January 9, 2008

Tonight Tom is at the hospital receiving a red blood and platelet transfusion. His levels are dropping faster now.

He receives 20,000 platelets each time he gets transfused. He loses between 4,000 and 5,000 platelets a day. Tuesday when he went in he had less than 5,000 platelets. So, as you can tell by the math he would essentially drop to 0 in 5 to 7 days, without intervention. When Tom's platelets are low he begins to bleed in various noticeable ways. He develops petechia or purpura (bleeding uner the skin), he has an overwhelming taste of blood in his mouth as his gums bleed and his nose bleeds. The risk at levels below 10,000 is that he will bleed internally or behind his eyes, which can lead to blindness.

We're still learning about his red blood levels. He was at 5.4 on Christmas Eve when he received 2 units, bringing him up to approximately 7.4. They gave him an additional 2 units 5 1/2 days later. Today his red blood levels were at 8. A greater portion of this loss took place this week. When Tom's red blood cells are low he feels extremely weak and sleeps a lot. Its our understanding that this is due to the lack of oxygen reaching his muscles.

Yesterday Dr. Olsen asked me to share with him the hematology/oncology specialists in our health insurance network that are in the City of Hope, UCLA, USC and Cedars-Sinai medical groups. It has been quite a comfort that we enrolled in a PPO starting this January, which allows us access to these types of high-quality services. I shared the information with Dr. Olsen today. He contacted team leader, Dr. Stephen Forman at City of Hope. It appears that Tom will be assigned to Dr. Nadel. Unfortunately Tom missed a call from New Patient Services today, when he was having his temperature taken at the hospital and wasn't able to pick up the phone. We expect to connect on Monday. This will allow us to get a head start on the bone marrow transplant process while waiting for T Cell Lymphoma to be ruled out.

I hope this finds you and those you love in good health and happiness, Barbara