yo-yo

• Hemoglobin 13.3 (WHO normal 14.0-17.3) — normal by UM standards
  
• Absolute neutrophil count 4.1 (normal 1.4-7.5) — NORMAL
  
• White blood cell count 5.1 (normal 4-10) — NORMAL
• Platelet count 218 (normal 150-450) — NORMAL

Wow. I've never been through a bounce like this one. I feel like a human yo-yo.

Saw Dr. B today. His news is nowhere near as bad as they'd told me a week ago. In fact, the news is great — not perfect, but great.

So. The morphology — visual examination of my bone marrow biopsy, under a microscope — had revealed a small nodule, entirely normal in a 50-year-old guy. They stained the sample to find out what was in it. One of the stains showed CD-20, the cell surface protein that's typical of hairy cells. They determined that 5-10 percent of the bone marrow space consisted of CD-20 positive cells. That's what Dr. B's PA reported to me as "5-10 percent hairy cells."

For whatever reason (who the hell cares, now), she misinterpreted this result. CD-20's expressed on all B-cells, including the normal ones. So the 5-10 percent figure says exactly nothing about the percentage of hairy cells in my bone marrow.

What about the flow cytometry, the laser-based protein marker detector, far more accurate than morphology? On the flow, things looked, in fact, PRETTY DAMN GOOD. Less than 2 percent hairy cells! Yow! Dr. B said this is somewhere between a complete remission and a partial remission, in other words, a very very good partial remission — not at all what I'd been living with all week. Boing-a boing-a boing-a; this time the bounce is up. Sometimes you're the bug, but sometimes, sometimes, you get to be the windshield. Splat.

On top of that, my blood counts look great. Low lymphocytes (0.4), but we knew that. Almost normal red cells (4.43; normal is 4.5). Hemoglobin at 13.3, which UM counts as normal. Probably both of those will still rise for another week or two. Everything else well inside the normal range. I haven't seen a test like that in years.

What to do next? Dr. B's answer: nothing. No more treatments. Watch and wait. He calculates that the risks of rituxan aren't worth the additional benefit, especially because nobody's really sure, yet, whether there actually is any additional benefit from 2-CdA + rituxan. Most people in my category typically go years, even many years, before a remission (though some don't, and I'm mindful that I could always turn out to be in that camp).

We ended up leaving it that I'll go back for one more bone marrow biopsy in 3 months, see where I stand then. (Don't have to, but I want to, for psychological more than for medical reasons.) It's even possible that by then the 2 percent will drop further, though it could also go higher. But unless it really shoots up, I'm set for a while, and convinced that waiting is the right thing to do.

More later, after I celebrate. Yo-yo.

There is a girl in New York City
Who calls herself the human trampoline
And sometimes when I'm falling flying
Or tumbling in turmoil I say
Whoa so this is what she means...
She means we're bouncing into Graceland