December 30, 2008

Tom's appointment yielded the expected scheduling of another bone marrow extraction (AKA biopsy). That procedure will take place Friday afternoon, which was as soon as we could get. I offered to help the doctor do it on Thursday, since his nurses will be out. I even offered up nurses that I know. But, none of that worked. We will get the results on Monday or Tuesday.

At this point the doctor is concerned about his total blood count. Though all of his blood elements (white, red, platelet) have been low for some time the platelets had been the only count at critical levels. A week ago was the first time the red blood cells had dropped to critical and his white blood cells seem to be following suit. The doctor also noted that Tom does not fit neatly into any diagnostic category. We're even further from understanding how his liver had factored into this. The ibuprofen theory becomes more and more unlikely all the time. I'm guessing it's one small nudge away from being completely out.

He did discuss with us the potential nature of the condition as something that may not have "declared" itself by the time that the first bone marrow biopsy was performed. He said that sometimes it takes time for all of the symptoms of an existing disease to present. The doctor also mentioned that he gets, at the most, 1 to 2 cases per year that are this difficult to figure out.

He also gave us two scenarios that he has considered. The worst case scenario would be leukemia (http://en.wikipedia.org/wiki/Leukemia). Based on what has occurred so far it seems as though Tom would fall in the myelogenous category. The other scenario that he mentioned was aplastic anemia (http://en.wikipedia.org/wiki/Aplastic_anemia) . . . ever heard of the "Boy in the Plastic Bubble?" Luckily treatment options have improved significantly since John Travolta was a teenager.

Once we get the results from this biopsy and a diagnosis & recommended course of treatment from Dr. Olsen we'll seek out second and third opinions, if for no other reason than to be thorough.

So, I don't know that I'll have much more information for about a week, but if I do I'll let everyone know.

The prayers and thoughts are so meaningful. Thank you. Tom doesn't ask for much, only prayer: something both powerful AND convenient to give.

With much love,

The Highland Park DuBranskys