Just good news this time.
I’ve been feeling decent to good for a few months now. I’ve been doing things which city people would call “hikes”, but I call “itsy-bitsy, teensy-tinsy miniature walklettes.” Three to four miles on mostly flat ground. That’s good for a leukemia patient, but the thrill of clearing such a low bar is minimal.
Once I started the fancy-pants new anti-cancer drug, Olutasidenib, my blood counts started perking up. The white blood cells, platelets, and neutrophils went from near zero to normal range within a couple of weeks. I went from needing a transfusion every couple of weeks to not needing one for three months. But, there were still some blast cells showing up in my blood, so my UCSF doctor added another medication to the mix to stop the spread of a different mutation I have. I didn’t really notice a change with the second one, but…
There were two major hurdles to getting the transplant. The transplant is really the only way through this whole leukemia thang. First, we had to pommel the disease into remission. Second, I had to get an oral surgeon to dig into my gums and remove the roots of some teeth which had crumbled away some years back. The roots were a serious infection hazard, and the first part of the transplant process is to completely wipe out the patient’s immune system. So we really really really didn’t want an abscess during the transplant.
I’m on Medi-Cal. It’s great for regular medical stuff. I’ve racked up hundreds of thousands of dollars in medical expenses which they’ve paid without a whimper or a co-pay. BUT— and I don’t like big butts—they’re terrible for dental stuff. They sorta-kinda theoretically hypothetically supposedly cover a lot of dental things, but the dentists hate Medi-Cal and the oral surgeons mostly refuse to deal with Medi-Cal patients at all. The few that do work with Medi-Cal are booked ahead for several months. So, we’ve been trying to get an appointment in a narrow time window from university dental clinics.
It took me and the oncology team at UCSF several months to even make contact with a human being at the UCSF Dental Clinic. I was convinced the dental clinic consisted entirely of a phone answering machine which nobody ever checked. It turns out, there’s also a human there who comes in for a couple of hours every other week and invents new flaming hoops of Kafkaesque bureaucracy for folks to leap through.
The University of the Pacific also has a dental clinic which was a theoretical possibility. They only take referrals which are delivered by carrier pigeons. Or something like that.
I had been scheduled to do the work at the UC Davis Dental Clinic back in May or thereabouts. But, I didn’t go into remission on schedule and my blood counts were too poopy. My platelets were really low, and there was a concern that it’d be hard to stop the bleeding from the surgery. So, that appointment got cancelled. When it was time to get the work done for realz this time, I thought it would be a good option to do it at Davis. I called them. Their outbound message said “if you’re a Medi-Cal patient, go away. We hate you.” OK, maybe that’s not an exact quote, but it’s a close paraphrase. Anyway, I persevered, and the combination of being an established patient and my poor poor pitiful cancer patient sob story allowed me to schedule an appointment in their next available slot: the middle of next March. FUCK. THAT.
Rewind. Once upon a time, before I’d even heard of acute myeloid leukemia, I was planning on completing this oral surgery on a non-emergency basis. Even then, it needed to be done. I had a referral from our local dental clinic to an oral surgeon in Novato. I made the trek to Novato for a consultation. They were going to call me in the next few weeks with a precise schedule for the surgery. They never did. Since it was non-emergency torture, maybe I didn’t follow up as soon as I should have. But by the time I did follow up, my referral had expired, and I’d be starting all over again. Since I was feeling verrrrrrrry looooooow energgggggy by then, I did not re-follow up.
Last week, I was reviewing dental options. Maybe, just maybe, the Novato folks could squeeze me in in a reasonable time frame. They already had my x-rays and stuff, and I could get a fresh referral easily enough. Worth a phone call, even if it’s a long shot. Last Friday afternoon, I called them and explained the situation. They said the could see me Tuesday at 8:45 am, and just do the deed without another consultation. I seized the opportunity, and they did the work yesterday. It wasn’t fun, but it’s done.
On the remission front, I went to UCSF last week and had a bone marrow biopsy done. The biopsy is the tool they use to really get a look at what’s going on in there, and determine if I’m really truly honest-to-goodness in remission. Since my blood counts were good and my energy level was decent, there was reason for optimism. I’ve been refraining from giving folks updates since I wanted real info rather than spreading unbridled optimism with the possibility of crushing disappointment. I got a call today from the UCSF team. The biopsy is clean. Full speed ahead to the transplant.
Yay!!!! Great news on both the dental work completion and the clean biopsy! Full steam ahead!!!!