Wednesday, July 29, 2015

Day 11 post-Cells: I'm a What?

Day 11 of the trial corresponded to Day 22 in the hospital.  It was a Sunday.

During morning rounds, again just two doctors visited. This time the on-call fellow was joined by the attending doc who had been with me since I arrived at NIH. My bone marrow was waking up, and there was talk of me going home "by Wednesday," at the latest. (ANC this day was 3460. Previous values were: 1300, 330, 90, 10, 0, 0, 0...) The docs fully expected that I would reach the required "third consecutive ANC over 1,000" by Monday. My platelet counts were rising, too.

I chirped about being released on Bastille Day. I thought it would be poetic, being "released" and all.  O.K. so I wasn't a political prisoner...  The attending sort of looked at me like I was a loon, and seemed eager to escape the crazy person's room. ha.

Me:  Hey wait!

Attending: [stops dead in his tracks]  Yes?

Me: The Guy visited me yesterday.

Attending:  [pulls up a chair]  Oh he did?  I thought he might.

Me:  Yes.  He did.  And...[pointing to on-call fellow] she can corroborate!  The Guy called me a "pioneer". How is that possible, that The Pioneer called me a "pioneer"? Is that just his way of encouraging people? Does he say this to everybody?

Attending:  No. No, he wouldn't do that.  <thoughtful>  Lemme tell you...he is The Pioneer, but if he is, then you're the wagon wheel.

Me:  Immawhat?

Attending:  You're the wheel on the wagon that he's riding in on.

Me:  Well!  I'm the wagon wheel.  <confused> O.K.  Could you explain just what we're talking about here?  Because:  sleep deprivation.  (words to that effect)

Attending:  Mrs. Ryan, my (theoretical) tumors and your tumors have different genetic mutations. Even if we have the same disease (colon cancer), our tumors are not the same genetically. Your tumors are producing a "target" that your specific white blood cells (TIL) can "see." It's very exciting to us because the mutation your cells are recognizing is like the Cadillac of mutations--everyone has high interest in K-RAS mutations. The potential--who knows how far in the future--may be that instead of these "one-off" cures we are getting, there is the potential that because of your cells, future cancer patients with the same tumor mutation and the same HLA blood type may be able to be cured with an "off-the-shelf" treatment.

Me:  <blink. blink.>

Attending:  Of course, we won't know anything for sure for months.

Me [in my head]:  They keep saying that.

They both left then, and for the second day in a row I sat alone in the hospital room with information that was almost too-good-to-be-true.

I started thinking about all of the questions that I would ask my own fellow when I would see him the following morning.  Poor doc.

No comments:

Post a Comment