Tuesday, 26th January

We had our appointment with Prof yesterday evening for a check-up, to monitor side effects of the cortisone and also to discuss the Nplate injections which will start on Friday.  Jimmy's platelets continue to rise and fall so no change here.  Prof was very impressed that Jimmy is back playing golf again and said that he thinks Jimmy has better quality of life than he does.  Always a sense of humour :)

Nplate (Romiplostim) is an injection which he will receive once a week for life.  It is a man-made form of a protein that stimulates the bone barrow to increase the production of platelets (blood-clotting cells) in your body.  As mentioned before, Jimmy has developed Thrombocytopenia as a result of the stem cell transplant.  The immune system malfunctions and begins attacking platelets as if they were foreign substances.  Antibodies produced by your immune system attach themselves to the platelets, marking the platelets for destruction.  The spleen, which helps your body fight infection, recognises the antibodies and removes the platelets from your system.  The result of this case of mistaken identity is a lower number of circulating platelets than is normal.

Nplate is given after other medications like Cortisone have been tried without successful treatment symptoms and it will prevent Jimmy having any bleeding episodes which is caused by the lack of platelets in his blood.  Nplate unfortunately is not a cure for Thrombocytopenia and will not make his platelet counts normal.

Jimmy will continue to have blood tests done on a weekly basis to make sure this medication is helping his condition and not causing harmful effects.  As with most cancer treatments there is a host of dangerous side effects and the risks of taking the medicine must be weighed against the good it will do. There are also long term use effects on the bone marrow and then the fact that other drugs may interact with Nplate including prescription and over-the-counter medicines, vitamins and herbal products.

Once Jimmy starts the injections Prof is going to wean him off his cortisone.  For the first two weeks he will continue to take 7 a day which will then be reduced to 4 a day for 1 week and then 2 a day for 1 week.  We will then see Prof again, this will be in a months time, to discuss blood results etc.  And hopefully our next step will be to get Jimmy on maintenance to extend his remission for as long as possible.

Saturday was the one year anniversary of Jimmy's stem cell transplant.  Perfect timing was going to Billy's 60th birthday party so we had a little toast on the side to celebrate.  I will never forget how excited the doctors and nurses where, congratulating Jimmy and telling him that he can now celebrate 2 birthdays each year.

Jimmy receiving his stem cells one year ago

We are all very excited for Loren.  She has had a host family match and will be leaving for the USA near the end of February.  She joins a family with 2 year old twins in Stephens City, Virginia.  Megan arrives home around the 22nd of February for a holiday and I can't wait.  Very excited I find myself counting the days till her return and then can't help feeling a bit sad because it is getting closer to Loren leaving.  Bitter sweet to say the least but at least but I do look forward to having them together for 1 week.