I (or we, since Brigid went) had my appointment Friday morning with Dr. Virginia Klimek, a hematologist at Sloan Kettering with a strong interest in Myelo-Displasia Syndrome (MDS). My history of low white cell counts since my chemotherapy has Dr. Zelenetz concerned I am at heightened risk of developing this very serious (and rare) bone marrow disease.
As we were getting ready to drive to Sloan this morning I made a small joke to Brigid about being sure to wear clean underwear, even though I figured "Heck I'm seeing a hematologist, I wont even be examined."
Well, just about the first thing she said after introducing herself and quizzing me on what Dr. Zelenetz had said to us was "I'd like to repeat the bone marrow biopsy, since I think part of the sample Dr. Zelenetz got (seven weeks go) was a little below par."
So I had another biopsy! She took out some extra, since she's doing some research, etc, which was fine with me and I Ok'd.
In a bone marrow biopsy, they stick a needle into your iliac crest (the bony area just above your rear end) and aspirate out some fluid, marrow, and a small chip of bone. It takes about ten minutes and this is the fifth one I've had. Not a big deal.
Anyway, while she was doing it we had a chat about going to the gym - she started working on power lifting awhile ago with a personal trainer, with the idea of competing (The three powerlifting lifts are the bench press, squat, and dead lift - not the first thing I'd think of as something a woman doctor would take up as a hobby). She hadn't been able to do much this year, due to work pressures.
She also did a great job with the procedure - the only thing I felt was the lidocaine local anesthetic going in (it burns for about two seconds) and then virtually nothing. I told her she got an A+ and when I saw Dr. Zelenetz I was going to tell him she was better at it then him. She said something like "Oh no, don't say that, he's the one who taught me."
But I digress. Dr. Klimek spent quite a bit of time with us, going over my history as it relates to my medications and blood counts since the stem cell transplant in January. While she chose her words carefully, she seemed to have doubts about whether I am at increased risk of MDS. She feels I could have the low white counts due to the follow-up rituxin therapy that I had as recently as August. It's also the sort of disease that in high dose chemotherapy and stem cell cases usually doesn't turn up for two to three years, and I am less than one year post high dose chemo. I'm sure she'll have additional things to say when we meet in a month to follow up with the bone marrow and cyto-genetic studies. In the meantime I'll have my blood counts monitored every Friday at the Sloan Kettering office in Sleepy Hollow.
My white count was above 4 today, which Klimek said was good - at the least it indicated that my bone marrow had the ability to respond well to the neulasta medication I got two and a half weeks ago.
So Dr. Klimek seemed cautiously optimistic. This is good - she made it clear that MDS is pretty serious. Brigid and I were quite impressed with the Doctor. She was very personable and is on top of her game. Dr. Klimek really knows her stuff.
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