Mick McKellar Update -- Day +646

Just a little intrepid...

It was only about 3 inches of new snow, but by golly, I grabbed the old scoop and cleared all three inches out of my driveway this afternoon! I know I looked ridiculous, all covered up and wearing a mask part of the time, stopping to gasp for breath every five minutes or so, and tottering about like an antique automaton — but when a half hour or so had passed, the snow was moved.

It is such an odd sensation, when small movements carry incredible consequences for my oxygen reserve. A life-long asthmatic, I can sense immediately when my oxygen level decreases even slightly. I know the progression from weakness and tingling in my extremities, to an unexplainable ache in my core, to a loss of focus, and finally the encroaching darkness as I begin to lose consciousness.

So when I work or exercise, I push until I begin to feel the loss, then I pull back, slow down, or stop until the tingling and weakness go away. It is a game of brinksmanship with a huge downside, but it is a necessary game to help retain some muscle tone in my major muscles. It's dancing on the brink of an abyss filled with a vacuum — one misstep and I get to try living without air for awhile — or forever.

Silent Fear / Secret Agony

This is nothing more nor less than the silent fear, the secret agony that shreds through the nerves of every child with severe asthma. I know the pain and fear of being smothered or of drowning (from the inside out), because I have walked that road thousands of times in my life.

A Bit of History...

In the sixth grade, we were outside for calisthenics and exercise. A new teacher started us running the circuit of the school yard. I stopped and told him I was asthmatic and could not run with the others, especially in the fall when my hay fever was bad. In 1961, there were no medications for asthma one could take as a preventative. He didn't believe me and ordered me to run.

So run I did. To my credit, I made three full circuits of the yard before I passed out, plowing face-first into the dirt — scattering dust and gravel all over his highly-polished new shoes. I came to almost immediately — I usually do, because once I pass out, the muscles in the chest relax and the weight of the atmosphere forces air into my lungs.

Now, I work with 27% lung capacity and the remnants left by damage done by bronchial asthma over nearly 58 years of coughing, choking, and gasping for air. Amazing how life comes full circle, and it is the small things you remember.

Other than the lung thingy, I seem to be doing quite well. I remain thankful for your prayers and good thoughts.

God bless and good night,

Mick

Mick McKellar Update — Day +637

I have not written an update for awhile. Part of my reticence can be chalked up to fatigue. Each and every day is a gift, yet each and every day is a battle — fought with an enemy both unseen and inside. There is no tumor to scan, so that I might have an image at which to glare. There actually is no cancer (of which I am aware) to blame, as my Philadelphia chromosome positive, Chronic Myeloid Leukemia is in full remission — the blood tests cannot detect the fusion protein that causes the cancer. However, that does not mean it is gone...the tests may simply not be powerful enough to detect it. Therefore I take medication each day to block its return.

Flashback

My medical problems spring largely from the blood and marrow transplant. The tiny warriors, those red-neck Tennessee T-Cells I received from my brother, Kevin, saved my life by wiping out any stray cancer cells and still police my blood stream for enemies. Unfortunately for me, their enemies list have included: my skin, my liver, my kidneys, and now my lungs. Quick and effective action by the BMT team at Mayo Clinic and Rochester Methodist Hospital saved my skin (it was literally coming off), my liver (renal failure), and my kidneys. All this happened within the first 100 days after transplant.

The lung attacks began without warning or detectable symptoms early in 2012. By April, 2012 my lung capacity was down to about 70%. By June, it was down to 27%. It has remained near that level since. Any infection becomes critical. If I get the flu, I go to the hospital. 

Presently

Right now, I am fighting something that is causing severe coughing jags, but no fevers, etc. All my other numbers, for the white blood count, liver function, kidney function, hemoglobin, platelets, and neutrophils look very good.

My blood pressure appears to be under control (with medications) and my blood sugar usually behaves itself (no insulin needed). The peripheral neuropathy in my feet, legs, and hands appears to have stabilized. The cataract surgery by Dr. Leep on October 23 appears to be a resounding success. My vision is terrific for near and distance, but not up close (as is expected). The right eye healed nicely with no apparent problems. However, everything seems much brighter than before, making me grab for sunglasses much more often.

Chicken

Our trip was better than I expected. We saw only four deer on the trip, however, two of them played chicken with my little Focus...and both were big enough to take out our windshield. Oddly, as I was driving east on M 28, about five miles east of Bruce Crossing, a fellow in a black pickup was tailgating me something awful. I mumbled something to Marian about wishing I could slam on the brakes to teach him a lesson. Five seconds later, a very large doe ran in front of my car -- barely 20 feet ahead -- and I had to slam on my brakes to avoid possible collision. The fellow in back stayed well back for a minute or two until he sped past me in a fog of salt dust, engine smoke, and chagrin.

The remainder of this update continues on my other blog: out of my mind: The Jag

Thank you all for your prayers and good thoughts. 

God bless and good night,

Mick

Mick McKellar Update -- Day +613

A black patch would've been cool...

"Arrrrrh!"

OK, so I did say it plenty of times on Tuesday afternoon — at least, until about 4:00 PM, when the patch came off — by instructions from the doctor and the nurses. I was also instructed to rest for the afternoon and take it easy on Wednesday. Nobody had to remind me, as even cataract surgery appears to be an insult to the body, and mine did not like it much.

I snapped a blurry picture of my eye patch, but I could not tell it was blurry until today, because my vision was rather blurry — even in my good eye. Also, I tried to read some messages on screen and reply to a few, but staring at my monitor hurt my right eye and my vision was pretty bad for Tuesday afternoon and most of Wednesday — probably due to swelling from the surgery. This afternoon, my vision has improved dramatically, though my right eye vision is still a bit blurry. I am hoping it will continue to improve over the next few days. One lesson I learned in the last two years is that I heal much slower than when I was younger and before my CML/GvHD adventure.

Look Ma! Two eyes!

Colder World

My world has become a bit colder, whiter, bluer than before the surgery. One of the two cataracts removed from my right eye was an old fashioned yellow cataract and it added a warm, sepia-tone to my vision when using either just the right eye or both. The tint is gone, and colors are a bit crisper and colder than before.

With Marian's help, I take eye drops (an antibiotic/steroid combination and an NSAID drop) to help prevent infection, reduce swelling, and control pain. These may continue for up to three weeks. I'm just hoping my eyes will be good enough to drive when we have to make our next obligatory visit at Mayo Clinic on November 15. One would think that, with all the available communication technologies (video conferencing, teleconferencing, even Skype), capable physicians here could work with capable physicians there, and save not only the awful expense of moving our bodies 400 miles for tests and consultations that could be done here and via electronic communication, but could also remove the very real dangers of travel in our neck of the woods during the gales of November, the storms of December, and the deep freeze of January/February. However, these options are not offered — and how do you argue with the people who worked so hard to save your life?

My Mysterious Medical Status

Blood was drawn early this morning and tests were run at Portage Health. A nurse called me with the numbers, and they look pretty good. Considering I had surgery day before yesterday and have not done my "morning constitutional" for three days (it was raining too hard this morning), I was quite pleased with them. There is not much new to report, other than a few mysterious purple spots on my forearms, which seem to be responding to steroid creams. I still manage to get out of breath while washing dishes. I find this embarrassing, but have accepted it as part of my "new normal" — a normal that seems to change almost daily.

613

There's nothing special to me about the number 613, other than this is day 613 since my transplant. February 21, 2013 will mark my two year anniversary of the gift of life from my brother Kevin, but that day seems a long way ahead. Although some of my transplant contemporaries (and friends) have passed on in the last few months, it seems I have been touched by God and carried forward in His strong embrace. My emotional roller coaster ride — from sadness and fear to joy and gratitude — has been exciting, tiring, and a bit scary. Physical symptoms come and go so quickly, I hardly have time to notice before they depart, only to be replaced by a new cough, a new mark, or a new pain. One thing is certain: Life with GvHD is never boring.

Thanks to all who pray for us and send us your good thoughts and best wishes.

I will write more as my eyesight improves and I can spend more time staring at a computer monitor. Until then, God bless and good afternoon!

Mick

Mick McKellar Update — Day +595/596

The Eyes Have It

Some may have noticed that my updates and other writings have become sparse and sporadic. The vision in my right eye has degraded rapidly over the last few weeks — most noticeably in the last two weeks. A visit to my eye doctor confirmed my suspicions: It appears that I now have two cataracts in my right eye. The old, yellow, nuclear sclerotic cataract is still there...slowly growing and gently pushing my right-eyed world toward sepia-toned sunsets. However, there is a new player on board. A fast growing friend for Ol' Yeller called (I believe...my hearing isn't too good) a posterior subcapsular cataract — most likely a side-effect of my long and close association with steroid medication — probably Prednisone.

If all goes as planned, I am scheduled for cataract surgery on October 23, 2012. There will be some tests beforehand...to ascertain that I am up to the effort and that my already somewhat abused body will handle the additional insult. An eerily similar situation occurred in 2001, when what we called a "white cataract" appeared with the slow-growing and docile yellow cataract in my left eye. It grew very quickly and caused numerous and dangerous problems with my eyesight. The doctor I saw Friday is the same doctor who removed the cataracts from my left eye eleven years ago. The vision in my left eye is still 20/20 and there have been no discernible problems or complications following that surgery. I am holding onto hope and praying for another success.

But, Can He Drive?

That question haunts me now. Even if the surgery goes well, and no additional treatments are needed, it will likely be at least four weeks before I will have new glasses — hopefully for reading and close work. The zinger in the Zeitgeist is another trip to Rochester, currently scheduled for November 14-16, 2012. Nine-hour drives on some rather lonely roads in potentially hostile weather conditions rides rather low on my list of Tolerable To-Do's. There's always a chance, with a bit of luck and a wink of God's eye, that we will find some decent weather in mid-November, but "the gales of November" are real and those Alberta Clippers sail through all winter long.

I'm also hoping that, with proper paste-ups and mechanicals...and the old snow tires back on the front...our 10-year old Focus will once again handle what mother nature and Lake Superior deign to send our way. It is a long and tiring drive in good weather, with lots of daylight. When the days grow short and Heikki Lunta grows restive, the drive may become reminiscent of an episode of Ice Road Truckers.

One can feel detached from the rest of the world up here, but seldom do I feel as alone as when plowing through blowing and drifting snow in the dark on M-26/US-45/M-28, en route to Ironwood and beyond. For most of that trip, I can't get a single bar on my old Tracfone. At one time, being "out there and out of touch" was a rush, and I really enjoyed testing my driving abilities against winter's worst. Now, tottering about in the white wilderness on those wacky and wonderfully slick winter roads can seem a bit extreme without sufficient cause.

The Numbers Game

My blood test numbers are all stable and look very good. My lung function numbers seem to be at a plateau and do not vary. My blood glucose numbers remain at or below 100, with a rare venture up to 103. My blood pressure, higher since we switched from the medication that caused a persistent dry cough, still remains in a comfort zone.

Still Intrepid, After All...

With few exceptions, I still walk my walk -- .75 miles each morning and more, when possible. A couple of days ago,  however, I was afraid the kids at their bus stop would shove a carrot up my nose and call me Frosty -- so plastered with wet snow from a lake effect squall was I. The early morning walks will grow more interesting as they grow darker and more slippery.

It remains for me to discover how well (and how slowly) I can participate in snow removal. Last winter, I found snow scooping a reliable resource for constant and aerobic exercise. Of course, I am willing to wait a couple of months to do the research...

I started this as an update for day +595 and I am finishing it as an update for day +596. It took four sessions to complete because my eyes get so tired trying to focus on the screen.

Now I need to get some sleep. I have an EKG scheduled for tomorrow. Thanks to you all for your prayers and good thoughts.

God bless and good night,

Mick

Mick McKellar Update -- Day +581

Bouncing

I hit the floor in the kitchen tonight...and I hit it hard. My right foot tangled in the cord from my headset on my computer, and tripped me up on my way into the kitchen. I stumbled forward, carrying a china dish and coffee cup. Somehow, I managed not to break either one, but landed on my left knee and left side — with my elbow tucked in close to help absorb the shock and stop my face from plowing into the vinyl flooring. I think I bounced at least once.

Normally, I would tuck and roll when falling forward, but there is so much breakable stuff in the kitchen and I didn't know where to tuck the coffee mug and plate. Because of the neuropathy in my feet and legs, I toppled like a hopping tree.

It seems, however, that the extraordinary density of my bones saved me once again, despite months of treatments with steroids and medications that tend to weaken them. My left knee works, although it hurts like the dickens. The left side of my chest is sore to the touch and it hurts some when I breathe, but there seems to be no bruising or discoloration. I'm hoping a pair of extra-strength acetaminophen tablets will permit some healing sleep tonight. Perhaps the light of morning will lend insight and help me judge the extent of my injury.

My condition, listed as CML, may now be defined as Clumsy Man (with) Leukemia.

God bless and good night,

Mick

Mick McKellar Update — Day +580

Home Safely

Marian and I arrived home yesterday afternoon, a bit frazzled, but otherwise in good order. We met a few sprinkles along the way and the usual "hurry up and fix it" late season road repairs and construction projects, but the roads were good and the weather cooperative. I drove from Rochester, MN to Ashland, WI, when sudden neuritis pain in my right foot and ankle reminded me to share the chore. Marian drove the rest of the way. It was a pleasant return trip. We searched the radio for "oldies" stations and played CDs. Marian sang along. I tried (who wouldn't?) and spent a good deal of the time coughing. Bombastic Elwin has become Whispering Mick...

Redux?

We're not yet certain when I must go back to Rochester. We would very much like to put off another trip until February. I have to return in late February or early March of 2013 to celebrate the second anniversary of my blood and marrow transplant with a bevy of tests, evaluations, and consultations. However, the doctors at Mayo Clinic are a conservative group and may require yet another visit before the end of 2012. That decision will be forthcoming.

What's So Special About 27%?

Back in June, they discovered that I had ~27% lung capacity remaining. During my emergency visit (first week of August), a pulmonary function study showed a slight decrease to between 27% and 25%. The PFS done on September 19 showed my lung capacity had increased a little...back to the 27% of the June test — but no better. The working diagnosis now is bronchiolitis obliterans, probably as a result of chronic Graft versus Host Disease (cGvHD). The rapid loss of lung function that happened between February 2012 (67%, I believe) and June (the 27% figure), seems to have stopped. That's the good news. The bad news is that, most likely, what I have lost is gone. However, as my doctor pointed out, there have been cases where a few patients have regained some measure of lung function through exercise and perhaps, through pure stubbornness.

The stubbornness part, I have down to a science.

While I am busy working for, and praying for, yet another miracle — my focus must remain on NOT permitting another insult to my lungs — the very kind of thing that might reactivate those renegade T-cells, starting another round of lost lung function. I can still function, in a limited fashion, at 27%. Below that, supplemental oxygen may become necessary, and chances to get out and walk become scarce. Normally, winter is one of my prime times for road-walking. At this point, I don't yet know how very cold air will affect my new normal. I may be looking for a used (or very inexpensive) treadmill this winter. Time, and lower temps will tell.

Intrepid — Again Today

The cool air this morning was welcome as I restarted my daily constitutionals — walking my .75 mile track (a six-block rectangle) in about 30 minutes. I know that sounds incredibly slow, but from my perspective, I was ready to shout, "Meep! Meep!" Brandishing an adjustable aluminum cane, I cut quite a dapper swath...toddling about the neighborhood.

5 — 6 — 7 — 8: Inoculate, Inoculate!

One last minute decision was a really positive result of this last visit to Mayo Clinic: I received round one of my vaccinations, post stem-cell transplant. I received five (count 'em five!) shots in my arms (three in the left, two in the right) for: Tetanus-Diptheria-Pertussis, Haemophilus influenza type B (Hib), Hepatitis B, Pneumococcal vaccine, and Inactivated polio. They recommended I wait on the Influenza (flu) shot until about mid-October, so that its limited effectiveness could span the worst of the "flu season." No live viruses are permitted, so the shingles vaccination is forbidden.

Will I get the full benefit of these vaccinations? Not likely, because my immune system is so compromised. However, they judged that that benefit was worth the risk.

A few changes have been made in my medications, mainly to help get me off the prednisone (slowly) and stop a cough which was likely triggered by one of my blood pressure medications. My numbers: the results of my blood tests, etc., all look very good. My blood pressure has been well within target range, and my blood glucose has been good — despite my continuance with prednisone.

Faces

I am a bit slow sending out this update — we came home last night. Prior to this visit, I read all the literature provided to all BMT recipients by Mayo Clinic, and more, about BMT, the process and the prognoses. I know the numbers...we all know the numbers. This last visit, however, put some familiar faces and fond memories on those numbers. One of those faces...a very good friend...died in August after two failed transplants and a valiant fight. I guess I have been dealing with that, as well as the other changes leading me to my new normal.

Thank you all for your prayers and good thoughts. I cannot tell you how much they mean to us.

God bless and good night,

Mick

Mick McKellar Update -- Day +568

Riddle of the Sphinx

What walks on 4 legs in the morning 2 legs in the noon and 3 legs at night? In Greek Mythology, the Sphinx at Thebes posed this question to travelers. If they answered incorrectly -- they were killed. If they answered correctly, the Sphinx would kill herself. Watch out Sphinx...here comes old Oedipus (and me).

The answer is: a human. He or she crawls on all fours at the beginning of life (morning), walks on two legs in the prime of life (noon), and uses a walking stick or cane at the end of life (evening).

I was pondering this old riddle as I finished my morning constitution. You see, I now carry a cane as I march along through the morning mists -- a very slow march, but ready, steady, go(ing) forward at my own pace. I have become a bit unsteady on my feet (because of the peripheral neuropathy problem in my feet, legs, and hands) -- so, I use the cane as an out-rigger -- to prevent tipping. I also lean on it when I stop momentarily to catch my breath. Most days, like today, I walk a six-block square -- about .75 miles. Yesterday, I must have been feeling my oats, so I walked from home to Hecla Street in Laurium and back -- about 1.5 miles.

I felt like I had run a marathon.

I may try it again, but not for a week or two. It's all part of learning to live within my new normal.

Batteries Included

I completed a battery of blood tests last Thursday. My doctor at Mayo Clinic told me the tests were good/stable. I hope to learn more details when I see my local oncologist on Thursday (after more blood tests, of course). It is not that I understand completely all the ramifications of the hard numbers, but they do help me make judgment calls about going outdoors and attending events where I may be exposed to infectious agents, etc. For now, I guess I remain both good and stable.

We are watching a new anomaly: When I get ready to retire, I have noticed on several occasions that my lower left leg and foot are pale and cold, and the right lower leg and foot are pink and warm. By morning, all is pink and warm again. I bumbled my way downstairs three nights ago and asked Marian (still up, watching the tube) to feel my left foot. After the initial quizzical stare, she obliged and was astounded at how cold my left foot was compared to my right. It's just one more thing I must check out.

Pins, Needles, and Numbness

Both of my feet, my ankles, patches of my legs up to my knees, and to some extent my hands consistently have that "pins and needles" sensation one gets when a limb "falls asleep." I wonder if little elf dentists sneak into my bedroom and practice injecting elf Novocaine into my extremities while I slumber. Navigating our stairway in the early morning dark takes a lot of focus and care. (My bedroom is upstairs, the bathroom is downstairs...)

Outside Influences

I don't need my medical problems to make each day eventful. For example, Saturday's post included eleven (yeah, 11!) envelopes from Blue Cross/Blue Shield, full of Explanation of Benefit statements, along with two new itemized charges lists from Mayo Clinic. Something fun to read arrives nearly every day. Joy!

Crammed!

Perhaps the most stressful has been our phone bill. Until this last bill, our AT&T phone bills have been free of problems, because we seldom use long distance on our land line, using our cell phone, Skype, or Google Voice to reach out and touch someone far away. Imagine my chagrin to find, on the latest bill, a series of long distance service charges from a company called American Phone Services, billing through another company listed as USBI. As if we would not notice a sudden $8.72 increase in our phone bill...

They were also billing for two calls I made using Google Voice -- a service which has been and remains free.

I contacted USBI via Internet and they responded almost immediately (next day). Their response was predictable...they are only the billing company, so they passed the buck to American Phone Services.

Today, I called American Phone Services. Their representative, obviously a native of India with a thick accent, insisted on three things: First, that our AT&T phone account is in Marian's name; second, that Marian requested their services on March 27, 2002; and third,  that we have been billed regularly and should not be surprised. She refused to cancel any services because she said Marian ordered them. So, I put Marian on the line. After some heated words, and a request to talk to her supervisor, they hung up on us.

There are three things VERY wrong with her statements: Our AT&T account, established more than 40 years ago, has always been in my name only; Marian never requested long distance services from any company; and such charges have never before appeared on our statements from AT&T. I verified this by calling AT&T customer service and talking to a representative, who checked back on previous bills for me. We will be paying our phone bill, but NOT the additional charges.

I don't know if we will get a correction from American Phone Services soon, however, I will be filing a complaint with the FCC. From what I read on their website, this problem is worsening because of all the things folks can charge to their phone bills.

The moral of the story is this (especially if you have a wire line phone): Read your phone bill carefully!

Maybe on my next update, I can complain about all the phone calls we receive for political surveys, political ads, and credit card scams. Maybe not...

Once more unto the breach, dear friends, once more...

With apologies to Henry, the game is afoot once more as we journey to Rochester on September 18, for two more days of testing and consultations. I have appointments on the 19th and 20th. We hope to come home again on September 21. That is that plan. Perhaps my neighbors will hear a thready, wheezing voice calling to his redoubtable old Focus on that early morning: "Follow your spirit, and upon this charge; Cry 'God for Harry, England, and Saint George!' Perhaps not...

As always, we are thankful for your prayers and good thoughts. God bless you, and good night!

Mick

Mick McKellar Update — Day +555

Much Ado About Nuttin' Much...

Friends and relatives of late may have noticed empty spaces normally filled to overflowing with Mick McKellar. I am not studying to become a hermit. My last adventure (including jetting to Rochester via LifeFlite) was apparently triggered by a lung infection — something I picked up and introduced to one of my lungs. This, plus a new medication that may reduce my immune system response even further, has amplified my innate and natural shyness (cough, cough), causing me to be very careful about shared air and surfaces. Déjà vu — all over again.

I'm 555 days out from my blood and marrow transplant, the gift of life from my brother, Kevin, and I had hoped for more stability in my condition. My primary disease — Philadelphia chromosome-positive, chronic myelogenous leukemia (CML) — remains in remission, thanks to ongoing medication and the frenetic activities of Kevin's Tennessee T-cells. Their anti-cancer effect is called the Graft versus Leukemia effect (GvL). They remain very active, but are unhappy. They know they are in the right neighborhood, but sense they are living in the wrong house, so they attack other rapid-growing cells.

This ongoing tendency to attack parts of the host body — ME! — is called chronic Graft versus Host Disease (cGvHD). This chronic form of GvHD appears to be the root cause of my ongoing difficulties. Odd that the treatment, apparently NOT a cure this time, is infinitely more painful than the disease. Way back in May 2010, when CML had me at death's door, I was leaning against the door jam, half asleep. I felt exhausted and disconnected from the rest of the world, as though I was slowly fading from life. It was not particularly warm, but it was fuzzy. Oddly, after that experience, dying no longer frightens me, although the thought that I came so close to waiting too long to seek medical help, gives me pause.

On the GvHD Train

Everyone who has a blood and marrow transplant (BMT) has a different experience. Doctors explain and medical staff/brochures/books/articles/DVDs/handouts train, but it remains shooting with a shotgun. After the first 100 days (the Acute period), during which I experienced some rather spectacular GvHD attacks, we hoped for a respite and then only a few, controllable chronic GvHD symptoms. Well, the ride has been a rough one, and we are still on the train — my caregiver and me...

We were ready to get off the GvHD train at the end of 2011, when my old nemesis, the skin rash, reappeared — but with a new wrinkle — appearing on my right foot in a new form, a fibroid form similar to scleroderma. Skin care and high dose steroids (mostly prednisone) since January, have controlled the rash, all but the patch on my foot. However, during this time a numbness and tingling, long a part of my walking experience, has spread up past my ankles to my lower legs and made an appearance in my hands. I believe they call it peripheral neuropathy. It feels like I'm wearing leather stockings that come to mid-calf, even when I am barefoot, yet my hands and feet remain extremely sensitive to hot and cold. Odd that...

Can't Sing About the Train Ride

Sometime between February 2012 (when I had 67% lung capacity) and June 2012, my lung capacity decreased to 27%. Tests during my last visit to Mayo Clinic (part of my recent emergency journey) show 25-27% capacity. The reason for the decrease remains, as yet, elusive. Best theories point at my constant companion — GvHD in the lungs or bronchiolitis obliterans. Treatment usually involves starting prednisone, but wait...I've been back on prednisone since February! They are trying some different medications, an antibiotic that has shown some benefit and just this week a medication called Cellcept. It's much like prednisone. It's used to prevent rejection by those having lung, kidney, or liver transplants. It also suppresses my immune system, but we don't know how far yet, so I am taking additional precautions against infection, etc. We wait and watch for any improvement and, of course, any new side effects. One thing is certain...I won't be singing about it. I cannot sing anymore — sustaining a note causes uncontrollable coughing. Unless I carefully control my breathing, even sustained conversation is difficult, something for which I believe Marian may secretly be just a tiny bit thankful... ;-)

HP = High Pressure

And then, there is the blood pressure problem. During my last adventure in medical emergency treatment, my blood pressure soared and refused to come back down. Now I take three medications instead of one to reign it back, and test my BP each day. I watch my sodium intake and avoid caffeine. Here I sit. De-sugared. De-salted. Decaffeinated. I am developing a close, personal relationship with Mrs. Dash. I religiously read product labels — often blanching at the amount of sodium per serving. Life changes once again.

Still Intrepid

Walking is still my major form of exercise. Upon my return from the latest trip, I began with a walk around the block, arriving home fatigued and out of breath. After several days, I increased to two blocks. A week ago I increased to four blocks square (.5 mi). Yesterday and today, I've expanded to six blocks (.75 mi). Moving slowly and carefully, carrying and sometimes using a cane, and resting to catch my breath at strategic points allowed me to arrive home fatigued, but not sounding like a broken down calliope.

I try to walk early, after first light and during the cool of the morning. However, this does nothing to mitigate exposure to ragweed pollen from plants to which I have allergies (like Goldenrod) that not only are in full bloom, but also grow in profusion along the way. So far, a single loratadine tab each day seems to control the histamine reaction to my daily exposure. The first hard frost will solve that problem.

New Normals

It is not so bad as it sounds. I sleep well at night and can still read (although my right eye cataract has deteriorated my vision). I breathe well enough when not exerting myself — so I don't yet need supplemental oxygen — a development I would love to avoid. I laugh (carefully) and manage to control both pain and nausea without the use of additional medications.

Most importantly: I am alive. I've receive 555 consecutive gifts of brand new days to fill with all the best I can manage. I pray and hope for many more, and in an odd way look forward to meeting and defeating each new challenge. As I continue to change and as each new challenge is presented, I will endeavor to write about it here on my blog.

Thanks to all of you who send good thoughts and prayers on our behalf. God bless and good afternoon.

Mick

Mick McKellar Update -- Day +540

Smug...before dinner...

Back from the Danger Zone again...

Marian and I arrived home safely last evening, thanks to the kind efforts of my older son, Andrew and his wife, Krisanna. They drove to Rochester on Friday (August 10), and expected to leave the next morning to come home. Well, I couldn't allow that...so after our celebratory dinner (at Olive Garden), I became ill and once again experienced respiratory distress — so much so, that I ended up in the emergency room at St. Mary's Hospital after midnight. More tests and another day in the hospital(s) patched me up again, but not until I had delayed everyone an extra day. Therefore, my most recent adventure stretched out from July 30 to August 12.

There and Back Again, A Curmudgeon's Holiday

Sorry Bilbo, I couldn't resist it...

Monday, July 30 started as most days start: surprise and joy at waking up, and then on to the meds. I had a slightly elevated temperature, but nothing to be worried about. Late that evening, as I was preparing for bed, I felt a chill and checked my temperature again...101.7 degrees! The rules say if my temp goes to 101.3 or higher, we simply head for the emergency room. Grabbing my med box, I tottered out to the old Focus and Marian drove me to Portage Health. By the time we arrived, my fever was 102.3 and I was having great difficulty breathing and experiencing increasing pain in my chest. My BP soared. They tested and medicated me, deciding to keep me overnight, so Marian went home to get some sleep.

Things went downhill rapidly. I was having pain in my jaw and left arm. I was floating in and out of consciousness...so they called Marian to come to the hospital immediately. It felt like my lungs were tiny and difficult to operate. However, true to form, after the drama was over — I recovered enough for them to forward me on to Marquette General for diagnosis and further treatment. X-rays and CT scans were revealing nothing.

Destination 2

The ambulance ride was uneventful, even pleasant (despite riding backwards on a gurney) and the fine folks at Marquette General accepted the baton and began searching for my bogeyman. I arrived with a cannula in my nose and festooned with IV's, cardio-sensors, and bandages from all the bloodletting. They began a more detailed search while trying contain the blood pressure monster. However, blood testing, scans, and a nuclear stress test revealed nothing specific. My blood pressure and breathing refused to settle down amicably, so they decided I should be transferred to Rochester Methodist and Mayo Clinic. Marian was staying with her brother in Marquette, and had to drive the old Focus home, to wait by the phone.

The Un-final Destination

Friday finds me strapped on a narrow gurney in an aluminum tube, hurtling to Rochester. I wish I could say I enjoyed the flight, but I was given Lasix just before departure (to help control blood pressure), with the predictable and inconvenient results. I was taken to critical care and moved to the BMT ward a day and a half later — finally able to breathe without supplemental oxygen. Of course, I developed type II diabetes because of the increased Prednisone and other medications, enduring constant glucose testing and Insulin shots. I am still testing my glucose level twice a day and injecting Insulin.

I am taking multiple medications to control my blood pressure and just purchased a home blood pressure monitor, so I can work with the folks at Mayo Clinic to fine tune (and hopefully REDUCE) medication levels.

I was discharged Thursday, August 9, to a motel room near the hospital, awaiting the arrival of my family on Friday evening. It was great to see them, so we decided to celebrate by dining out. Dinner was uneventful, but only a couple of hours later, Andrew was rushing me to the emergency room at St. Mary's hospital in extreme gastrointestinal distress. It quickly degenerated to respiratory distress, resulting in nine hours in the emergency department and transfer back to Rochester Memorial. Released (again) Saturday, and grabbing a few hours rest, I rode home with my family yesterday.

The Situation

Trying to manage all the different (some new) medications, testing, reporting, and monitoring feels like I am juggling cats. When I walk, I am reminded of the old man character Tim Conway portrayed in skits on the Carol Burnett show. My lung capacity is still around 25-27% and seems likely to remain low. Although I qualify, I resist supplemental oxygen. Perhaps the most disappointing result of all the medication changes is another dramatic reduction in my ability to taste food.

On the other hand...

We are home — safe and sound. Everything (including my brain) functions, though most at a reduced rate. And once again, I am certain I was helped back from the proverbial edge by the prayers and good thoughts of our friends and relatives. I thank you all.

Good night, and God bless,

Mick

Mick McKellar Update — Day +523

T.G.I.F. (?)

I always have liked Fridays. When working, Friday marked the end of the "official" work week, bringing a period of accomplishment to a close and sometimes opening a door to a couple of days away from the cares of my regular job. These days, Friday passes with little or no holiday air — perhaps because I no longer have an "official" job — leukemia has become my career and survival my profession. My old jobs defined my life by setting its parameters. In a fashion, my illness, my cancer, my malady defines my life by setting new parameters. It's a 24/7/365 gig and my first vacation will be my last. At least, I get to work at home...

A call about numbers...

The Blood and Marrow Transplant desk (at Mayo) called last night with the results of yesterday morning's blood tests (at Portage Health). Again, the numbers looked pretty good. There were no indicators of problems. Even my blood glucose was behaving itself, coming in at a respectable 97. The latest critical factor, my breathing, lung capacity, and oxygen level won't be tested again until August 16, when we return once more to Rochester for a day of testing and consultations.

Sunday story...

Although it is Friday afternoon, I was thinking about last Sunday morning. I began my "morning constitutional" at 6:20 am (despite a valiant effort to leave 15 minutes earlier). A slow walk on a cool morning, resplendent with a bright blue breeze and bounteous birdsong, should have been an anodyne for all that ailed me. However, I quickly was denied that sunrise analgesic by cockcrow coughing and carbonaceous Canadian air.

Sensing something was amiss, I slowed my gait almost immediately — for some reason the air seemed thicker than normal and had a faint smokey taste. I was unaware of the warnings about smoke stealing down from Ontario's forest fires, so I immediately searched the skies for signs of a local fire or some scofflaw burning rubbish in the open. I labored to no avail — it was imported smog that caused my cough and awakened my wheezing. Still, retaining some intestinal fortitude, or just plain stubbornness, I plodded onward — doing my best imitation of an old, single-piston, steam engine.

By the time I reached the corner of 4th and Hecla in Beautiful Downtown Laurium, I was gasping like a surprised fish out of water. I leaned against the morning cool stone of the Vivian building and waited for my head to clear. Recovering quickly, I let go of the building (It would stand on its own now...) and started toward the intersection. An older, black, pickup truck rumbled to stop in front of me, and a young man leaned out the drivers window.

"Are you OK?" He asked, "Do you need a ride somewhere?"

Caught by surprise and immensely gratified by the concerned look on his face and on the face of his young daughter beside him, I hesitated and rasped out: "I'm fine (cough) just stopped to catch my breath (cough) — thanks for asking." My smile must have mocked a grimace behind my sunglasses and under my floppy sun-hat. He looked unsure for a second, then flashed a quick grin and drove away.

I finished the remainder of my 2.5 mile route with a lighter step and less effort — partially because the rest of the path was slightly down hill toward home and partially because the kindness of that stranger lifted my spirits. The next morning would be the last day I would gasp my way through the route without medication to improve my breathing.

Tough Monday

Monday morning started out tough. The air seemed clear when I left the house — more than a half-hour late — and I had high hopes for a more pleasant walk, minus the labored breathing, wheezing, and coughing from Sunday morning. However, about half-way through my walk, the air seemed to thicken and I was once again gasping. Fortunately, about a half a mile from home, I was rescued by Marian. Driving home from dropping Amanda at work, she pulled over and suggested I might need a ride. I happily complied.

Only 2 miles for Monday...rats!

Things improved Monday afternoon when my new medications, ordered by my doctor in Rochester, MN, finally arrived via USPS from Medco mail order pharmacy. These medications, Advair and Singulair, were prescribed and ordered on June 28, yet circumstances, errors, and bureaucracies on steroids contrived to delay delivery nearly a full month.

I started taking the new medications Monday evening, and I think my breathing has eased.

Like pulling teeth...

Writing updates, a past pleasure and I hope a future joy, has become a momentary challenge. It seems the issue of chemo brain or chemo fog continues to haunt me by locking the doors to my mental kingdom and forcing me to use the windows to get in. I found this list of symptoms on the Mayo Web site:

Signs and symptoms of chemo brain may include:

• Being unusually disorganized
• Confusion
• Difficulty concentrating
• Difficulty finding the right word
• Difficulty learning new skills
• Difficulty multitasking
• Fatigue
• Feeling of mental fogginess
• Short attention span
• Short-term memory problems
• Taking longer than usual to complete routine tasks
• Trouble with verbal memory, such as remembering a conversation
• Trouble with visual memory, such as recalling an image or list of words

Signs and symptoms of cognitive or memory problems vary from person to person and are typically temporary, often subsiding within two years of completion of cancer treatment.

Also see: http://well.blogs.nytimes.com/2009/08/11/coping-with-chemo-brain/

Many of the doctors I see don't openly scoff at this problem, but smile patronizingly and share knowing glances over the issue. I manage to remain fairly high functioning, but only by concerted and extreme effort, using tools that constantly slip and twist in my mental hands. Like an athlete who knows when his muscles are not responding appropriately, I sense the faltering in my mental gymnastics. Let me explain...

Left Brain, Right Brain, Chemo Brain...

For a plethora of distant and even vaguely unimportant reasons, I lived much of my early life inside my own head. I created my own worlds and teased aspects of the "real" world to respond to my rules. What I could not accomplish with innate talent (e.g., singing or painting), I could force by fierce focus and consummate concentration. My memory seemed both phenomenal and inexhaustible. In the sixth grade, using 11th grade Scholastic testing materials, I read 700 words per minute with retention of 98-100%. I became fascinated with words...so many words! If we count distinct senses and archaic words (not in the OED), English approaches three-quarters of a million words. I wanted to know them all...

Enter Limitations

Despite my aspirations, plans, and perorations to family and friends, the modern world held no place for a teenaged Renaissance smart-ass, with self-delusions of grandeur. Smack-downs came early and often — the first of many lessons learned about reigning in the horsepower and keeping it under the hood; about gearing-down and applying torque to projects at once diverse, satisfying to the mind, and gratifying in detail. Life was good inside my head.

Then fences appeared, and my professional life became compartmentalized due to educational, ethical, vocational, political, and physical barriers and boxes. Yet within that framework, I could compose entire documents in my head, reorganize and edit the copy, and type out a nearly final draft — a real time saver. The Rolodex in my head held the data in a searchable format, easy and quick to retrieve — if not entirely complete. I didn't have a photographic memory, but an eidetic one. I could recall images in vivid detail, but might forget our meeting at 2 pm...or even someone's name -- a great memory for a poet.

Of course, as I approached my sixties, there was an image or two blurred or missing data from the Rolodex, but my cache of words remained my pride and joy.

Then came my worst nightmare.

Over the last two years, I have lost the ability to edit entire documents in my head, making it difficult and time-consuming to write and edit. Documents like this update take days to prepare and I find mistakes days later that appall and embarrass me. Word loss and word search have become critical, affecting even conversation. My Rolodex is out of date, perhaps broken. My poetic Muse left town in disgust and seems to be on a long sabbatical...

Most distressing is the change in my personality. I have less patience than earlier and get angry more often — usually through inability to quickly respond appropriately to a new challenge or problem. Communicating feels like sorting dimes while wearing choppers (leather mittens). I have all the concentration and focus of a caffeine-addicted gnat. At least, that is how it feels to me now.

Is it the chemotherapy drugs, the ongoing medications coursing through my veins in a toxic soup, the accumulated stressors of my journey since May 2010, or a combination of all the above? I don't know. I pray it is at least a temporary imprisonment in a smaller, less wondrous mental world. I pray I will get my tools back, all sharpened and organized — and the confidence and wit to use them. I pray that my Muse will return and reopen my ears to the music of poetry, and make fertile once again the barren, dusty, fallow plain in my brain.

I thank all who have read this far. I know it sounds depressing, but it's not as bad as my complaints describe. I am alive. I can think (slowly). I have not lost the will to fight. I have my faith, and God sustains me. And I have all of you, who pray for us and think about us as our journey continues. 523 days so far, and I pray for many more — time enough to crawl out from under the shadow of chemo brain (or whatever it is) and share more of the thoughts and insights that flare suddenly, brilliantly in my mind — and then escape before I can catch them. It is hard to do, wearing mental choppers...

Good day and God bless,

Mick

Mick McKellar Update -- Day +513

Smiling in the shade at Mt. Olympus

It seems I am destined to remain forever out of step with the latest fads and current styles. Just as so many are gearing up for a fabulous fright over the end of the world on December 21, 2012, I am finally focusing on the wonder and promise of each new day and the joy in just waking up and discovering I am alive. Oh, there are plenty of reasons...excuses, actually...to be upset with my situation. Although Philadelphia chromosome positive, chronic myelogenous (or myeloid) leukemia (CML) is not exactly rare (1-2 people, per 100,000 contract CML, and the only well-described risk factor for CML is exposure to ionizing radiation — no, I was not at Hiroshima in 1945), I beat those odds when I found it, or it found me. Not only that, but also to contract a strain resistant to imatinib (Gleevec) demonstrated mighty luck of the disagreeable and detrimental sort — especially when my CML seemingly skipped the advanced stage and went directly to the third and final stage: blast crisis. When four courses of chemotherapy failed to stop the beast, we chose to risk a blood and marrow stem cell transplant.

But, that is old news...

Over the 513 days since I received my brother Kevin's stem and T-cells, I have attempted to chronicle the complex relationship between my body and his blood. The transplant was a success and I remain in remission — with the help of teams of doctors and some very powerful medications. Each day brings either new or ongoing symptoms. Most of the medications I take are to treat the side-effects of other medications or Graft versus Host Disease (GVHD, where the new organ, the new T-cells, reject my body by attacking parts of me). Regular blood tests monitor my hematologic health and currently look pretty good. However, Kevin's Tennessee T-cells have not agreed to live quietly in a Yooper body. The latest manifestations of their disquiet include:

• The Neverending Skin Rash — almost gone, but forever there — ready to flare
• Some eye problems, including an worsening cataract in my right eye, and early stage dry macular degeneration in both eyes
• Peripheral neuropathy in hands and feet — progressive loss of sensation and control



Splayed in the shade...

• Loss of >50% of my lung function — decreases in both capacity and oxygen levels — currently unexplained — all diagnostic tests negative

The most distressing and limiting has been the breathing problems. It appears my childhood bronchial asthma demon may have joined forces on the dark side — with my new nemesis, GVHD — causing extreme shortness of breath, even when pursuing chores as simple as washing dishes or carrying a bag of groceries from car trunk to kitchen table.

Of course, I remain immune-suppressed, hyper-sensitive to sunlight, and tired (very tired). Yet, these are the risks with something as drastic as a BMT. Most BMT patients succumb to the effects of the treatment, not the disease after transplant. I accepted that going in, and I am extremely grateful for each and every day after transplant, days I would not have had without my brother's Gift and God's grace.

Then there is human bureaucracy...

...one of the few constants in the known universe. Let me step back to yesterday, day 512 after transplant.

I must admit, I did not fancy starting my week the way I ended my previous week: on the phone, trying to straighten out my prescription coverage ID numbers and regain access to my online accounts. The story would be funny, were it not so painfully important. I still do not have prescriptions that were ordered for me by my doctor in Rochester on June 28 or 29 — right after our last visit. In fact, thanks to some royal account number mix-ups, the order was held and then stopped. It was restarted only yesterday morning.

It all started with Medicare.

I qualified for Medicare coverage beginning 6/1/2012 — 24 months after my first eligibility for monthly Social Security Disability benefits. Upon this grand change, two things were to happen: First my pension with the Michigan Public School Employees Retirement System (MPSERS) would be adjusted upward because my SSA benefits went down to pay for part B of Medicare. It happens automatically for those turning age 65, but not for those on disability. I did not know I should have filed a form with MPSERS before June 1 to get the adjustment. The only place I know it says to file the form, is on the form itself...I certainly did not received any notification regarding forms to file upon Medicare eligibility. I mailed the form in June (same day I found out about the requirement), but was advised that I would not receive a retroactive adjustment for June...just too bad for me, I guess.

Shortly thereafter, I received a new BCBS card, with a different ID number than my old one, but not what I expected...for I expected to be enrolled in the Medicare Advantage plan. So, I called BCBS. Some very helpful folks at BCBS tracked down the problem: Oops! I had slipped through the cracks — and they would fix it. On the same day, I received my first ID cards from Catalyst RX, the folks who process prescriptions for retirees on MPSERS plans. I now had a second new ID number to use, separate from my BCBS ID number. Oh, joy!

A week or so later, I received a letter and new BCBS cards, this time for the Medicare Advantage plan...and a third new ID number. Now, I think I have the right number — for health insurance and medical. On the same day, I received yet another set of new cards from Catalyst RX, with the same ID number on them. So, I logged into my online pharmacy account to update ID numbers...after all I had two new prescriptions in the pipeline (for nearly two weeks already) and some refills coming due soon.

Friday Surprise!

I logged in and discovered I was locked out of my pharmacy account until I updated my profile. OK — I opened the profile page and entered my new ID numbers. None of them worked AND the system told me that my date of birth was incorrect — only it was correct. After multiple entries in various permutations and combinations with the new ID numbers, I gave up and called the online pharmacy for tech support. Not only was my account messed up because of the ID numbers, but I had TWO ACCOUNTS! One had my name with the "Jr." attached and the other did not have the suffix. When the helpful technician corrected the account, an odd looking claim number (not the Catalyst RX number) popped up. I told him it was not my number — so, he set up the account with the number I received from Catalyst RX. He stopped the processing on my new prescriptions, to restart them when the account updated. I could log in, but it would be some time before I could view my account. This was Friday.

Saturday Surprise!

There was a single envelope in Saturday's postal mail. With trepidation, I tore the envelope open and read, with unbelieving eyes, the notice from MPSERS that I had been enrolled in the Medco Medicare Prescription Plan and advising me that I had another new ID number for my prescription coverage. It was the odd looking number I had rejected on Friday...come back to haunt me. Then, later on Saturday, the specialty pharmacy unit of my mail order pharmacy called to schedule delivery of the next refill for the tyrosine kinase inhibitor medication that helps keep me in remission from my CML. They could not complete the process because my account was still inaccessible.

Monday Results!

Finally, yesterday, after more than an hour on the phone, my account was moved to the correct account number, activated again, and I was able to schedule the delivery of my special medication. They told me the orders for the new prescriptions were restarted again.

Journey to Mt. Olympus

Not everything has been taxing and negative for the past month. From July 8 — July 11, my daughter, Amanda and my son Andrew (and his family) invited us to spend a few days with them at Mt. Olympus Resort in Wisconsin Dells, WI. Although I spent most of my time on the periphery of events, staying out of the sun and far away from the water (and dense crowds of people with children), I had a great time — eating too much, laying about in the shade, and snapping photos with the telephoto lens on my camera. I did get to drive bumper cars (indoors) and go karts — and I went horseback riding for the first time in over 30 years (on a very shady trail along a canyon).

We had a suite with two bedrooms. The others slept in the bedrooms and I slept on the sofa-bed, with the air conditioning turned up full. Everyone was kind about waiting for the old wheezing geezer to catch up, and they came to visit me off in my distant, shady corners of the various theme and water parks at Mt. Olympus. I had a great time, gathering memories and sharing stories.

On that pleasant note, I will end this wild, rambling update and once again thank you all for your prayers and good thoughts. I have no idea what the diagnosis will be regarding this suddenly loss of lung function, nor do I know if the proposed treatment will help (three weeks and I still do not have the medications in hand). I leave those decisions in God's hands and will face whatever challenges may come, as we have learned to face them...one day at a time.

I have missed a couple of days of my 2.5 mile walk, because of breathing difficulties, but will try to resume in a day or so.

Good evening and God bless,

Mick

Mick McKellar Update — Day +500!

Me, Sandy, Tim, and Kevin

Serendipity — maybe, but in my (never) very humble opinion, it's great that the 500th day since the gift of life from my brother Kevin should also be the birthday of our country. Although I may gasp a bit for breath when singing about today's milestone, it truly feels wonderful to be alive and kickin' five hundred days from my blood and marrow stem cell transplant. It has been only a few short days since brothers Kevin and Tim, Kevin's son KJ, and my sister Sandy visited for a mini McKellar family reunion of sorts. We spent days pouring over old family photos Kevin had been storing since our Dad's death in 2005. When my son, Andrew, brought his family over, three generations of McKellars spent hours sharing and laughing ourselves silly over a game of Apples to Apples. 

I hope I can remember that day...

Sibling Revelry

I had four younger siblings, however in 2003, my youngest brother, Daniel, died from COPD (emphysema). Remaining of my parents' offspring are: me (the oldest), Tim, Sandy, and Kevin. We five all arrived within a span of less than seven years, so we are pretty tight age-wise. Growing up, however, a barrier (mostly of my own construction) grew up between me and my younger siblings. I believe it was partly due to an accident in my crib that injured my hands and feet when I was 18 months old, making my parents especially careful when playing with me...meaning they did not often play and almost never would "rough house" with me as a child. My mother said that, as a child, I was grim — and ofttimes referred to my saturnine face and dark, watchful eyes. At about age 3, I turned to books and pretty much quit playing games, except for flashlight tag and war games in our back yard, using small lumps of clay soil as weapons (like paintball, but without the armor...).

Perhaps the most disconcerting aspect of our evenings during their visit, was to finally hear myself described in their experience as studious, stiff, and standoffish. I guess I was rather self-contained — staying indoors most of the Detroit area summers because of asthma and hay fever — reading books and writing short stories and "sappy" poems. This made it difficult to relate to my extremely active siblings. Still it was magic to reminisce about things we did with (and to) each other. Although I've been telling the stories for years, I was overjoyed to hear them from another point of view. Their visit was a precious gift.

Still Waiting for the Other Shoe to Fall...

My doctor at Mayo Clinic called on Monday. The echocardiogram was normal...I do have a heart, and it does not look any worse than the last exam. Certainly, there was nothing apparent to cause my dramatic loss of lung function. The CT scan of my lungs showed nothing abnormal — no fuzzy clouds of infection, no blockages, no apparent damage. The results from the bronchoscopy were not yet available. They looked around with a camera, did a bronchoalveolar lavage, and a biopsy. I hope to hear something this week to explain why I am so short of breath and why my results on a pulmonary function study showed a nearly 60% loss of capacity and function, compared to my last test, more than two months ago.

My other test results looked great. My recalcitrant GVHD rash seems once again in retreat, though reluctant to retire from the battlefield. My eyes are holding their own, although the cataract in my right eye grows steadily worse — allowing me to view the right side of the world through the bottom of a old, yellow bottle. The neuropathy in my hands and feet remains, although I try to stem the tide with exercise and working about the house. Now, if only I could just carry a bag of groceries from the car without having to sit down and catch my breath, and then find something to mop the sweat from my bushy brow and newly capacious forehead before it drips into my sensitive eyes. 

Is the Intrepid Walker Back?

Perhaps. However, he is much slower than previously. Each morning, beginning July 1, I've walked my 2.5 mile path, as an early morning constitutional. I have to get up by 6:00 AM, and try to get on the road by 6:15 - 6:30 AM. This allows me to walk without worry about excessive exposure to direct (and very, very warm) sunlight. I must walk slowly — it takes me an hour, perhaps 2 or 3 minutes more, to walk the 2.5 miles, because I must stop to catch my breath and my bearings. Early joggers sometimes do a quick double-take at the slow-moving old fart — wearing long-sleeves, floppy hat, and sunglasses — tottering about on the early morning mean streets of Laurium. I say, let them giggle in their tiny shorts, tees, and trainers.

A few weeks ago, a small fellow (about 4 or 5 years old) asked me why I was wearing that hat. I told him it was to keep the last of my hair from blowing away. I could still see his small face, watching silently, as I turned the corner a block away. I think he may have believed me...

Best Wishes...

for a blessed and happy Fourth of July, and a great bundle of thank yous for all the prayers and good thoughts you send us. I must get to bed and try to sleep to the sound of fire crackers and home fireworks exploding in our neighborhood.

Good night and God bless,

Mick

Mick McKellar Update -- Day +495

We leave the fair metropolis of Rochester, MN, for home tomorrow morning -- very early (if we can manage to get up in time). The last two days have been a bit of a rollercoaster of tests, exams, and head-scratching. 

Thursday began benignly enough with the usual blood tests. The following test, a pulmonary function study, is difficult at times, and in this case set off alarms with my doctors. My previous tests had shown some decline in lung capacity, maybe 15% -- not unusual for someone my age, who has asthma and misspent many a year tending my food goiter. This test showed my capacity down 50-60%! Also, my oxygen level (usually 98-100% on the stair climb) was in the high 80's to lower 90's.

My regular numbers were all beautiful. My hemoglobin is now out of the anemic range and at the low end of normal. My white cell count, ANC, and platelets are in great shape. So, why can I not carry a bag of groceries from the car to the kitchen without sitting down to rest and catch my breath?

To answer that question (and others), we stayed one more day (today) for an echocardiogram, a CT scan of my torso, and (gulp) a bronchoscopy. The bronchoscopy (because of anesthesia) took about 3 hours and has left me with a sore throat, a slight fever, and a lot of questions that cannot be answered until the data from all the tests is analysed and studied.

Also, Marian will have to drive at least half the way home, because I am not supposed to drive for 24 hours from the beginning of my anesthesia. We hope to make it home in time for Marian to honor committments tomorrow evening. I will be waiting on pins and needles for test results and possible treatments. I hope to have more to share next week.

Well, I have to get packed and get to bed. 5:00 AM comes early, even in Central Daylight Time...

Thanks for your prayers and good thoughts! Good night, and God bless!

Mick

Mick McKellar Update — Day +487

Current medical situation: My numbers look pretty good. It is becoming very difficult to see where any of the GVHD rash exists. However, I am still taking substantial doses of Prednisone daily, with all its concomitant baggage. Numbness in my hands and feet remain a problem, but don't seem to be worsening. A recalcitrant bronchial cough plagues me daily, but a chest x-ray last week was clear. My allergies have been problematic this spring and summer, and fatigue and shortness of breath remain my constant companions. But, by-and-large, these are aggravations and inconveniences, and I can live a fairly normal life...as long as I remain out of the sunlight, stay away from crowds, don't go near the water, and remain near a bathroom (because of all the water I must drink). In six days, we travel back to Rochester, MN for blood tests, consultations, and exams. I hope to pass along good news from the visit.

I will pass it along, if I can get back into the habit of writing again.

I cannot explain my recent writing reticence, at least not entirely. More than a hundred attempts to compose and update or write a poem have been abandoned in the last few months. Perhaps I fear a prose/poem power failure. Maybe my muse has lost her moxie. I could be lost in a fog of mental fatigue, aided and abetted by a chemically-induced procrastination coma (i.e., I'm too lazy and blame it on the drugs...).

Possibly, I had nothing to talk about...

Yeah, right!

The Four Stages of Mankind — Revisited

There was a time when I only repeated stories, comments, observations, and questions for emphasis or to obtain clarity. Now, I often repeat myself because I simply forget what I said, or what I was told. I am certain I covered the Four Stages of Mankind somewhere in previous communications, but I was reflecting on them this afternoon and here they are, once again for the first time: Childhood, Adolescence, Adulthood, and "My, Don't You Look Good!"

I was thinking about this old joke, because I realized I have been using it to deal with the unexpected giddiness I've been experiencing when, upon meeting friends, family, and acquaintances, they have commented: "You look good!" Prior to my adventures with CML, the phrase just didn't pop up very often in the course of my life.

Mirrors were never particularly kind to me, but were never brutally unkind until my weight reached the 320+lbs. mark — and that shocking morning that my father was looking back at me — through the looking glass. The lowest point was after the third chemotherapy session, while I was in Rochester, MN for evaluation and testing. Flesh was melting from my bones and my hair was coming out in clumps. The image in the glass was beginning to resemble the Cryptkeeper from Tales From the Crypt. I was molting...and looked revolting. I looked ill. I looked like a leukemia patient.


Months after my transplant, when folks started to comment that I looked good, I truly thought they were only being kind — trying to cheer me up. I often dissembled and deflected the compliments...using the ratty old Stages of Mankind joke. Now, I believe they were truly surprised that I looked so normal. Obviously, things have improved, although the loss of hair, moon face, and double chins which have accompanied my Prednisone treatments remain an unpleasant fact of life. My life hasn't been and will never be normal, but acknowledgement that I do not look ill is reassuring and life reaffirming for me. I may be wry and dry, and juggling the jokes, but I am pleased as punch you noticed.

Echoes of Joy

Old dolorous Mick truly died when I was diagnosed with leukemia. I grew up, grim as bad weather, with a serious soul and a tendency toward the melodramatic. However, the man who dwells in the CML crucible is no longer that person. My soul remains serious, but my heart rejoices with each and every sunrise. I danced close enough to the abyss that death whispered a tune in my good ear. I don't fear death, but I like living and I don't believe God is done with me yet. I love life, but I hide it well.

Please keep in mind that if I am cranky, it just might be the Prednisone pushing all the wrong buttons. If my face is set like flint, with a dour caste and tight lips, I may simply be trying devilishly hard not to cough in your face. If I seem distant and a bit sad, I probably am — because I cannot yet remember why I just walked into the room. If I am not talking, I may be listening — or I might be asleep or adrift on a daydream.

I have noticed lately that the affairs of the REAL world seem increasingly distant, softer, dimmer. It sometimes feels as though I am sitting beside myself, casually watching me be me, or roaming about while the rented house I inhabit merely rests and awaits my return. Sometimes I am awake when I dream, and sometimes I dream that I am awake. Talking to God has become easier, although staying awake long enough to finish my prayers can be a trial. I can be alone, without being lonely, and I enjoy simply inhabiting my own head, dusting off old memories and rejoicing that I can remember them. I am re-reading my library, as I seem to have forgotten so much about books I read years ago — that "everything old is new again."

Thank you for following along on my update. There is so incredibly much I want to say, to write, to sculpt and paint with words, before I drift away from this cracked shell — but it seems that, at least for awhile, I have forgotten how to say it. I am working on it, I truly am...

Thanks to all to continue to pray for us and send good thoughts our way.

Good night and God bless,

Mick

Mick McKellar Update — Day +461

Another Anniversary...

Before I begin my long overdue journal entry, I feel obliged to mention the reason I am celebrating May 26, 2012. Two years ago, at 10:00 AM, I received the news that I had leukemia. Today, I count myself as a Two Year Cancer Survivor! It was several days (and a host of genetic tests) later that I was "officially" diagnosed with Philadelphia chromosome-positive, Chronic Myeloid Leukemia (CML). Three months later, it became Acute Myeloid Leukemia (blast crisis), and is now, once again, CML — but that is another story.

A life that began in January 1950, ended at 10:00 AM, May 26, 2010 as those three words, "You have leukemia," arrowed from my cell phone into my already compromised consciousness, totally prepared to hear "diabetes," not "death." You see, I was raised during a time when a diagnoses of leukemia was an automatic death sentence — and those moldy, old tapes were playing over and over again in my beleaguered brain on the ambulance ride to Marquette General. I had been sick for a long time, probably six months or more, and with a white blood count over 330,000 — I was knocking at the door of the hereafter. To be honest, I think it opened once or twice, but the security chain was in place and I was too tired to force the issue. Thanks to God's grace, thousands of prayers, and the wonders of modern medical science, I survived both this narrow escape and the blast crisis in October 2010 to receive a gracious and heroic gift of new life — a stem cell transplant (BMT) from my brother, Kevin, on February 21, 2011 — a miracle that happened only 461 days ago.

Although there are days when the treatment feels worse than the disease, like now — when my brother's red-neck, Tennessee T-cells are having a party in my skin and there's an increased presence of the newest wrinkle: peripheral neuropathy in my feet and hands — I am alive to feel it, treat it, endure it, and kvetch about it. Alive is good. Alive is victory. So, I am celebrating...indoors, of course.

A little adventure outside to mow some grass appears to be the impetus for my latest adventure in GVHD...

Wrap Up

Today, when I opened my eyes at 6:00 AM, my old Palm TX shouting Reveille at me, my first thought should have been: "Thank you, Lord, for another day!" Instead, I immediately focused on determining how I'd become so tangled in my bed sheet and blanket. I must have done a dervish dance in my sleep.

The Mad Russian: Ivan Awfulich

I suppose one bad joke deserves another: My demonic GVHD rash is back...and it itches! Little wonder I had trouble finding a comfortable sleeping position, as my frazzled nerve cells tracked that twitchy itch, on its sporadic tour of my epidermis. Even the wet wraps (yes, we're doing wet wraps again...) do little to belay its insidious crawl, its terrible tingly prickle. I want to scratch it. My fingers twitch with the unrelieved desire to drag my fingernails over irritated and reddened skin for that instantaneous and ephemeral relief. The creams help a little, but it still feels like I'm wearing a hair shirt on a hot day...

My doctor has increased my Prednisone dosage from 20 mg/day to 30 mg/day — a true set-back in our effort to slowly reduce my intake of this steroid which reduces inflammation and suppresses my immune system. We're hoping to begin the tapering once again, as soon as this "flare up" of the rash is under control.

Shine a little light on me...

Apparently, this latest adventure in GVHD is not solely the result of tapering my steroid treatment. Despite great caution — filter mask, SPF 50 sun block, long sleeves, dark glasses, broad-brimmed silly-looking hat, and gloves — an hour in the sun mowing grass appears to be the trigger for this latest flare up. Both my medical condition and several medications have made my skin ultra-sensitive to sunlight, and I have been ordered to stay indoors as much as possible. I considered mowing the grass a chore. Now, I would consider it a privilege. I work in my garage (see picture) and go for walks on extremely dreary days or during twilight hours.

The "eyes" have it...

My online reading and writing have been curtailed because of my eyes. They seem to tire easily when staring at glowing screens. Marian and I went to see The Avengers Thursday evening. I really liked the movie and even enjoyed (after a fashion) the 3-D effects. My eyes were red and sore after the show. So, lately I have spent more time reading — on my Nook e-reader (it doesn't glow) or in books from my rather extensive library. One positive effect of the memory loss resulting from the cumulative effects of chemotherapy and the accumulation of 59 years of reading (I began reading at age 3) is a general fuzziness about storyline, plot, and characters in some of my favorite old books. Re-reading them is a pleasure and a voyage of re-discovery.

On this day of celebration, I thank everyone who has prayed for, and is praying for me and for Marian — who may indeed have the toughest job of all — caring for an ill-tempered, curmudgeonly old bear with a headache and an unreachable itch. Your prayers sustain us and your good thoughts give us hope.

God bless and good day.

Mick