Limbo

• Hemoglobin 8.6 (WHO normal 14.0-17.3)
• Absolute neutrophil count 0.3 (normal 1.4-7.5)
• White blood cell count 0.6 (normal 4-10)
• Red blood cell count 2.68 (normal 4.5-5.9)
• Platelet count 133 (normal 150-450)

Still stuck in the hospital. Probably they will not let me out until my neutrophils hit 0.6. So yesterday's 0.4 and today's 0.3 look like setbacks. Still, the average case starts seeing a neutrophil rebound on day 21, which will be tomorrow.

That's an average, so I might be slower, but I do think it's coming soon. I've felt stronger today and yesterday. And the real harbinger is the platelets at 133, up 23 points from just 2 days ago. The platelet concentration dropped for a while after my transfusion, but that's because they were diluted by the new red blood. (All the measures are X per unit of volume, so if you add one thing the concentration of everything else drops.) Since platelets are the first cell line to come back after chemo, this is a very good sign.

Finally got a nurse who really responded to my request for people to stay the f- out of my room in the middle of the night, so I slept OK between 11:30 and 6:40, and then went back to sleep until 9 even with a few further interruptions for blood draw, vitals, and pills.

On the pneumonia, still waiting for a final call. The infectious disease doc says the high-res CT shows a slight improvement over the NIH scan from 2.5 weeks ago. That's good news. The problem is that it's not definitive for fungal vs. bacterial pneumonia. The CT people lean heavily toward bacterial, but there is some nodularity that could indicate fungi. My ID doc is discussing today with a pneumonia specialist, but she thinks they will probably keep me on VFend (antifungal) for a while just in case.

This drug's nasty side effect is "visual disturbances." For me, that meant reading along on a black and white page and suddenly seeing everything highlighted in gray. It looked so much like MS Word highlighting that I actually held the page up to the light backwards to see if the highlighting was real. Then colors became lighter and somewhat attenuated, and everything shimmered slightly. Fortunately this only lasted about an hour. Another, much more fun effect appeared when going to sleep. In the half-awake state you reach on the way down, vivid color images materialized, shifted, grew. I soon realized I could control them, to a degree — distort them, morph them into new images, alter the colors. Interesting, and might make for some nice high-res color dreams. I once took mefloquine, an antimalarial, for 6 weeks and got this effect. Some of the coolest dreams of my life, much enhanced by having them in a tent under the stars of southern Madagascar.

They've backed off the VFend dose and we'll see how that goes.

Hoping to get some work done today, but I can feel a headache looming and think I'd better try to sleep some more first.