11-22-10   Monday  Day +26

 Status: 8.5/10.  A good day, and even better when we saw our labs!  Red cells, white cells, and platelets all climbing.  They’ve even moved our appointments to the afternoon presuming short visits (“Labs look good, go home”).

Events:  Most of the day is centered around the timing of my meds.  Some have to be taken an hour before or two hours after a meal, some with food, some at specific times – takes an Excel spread sheet.

Comments:   To answer two questions : Not long ago patients would spend 60-100 days after transplant in the hospital, even after their counts were in a safe level.  You were sleep deprived, fed bad food, exposed to antibiotic-resistant bugs, and driven toward psychosis.  The concept at Hopkins was to release you from the hospital environment and be seen daily in their InPatient/OutPatient Comprensive Care Center (IPOP).

  When Dr. Henry Miller, my fraternity little brother, and I went to medical school what we knew of immunology was little (or maybe I slept through the lectures).  Basically there were T-lymphocytes (“T” because they were produced in the thymus gland) and B-lymphocytes (“B “ because no one knew where they came from, but in chickens they were produced in an appendix-like organ called the Bursa.)

  When viruses and bacteria invade the body, the first reaction of the immune system is a general “call out the Marines.”  Just get men and guns to the beachhead and head off whoever is attacking until we get reinforcements.  During this holding action, a number of the invaders are captured and interrogated (makes water boarding look like taking a refreshing sip).  “Who sent you here?  How many of you are there?  What weapons do you have?  Guns?  Tanks?  Bazookas?”  With this new intelligence the B-cells  direct the making of specific antibodies to fight off the invaders.

   More importantly, the immune system creates a list of each attack in special cells called memory cells that have the blueprint to make specific antibodies against those invaders.  The next time those same organisms try to invade the body, antibody production is all ready to go.  That’s why if you’ve had measles once, you won’t get it again – your body already has antibodies against it.

  The question is when this is all done what memory cells will I have?  Will I still have my old ones?  Will I get my donor’s?  The answer is it all depends.  It seems most people lose most of their memory cells, and I don’t know if they get any from the donor.  Bottom line, I’ll most likely have to be revaccinated against a dozen or so infections.

  Although I get elated to see my counts go up, I get much more so by reading your comments.  They have real healing power.  There’s no way I can ever say thanks.

Love,

-Bruce

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16 Responses to “”

  1. Jill O'Mahony Stewart Says:

    It’s good to see you feeling well enough for a microbiology lesson, Dr. Dan!! You will be front and center, next to the other turkeys, at our Thanksgiving as we pray for your continued recovery! Love, Jill

  2. Hansan Family Says:

    Bruce,
    Having given so much to the field of medicine, it is great to see that you are the beneficiary of medical advances and understanding. Thanks for the continued lessons and have a great Thanksgiving. We are thankful for your continued progress. The Hansan’s

  3. wendy Says:

    thanks is in how you choose to live the rest of your life… continue healing and informing the world of the much needed education on BMT

  4. Victoria Cushey Says:

    Darling Bruce,

    What a difference an email makes…everyday I receive your blog in my InBox. The minute I see it, I read it — every word, every detail…and I hold my breath with hope. Some days I dramatically sigh…and days like today, I feel like jumping up and down, so just thought I’d let you know I just burned a few calories after reading your post.

    The coolest part of your entries is your tone — we daily Bruce Dan readers know how you’re doing from the first line — even if you don’t exactly tell us until the next sentence. And today’s first line was fantastic! But even better was the tone…I could see your smile.

    And I love, love, love the biology lessons — especially today’s re: the human immune system. Your descriptions are perfect for me…it’s like reading about a subject I understand from a macro level, but then I realize, I really don’t…until your micro analogies make it clear. I think you should write a book for me…Internal Medicine for Dummies. 😉

    I love you. I think of you everyday. And I continue to hold my breath when your entries arrive. So keep getting better so I don’t faint, ok?

    xoxo,
    Robin Victoria

  5. Margot Mahoney Says:

    Great news again. Clearly there is no loss of memory cells in your ol’ grey matter! Your battle description is like something out of a Woody Allen film. I can truly visualize!
    Thanks for bringing a smile to my tired ol’ face at this late hour!

  6. Susan Bies Says:

    Bruce,
    Can’t seem to go to sleep without reading your post each night. I get a thrill if i read your post and there are few/no responses, it means i got to read it first, silly i know. While I don’t write with frequency, it doesn’t mean you aren’t perpetually in my thoughts. I walked into a starbucks recently and swore I saw you. I thought (with a smile on my face) what a supreme treat it would be to see you sitting in that exact spot one day in the near future. Not sure if you even drink coffee, but I know the conversation would be lively nonetheless. best, susan

  7. Judie Davidson Says:

    I was chatting with another TaxAide volunteer who used to work in Chicago. I told her about my friend who recently had a bone marrow transplant and was writing a wonderful blog. When I said “he used to be a TV doc in the Chicago area, she says, “You mean, Dr. Dan?” See Bruce, lots of people have memories of you. Glad you are doing so well.

  8. Michael & Greta Says:

    Oh happy day! 🙂

  9. Shelley Fleet Says:

    How thrilling to watch the counts jump up and know that your new marrow is working so well. Yes, we all have much to be thankful for.
    I’m also enjoying the medical info in your blogs. Do you think you could sign up yor blog to be CME credits?

  10. Hopie Says:

    Up early to read the comments on your blog, some even make me cry, About Judie’s friend in Chicago remembering you. Don’t know why!.
    Love you and can’t wait to see you. Mom

  11. Roxanne K. Young Says:

    Bruce!

    Totally aces. Cells, keep up the good work.

    Roxanne

  12. Warren Says:

    Sounding good. Keep it up.

  13. Catherine O'Brien Says:

    I really love it when you are reporting so much good news! It will enhance my thankfulness this Thanksgiving.

    Lots and lots of love,
    Catherine

  14. Laurie Samuels Says:

    So good to be better informed about how the body works…. and even better to know that your body is doing its job!

    I am very happy to hear that you continue to be headed up, up, up… It is great that they let you out of the hospital during this fragile time. I know Lisa is making your home away from home as nice as she can. It may not be home…. but hey, it ain’t the hospital.

    Continued love and hugs to you all and best wishes for a truly “thankful” and “blessed” Thanksgiving! We will be thinking of you and yours on this special holiday. Laurie (and the Samuels family)

  15. joel steinberg Says:

    Keep sending the excellent reports. And it is the Bursa of Fabricius–named by one Fabricius (of course) and more commonly know as “The Pope’s Nose.” It’s that tasty, fatty stuff in the tail of the chicken that is so yummy to chew upon. And the turkey, too. So think for a moment about Fabricius, B-cells, and good health as you enjoy your very well deserved Thanksgiving dinner. Joel S.

  16. Leslie Singman and Family Says:

    I have not been on the blog in about a week. So exciting to hear about your transfer to the apartment nearby and all the good signs in your blood work. We will be thinking of you this Thanksgiving and giving thanks for your improved health and speedy recovery!

    Leslie

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