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August 14, 2003

Friends,

I am now sitting in the hospital doing an update again. One of my co-workers was fond of repeating the phrase, "the best battle plan never survives the first contact with the enemy". I don't know if that is the exact quote, but it is close enough. The Plan has kind of fallen apart. I did not get any chemo today. Maybe tomorrow. I checked in at 0800, and quickly got lab work done. Then we waited until 3pm or so to get an ultrasound done, to ensure that my blood clot had disappeared. It was fine. Then, I was to be seen by vascular surgeons to discuss installation of another catheter. They didn't come until about 5:15pm. Their plan is to put in the catheter at 7:30 tomorrow morning. Once the catheter is in, we can start the chemo. Because nothing was going on tonight, I left the hospital and went out for dinner with my parents and Menchie. When we got back, there was a new plan. They stuck an IV in my left wrist, after two failed attempts in my right arm and hand. It was really painful! Now they are going to give me "fresh frozen plasma" to try to get my INR down. They also gave me a shot of Vitamin K to counteract the coumadin. Only if those actions are successful are they going to let me get the catheter put in. Otherwise, we wait. And wait. And wait. And wait.... I was hoping to have a quiet night, but no such luck!

On the medical front, the biopsy results are in. The results are not as good as one might have hoped. Remission would be defined as no more than 5% blasts in the bone marrow. I had between 5 and 8%. This is pretty borderline, so the doctors decided to go ahead with the High Dose ARA-C. As described above, the doctors are trying to get my INR down using Vitamin K and fresh frozen plasma. They will give me one unit and check my INR, then give me another if necessary. They also gave me Tylenol and Benadryl. So if I start getting incoherent, it is probably the Benadryl taking effect.

Lab Results

Blood Cell Type

Normal Low

8/7

8/12

8/14

WBC 4.5 3.0 3.0 2.6
RBC 4.30 3.19 3.50 3.57
HGB 13.9 10.5 11.8 11.7
PLT 130 178 213 204

Til Tomorrow!

Ted

tw@wilcoxent.com

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