Allow me to draw your attention to this bag of yellow, single-donor platelets I hold in my left hand. These platelets are going to be eased by gravity into my port early Monday evening because as of Monday morning my platelets remain too low for the spine biopsy on Tuesday (today). Watch as the platelet bag becomes empty, and watch as the nurse draws my blood to monitor my post-transfusion platelet level. Wait for it, wait 30 minutes to discover my new platelet value, here comes my fancy trick <envision my magic sparkle jazz hands here>--ta-da! My platelets are lower than before the transfusion! Isn't that fancy? Did I dazzle you with my magic, or did you miss it? Here, let me do it again. This time it is after midnight, and I pre-medicate with tylenol, benadryl, and a steroid to help protect the platelets. Again, I present to you a bag of single-donor platelets hanging from a stainless steel hook. Again we draw some blood to test for all sorts of goofy things: antibodies against the platelets, some heparin-related disorder (this is the substance that is injected to hang out in my port when my port is not in use), some other crud, and platelet levels. I wave my magic sparkle jazz hands and--ta-da! My platelets again are lower than before! I am so amazing. But I'm not done yet, oh no. Now it's 6 am and I will attempt a bag of multi-donor platelets. I pre-medicate, the platelets infuse slowly, I release some blood, and...can I have it quiet in the audience, please? <drumroll> My platelets are up! I guess I'm not a very good magician, but oh heavens am I relieved to be able to receive platelets and to have the spine biopsy today.
My platelets are still not to the threshold that my oncologist would like (100), but they are above the threshold the radiologist/spine surgeon would like (50). I therefore received yet another bag of multi-donor platelets about an hour ago, and we'll send a sample of my blood to the lab any minute now. Outlook is good for the spine biopsy today, probably early afternoon. We are very curious about my amazing disappearing platelet trick, but because my body accepted the multi-donor platelets it is no longer an acute thing to worry about.
I spoke with the radiologist this morning, and here's a sketch of the procedure: make me goofy with drugs but don't put me under, insert needle through the skin at T9 vertebral body using some window that is naturally present in the spine, manually drill a hole through a bit of bone, take a sample of marrow, wait for results (some results could come as early as today and as late as in 2 days). As I've been verbalizing this week to geographically proximal folks, there's no middle ground for the results. They will either be huge-sigh-of-relief results because I have a mild injury and T9 is simply healing, or they will be sob-on-a-loved-one's-shoulder results because I have a tumor in T9 that managed to grow DURING general mitotic inhibitor chemotherapy. Either way, I'm sure I will curse. The word choice will be dictated by the nature of the news.
I am surprisingly calm, possibly because I am hungry and dehydrated (nothing to eat or drink since midnight). I am positively delighted to be moving forward and getting answers regarding T9. This platelet thing has been inconvenient at worst, painless at best. My recovery after the biopsy is supposed to be only 3-4 hours, so I should be home tonight. If I'm lucid, I'll post and tell you how it went, otherwise I'll wait until I have some results to share. Hopefully the good kind.