History #11 – induction – first hospitalization – discharge into “crazy backwards nonsensical land”

February 14, 2007 at 5:39 am | Posted in chemo side effects, chemotherapy, Diagnosis and treatment history, My initial treatment -- induction, Sam Cantin, Stanford Hospital | Leave a comment

Having spent the holidays 2001 in the hospital, having lines inserted, beginning chemotherapy and ATRA, coming to grips with all the physical and emotional changes, the first few days of 2002 were seemingly uneventful.

The biggest change was the beginning of the effects of the chemo that were promised. Remember the caution about mouth sores, and the mouth-cleaning regimen I started several times a day? The mouth sores did come. I can’t remember exactly what they were or what they looked like, but I do remember having a sore throat, and ulcer-like lesions in the mouth. At this stage I didn’t get nauseous or have other gastric problems, but I do recall wanting softer food as time went on, and it becoming more difficult to speak.

You’d think that with the onset of some of the side effects of the chemo and the potential for infection that you’d stay in the hospital. However, after a few days into the New Year my doctors informed me that I was to be discharged. I would get antibiotics on an outpatient basis in the hematology clinic. If you think I got an earful about being careful about anything that could cause infections while in the hospital, just wait. I got a huge 3-inch thick 3-ring binder on anything and everything that can cause infections at home, and things to stay away from. Among them included:

Houseplants and gardening. The dirt has bugs.

  • Fresh food of any kind. Anything not processed, canned, pasteurized, or otherwise denuded has bugs.
  • Outside air. Anytime I was to go outside I was to wear a mask with a HEPA filter, which supposedly filters out most of the bugs. It was encouraged to mostly stay indoors with the indoor bugs rather than the outdoor bugs. Besides, wearing it made me look like those guys who clean up after industrial spills.
  • The kitty litter. That too has bugs. (That one wasn’t that bad for me, but was for Sam. We had 3 cats at the time, so you can imagine the amount of work for him from that.)

There were many, many more restrictions than that. But the entirety was intimidating and overwhelming.

Prior to discharge, the staff went over these restrictions with me. While I was home, I was told to be ever vigilant for signs of infection, and take my temperature several times a day. If I did have a fever or otherwise seem to be at the early stages of an infection, I was to IMMEDIATELY call the Hematology Fellow on call so I could be readmitted for emergency antibiotics. Remember, the whole purpose of chemo is to kill fast growing cells, which include white blood cells. So after a week or so of chemo my white count was in the negative range.

I had no way to fight infections. Yet, I was going home to a place apparently filled with bugs that would give me infections. And if I got an infection, I could die immediately. And I was 30 minutes away from the hospital if any one or all of those bugs gave me a nasty life-threatening infection.

While hearing all this and taking it in, I asked, “Wouldn’t it be better to just stay in the hospital rather than go home?”

The doctor told me, “Oh no, you’re much more likely to get an infection in the hospital. Home is safer.”

Home is a place I could die within a few hours of most everything, and it’s safer than the hospital?

This is the crazy backwards nonsensical-land leukemia patients find themselves.



History #10 – treatment – induction – first hospitalization – last week December 2001 – Merry Christmas…

February 3, 2007 at 7:01 am | Posted in AIG, chemo side effects, My initial treatment -- induction, Sam Cantin, Susie Engard | Leave a comment

When I’ve spoken to groups for the Leukemia & Lymphoma Society over the years, I sometimes started with a question – “What were you doing Christmas 2001?” My answer was, in Stanford Hospital getting treatment that would save my life. (A good opener – very dramatic and catchy.)

In the days before Christmas 2001, I had the preparations for chemo made as described above, but felt good. The mental attitude was another thing. All of the preparations increased the fear of the unknown. Mouth sores? Infections? I wasn’t having headaches from the ATRA, but still worried about that. And although the prognosis was good, there was that 20% possibility of not making it to remission or surviving. It was all still there, looming. And all one could do was to prepare, and think about it.

One thing that really helped was my connection to my work. At the time I was working as a healthcare consultant for a medical malpractice insurer, and my job was to travel to places all over the western US, including Alaska and Hawaii. I really enjoyed the travel, and the content of the work. I was able to do education and write professionally for work newsletters and other things. At the time of my illness, I had been working on a risk management newsletter for long-term care. I had an outline, and all the content laid out in bullet points. So I had asked to have my laptop brought to the hospital, and to keep my mind off the uncertainty I worked some on the publication. I also sent emails to my co-workers, not just about finishing that publication, but to tell them about how I was doing.

My connection to the people of my work was a godsend, too. I was always very open with what was going on, what was about to happen, and how I felt. I remember reading a story about a woman in the early years of treatment of breast cancer who went through treatment without telling anyone – most of the family, co-workers and friends – for a decade. She hid all the details of her illnesses, taking “vacations” when the symptoms and treatments got worse. Most never knew until just before she died.

I could never do that. I didn’t want to be private about this. There was something about telling others about what I was going through, and implicitly soliciting their thoughts and prayers, that I knew would help me. So I was emailing from the hospital room to not just work, but to old friends and all my family. Not long after admission, I started getting cards and calls from everyone. It really helped. Others started sending emails, just talking about normal routines and things that happened at work. It really really made a huge difference.

But I suppose the one thing that kept me sanest of all was Sam and Susie. One, or the other, or often both, had been there all the time those first few days. They were there through it all – the insertion of the pic line, the shaving of the head. And they kept me grounded – they worried about me, probably than I worried about me.

And probably the best thing they did for me was to make my Christmas and New Years of that holiday season as best it could be. They worked to find various kinds of foods I wanted, that I could eat. Sam made incredibly terrific homemade pecan pies – and he was smart enough to make enough for the staff, which made him very popular. I recall wanting pizza something fierce, which of course was off-limits (no cheese). Somehow they got some processed cheese and did something. I remember getting some kind of cheese at that time, and it was really great. They both decorated the room, and were there to help me make it through those times.

The best thing, though, was a gift Susie got me. I’ve mentioned it already in her own post honoring her, but it’s worth repeating here. She gave me a battery-operated candle, with a card on it that read, “To remind you there is light at the end of the tunnel.”


That’s exactly what I needed at that time. In fact, I still need it today. We all do.

History #9 – treatment – induction – first hospitalization – last week Dec 2001 – Side effects: be afraid! Be very afraid!

February 3, 2007 at 6:53 am | Posted in APML, chemo side effects, chemotherapy, Diagnosis and treatment history, My initial treatment -- induction, Stanford Hospital | Leave a comment

So, in the first few days since beginning treatment, I had a pic line inserted, and began getting chemotherapy through it. I was also beginning to take ATRA, the small pills that make the difference in the good prognosis for my subtype of leukemia. And they had begun the process of getting me ready for the next challenges – the side effects of these treatments that would save my life.

As I mentioned, the only possible side effect of ATRA was a doozy – some people died initially while taking ATRA because of reaction to it. To have reactions not only would have been potentially lethal, but it would have required (if I survived) other forms of treatment. So they watched me closely for headaches, the initial sign of impending toxicity. I got asked it a lot. Very fortunately, I never did get the headaches.

But the side effects from the chemo were a different story entirely. You were guaranteed to get many if not all of them, and I spent much of the first few days of hospitalization getting prepared for them. First and foremost, because chemo wipes out your white blood cells you’re pretty much defenseless against infection. This would be true not for just this hospitalization, but for most of the first few months of 2002.

This caused numerous challenges. First, I had to be in an isolation room, on the hematology ward, which had all isolation rooms. Not the complete very strict isolation that bone marrow transplants have, but with a few restrictions to avoid infectious pathogens. You couldn’t have plants or flowers in the room (to avoid the contaminants that are in the dirt), and the diet couldn’t allow for any fresh food (once again to avoid possible contaminants). And no cheese or yogurt. So the food was all processed and/or canned. These restrictions would be worse when I went home, as you’ll see later.

The other problem with chemo, along with the chance of infection, was the effect it had on the mouth and the rest of the digestive system. A little biology is in order here. What chemo does is kill fast growing cells all over the body. The intent is to kill the bone marrow that produces blood cells, with the hope that what grows back is healthy bone marrow. But it kills other fast growing cells in the body beyond those. One that is seen in a lot of chemo patients is the loss of hair. Hair follicles have very fast growing cells, so when they die the hair falls out.

But the other group of cells that grow fast are in the digestive system. All of your digestive system – from the mouth, the throat, the stomach, the intestines, the colon, the rectum, everything – have fast growing cells. So, the chemo affects them as well. You may have heard of the vomiting and nausea that chemotherapy patients have. This is why.

For the initial purposes, though, the mouth was the biggest concern. From what they told me, mouth sores are very common, and pose a great challenge. Think of it – if you brush your teeth with a stiff brush, you sometimes have gums that bleed. This not a good time for patients who have a bleeding disorder to have bleeding gums. Also, during the time of chemo the ability to fight infection is gone, so this is a very quick and easy entry point for germs to get in the body that could kill. So, they had patients immediately get into the habit of good oral care that could be done throughout chemotherapy, using special foam brushes, special liquids in place of toothpaste, and special “swish and swallow” fluids to kill germs and other stuff in the mouth.

So, they had me begin to do oral care like that four times a day, and to be rigorous and diligent. They said good habits formed before any sores or other problems start solve problems later. Another thing they did was rather interesting. There was one really nice nurses aide who came in one day with a head shaver. She made the offer of shaving the head at that time. I was still a week or so away from hair loss from the chemo, but this made sense – instead of waiting for the hair to fall out, to look in the mirror each day to see if it was still there, and dreading the day it was gone, cutting the hair ahead of time gave me control over the situation. If I were going to have to lose my hair, I would rather do it on my own accord. It was quite empowering.

Still, even with a shaved head, frequent oral care, and processed foods, I felt fine. But all of this preparation was an omen of things to come. And I waited.

History #8 – treatment – induction – December 23, 2001 – pretty poison

February 3, 2007 at 6:49 am | Posted in APML, chemotherapy, My initial treatment -- induction, Stanford Hospital | Leave a comment

So, a couple days before Christmas 2001, I had begun the first stages of what was the beginning of chemotherapy to get to remission. The first few days were relatively free of pain, from what I can remember. It seemed more to set the stage for further treatment and challenges, rather than be difficult in and of itself.

Three things started the treatment process. The first was the insertion of what is called “pic line.” A surgeon comes in and makes an incision into your chest above your heart, and into one of the blood vessels that goes into your heart, then sutures it into place. As bad as it sounds, it is relatively innocuous (much less so than the bone marrow biopsy). I had it for almost five months through the treatment and recuperation. It was more difficult to shower, as you had to have it covered, but otherwise it remained on your chest without much trouble. In fact, it made having blood drawn for tests a cinch, since it avoided multiple needle sticks – they just took it straight from the pic line.

The real reason for the pic line, however, was for a purpose that became apparent quickly. Not long after the line was in, a nurse came into my room. She was pretty much covered from head to toe in protective equipment – special gown, thick gloves, and something to cover her face. She looked like she was one of those “haz-mat” clean up people in their special garb. She said she was going to give me my first dose of chemotherapy, through the pic line. I asked her why all the special get up, and she blithely tossed off, “Oh, the medication is toxic, and if I get any of it on me it will damage my skin. I have to be careful.” This as she connected to IV bag containing the chemo to a tube that she connected into my pic line. The pic line would deliver that “toxic” chemo directly into my heart. Great.

She hung it, and it was this very beautiful brilliant red color. I watched it slowly loop through the IV tubing into the end of the catheter that went into my pic line. Pretty poison, indeed.

The third thing that started in the treatment process at that time was other medication that was brought into me those first few days. Instead of pretty liquid poison, a nurse brought in a medication cup with about 10 pills the size of small peas. This was the ATRA, the treatment that makes APML the “good” kind of leukemia to have. I would taking those pills for the next year or so to ensure that the healthy bone marrow continued to pump out good cells. And the nurse could come in her/his normal uniform to bring it to me.

I would be taking ATRA, that is, assuming I didn’t have a reaction to them, and require other types of treatment. The staff would be watching me for signs of that. The main symptom on oncoming reaction was headaches. So I got asked the question of whether I had a headache a lot in the coming days.

History #7 – Diagnosis – December 23, 2001 – good news but more biopsies

January 30, 2007 at 5:54 am | Posted in APML, Diagnosis and treatment history, My initial treatment -- induction, Stanford Hospital | Leave a comment

Around the time of the second attempt, the attending hematologist, Beth Martin, a very bright young blond woman, came back in. She had the results of the initial blood test. Now came the time I found out what was to happen with my life, or how much I had left.

You may recall in the previous posts, the night before, when I was first told about my diagnosis without knowing the prognosis, I was lost, despondent, and out of hope. Fortunately by not being a morning person, by this time all those emotions weren’t really registering. Add to that the experiences of the failed bone marrow biopsy attempts, and thoughts of prognosis and outcomes weren’t as foremost in my mind.

But now Dr. Martin came back in to tell me what had been found. And she was happy.

While it might seem odd to be upbeat in telling someone they have leukemia, Dr. Martin told me that morning that I have the kind of leukemia that they hope people have. She said there was a treatment for the subtype I have (APML) which makes this subtype much more survivable than other types of similar types of mylogenous leukemia.

She said that for six weeks I would be treated in a phase called “induction.” In that, I would have chemotherapy to kill the bone marrow, and take a pill, called all-trans retinoic acid, or ATRA. ATRA had been found to help healthy bone marrow grow back after the chemotherapy had done its job.

Specifically with regards to prognosis, she said that if I could make it through the next six weeks of induction, I would have an 80% chance of making it to 5 years disease free. The reason why the 20% figure was discussed was, mostly because of side effects of ATRA. For some reason certain patients would have a reaction in the first few days of taking it. A few others, usually older patients, have difficulty surviving the initial chemotherapy, which could be pretty harsh.

If I made it through the upcoming six weeks of induction and went into remission, then I would go into the next phase of treatment, called consolidation, where less strong chemotherapy will be provided for four courses through April. Then I should go into complete remission. If this all progressed without relapse, then I could likely resume a normal life by the summer.

Terrific news. But in the context of that moment it likely didn’t register like it should have. I did have to have a painful bone marrow biopsy, after all. And I did have to go through those six weeks of treatment.

But, little did I know that I was saved through many trials and tribulations that other blood cancer patients have to go through. While there was the possibility of relapse, the chances were good. And if I were to relapse, or have a reaction to the ATRA, then there was yet another experimental treatment that could be done before a bone marrow transplant. And for those of you who don’t know, bone marrow transplants are a much detailed and dangerous procedure, with the need for weeks of strict isolation. Basically, I didn’t know how good I had it.

I didn’t know, because not long after, Dr. Martin and the Fellow came in to yet again attempt the bone marrow transplant. To make a long story shorter (that I don’t remember that well anyway), the had to try three more times before they were able to aspirate bone marrow on the fifth try. Each time they had to give me stronger medication to ease the pain ahead of time (Demerol injections, etc.) and each time it was too painful to continue. The final time they had to put me in the hospital (which was to occur anyway, since treatment would start immediately) and give me IV morphine by drip to do the biopsy in a sedated state.

The last time was nice. I didn’t remember that one.

And it wouldn’t be that last time in my months of recovery that a morphine IV drip was used or enjoyed.

History #6 – Diagnosis – December 22, 2001 – Stanford – Biopsy

January 30, 2007 at 5:18 am | Posted in Diagnosis and treatment history, Initial diagnosis of APML, Stanford Hospital, Susie Engard | 1 Comment


Early that morning we arrived at the Hematology Clinic for definitive diagnosis of the type of leukemia and to begin initial treatment.

For some reason I can’t recall now, Sam took me to the hospital and left. I can’t recall if he was working days, or he had to sleep for work. But my friend Susie came, and stayed with me that first day.

And it was an interesting day, to say the least. To diagnose the kind of leukemia, they were going to do two tests – one withdrawing blood, and another through bone marrow biopsy. Some of the blood work they could analyze here; other tests would have to be sent over to the University of New Mexico (why there, not really sure to this day) for special chromosomal analysis. They could tell with certainty, however, with the blood test that could be done that morning. So they took blood and began that.

The other test they attempted that morning was a bone marrow biopsy. For those who don’t know, a bone marrow biopsy takes a sample of bone marrow from the hip for analysis. To get marrow from the bone, they use a long needle, shove it through the hip bone (which is fairly close to the skin) and aspirate with a syringe. Sounds simple, right?

The staff there told me that while a little painful, it was more of a more intense quick bee sting. So for pain medication, they gave me a lollipop with medication designed for children, saying that would be all I needed. So, after I’d finished it, the Hematology Fellow came in and attempted to do the aspiration.

What we came to find out was that in my type of leukemia, the marrow produces large numbers of immature cells, multiple times more than is normal. And many of them were in the marrow, making it thicker than normal, and more than could be aspirated. So, the Fellow had difficulty.

Let me expand on that – the Fellow had a LOT of difficulty. While it did hurt some when the needle first went through, that was nothing like what came next. When the Fellow couldn’t aspirate, he would push the needle in further, sort of digging around until he thought he might be able to aspirate, and tried again. He did this several times. It was, uhm, quite painful with all that manipulation, as you might imagine. So not to long after a first attempt the Fellow stopped.

He ordered some type of pill (I think a Valium or something) and we tried again. Same result. We would have to go even stronger.

To be continued…..



History #5 – diagnosis – December 21 – Day of diagnosis, part 2 — packing

January 27, 2007 at 10:16 am | Posted in AIG, Diagnosis and treatment history, Initial diagnosis of APML | Leave a comment

So, on December 21, by the evening so far I had been to a hematologist, had been told I did in fact have leukemia, been set up in the morning to go to Stanford Hospital for an exact diagnosis and to start treatment, had told Sam and my boss Emily, and and finally broken down and cried. When I got over that, what to do now? What to think?

It was a surreal experience. I had several thoughts at that time. First, it seemed really hopeless. Without a specific diagnosis, which would come in the morning, there was no way to know the prognosis and potential outcome. So I was faced with not knowing what was going to be my life for the next few years. How can you have hope for a future — any future — not knowing what was going to happen? Was I going to have an easy time with it, or go through what little I had heard — years of treatment, severe, with multiple complications? Or perhaps even not making it? It was a very difficult moment.

I tried to do anything to figure out what might happen. Normally I’m a very inquisitive person, and will find lots of info about what I have and what I’m about to do. The only thing I could do at that time was to go on the internet. A bit of advice — unless you’re at a very reputable website that is frequently updated, never get health information from the internet. At least that was true in 2001. That evening I got on the internet, searched “leukemia,” but found stuff that was either very outdated, or very depressing. I have no idea what I actually did see, but what I tell people I saw was akin to “Fred’s Fishing Bait and Leukemia Page,” where someone just tells his story — with experiences much worse than what you can ever expect. And also I remember seeing material that had an extremely poor prognosis, talking about difficult treatments and poor survival rates. Much of that was several years old. I knew I was going to Stanford, and I would have the most up to date treatment there was, so it might be better than that. But there was no way to know.

Bottom line — Listen to your doctors, and don’t rely as much on the web for information. The docs will know best and have much more correct info than what you can find on your own in most cases.

Another thought that went through my head was that I didn’t want to end up as a “movie of the week.” You know, one of those really awful unnamed disease movies, that ends with the hero or heroine, very pale, saying goodbye to crying children and friends while stoic. It seemed like a clique. I couldn’t believe that it might end like that.

So, I knew I didn’t want to think about any of this. I didn’t know what to do to pass the time that evening, to not think. So what did I do?

I went to my office. And I packed.

Our offices were scheduled to move to another part of the floor in January. I knew that one of two things would happen to my stuff — either (1) someone would move my stuff while I recovered over the next few months or perhaps years, or (2) someone would pack my stuff after I died. Morbid, I know, but it was a time for morbid thoughts. So, to save anyone from packing my stuff after I died, and to give me something to do to get my mind off thinking, Sam (who had gotten up) took me into San Francisco, and I packed that night. It was a weird thing to do, but it helped.

History #4 – diagnosis – December 21 – The day of diagnosis, part 1 — “You have leukemia”

January 27, 2007 at 10:10 am | Posted in AIG, Diagnosis and treatment history, Emily Rhinehart, Initial diagnosis of APML, Sam Cantin, Stanford Hospital, symptoms of APML | Leave a comment

On December 21, even though I had a appointment with a hematologist that I implicitly knew would change my life, I went to work. At least I think I went to work that day, I can’t remember for sure what I did that day after the Christmas party with my co-workers. My appointment was at 4 in the afternoon. When I went in, the hematologist looked at me, looked at the bloodwork my primary care physician sent, and went into the other room. When he came back, he told me those words that changed my life — “You have leukemia.”

“You have leukemia.” I knew it was coming, but it still shocked me. I was numb.

He had no way of knowing what kind, or what the prognosis was, without further testing. So he went in the other room to had made arrangements for me to be worked up at the Hemotology Clinic at Stanford Hospital that next morning. He gave me the name of the hematology fellow — I remember talking to him on the phone in the first hematologist’s office that afternoon — and directions on where to go in the morning. I was scheduled for 7 am that next morning.

I went home. Sam was asleep (he had been working nights, and had to work that night, so he was sleeping to be ready for work that night). We talked a bit, and Sam reiterated that no matter what I would go through he would support and care for me during my recovery.  He was terrific and supportive. He went back to bed, since he had to work.

I then didn’t know what to do, who to call. I tried calling my sister and for some reason she was unavailable, as was the rest of my family. Then, all I could think of was to call my boss Emily in Atlanta at home and tell her, well, I wouldn’t be at work for a while. I don’t remember much of the conversation, but I do remember breaking down on the phone with her. I was crying, she was crying. She was terrific, and said she would keep in touch with Sam to know what was going on.

More of what occurred that day in the next post.

History #3 – diagnosis – December 19, 2001 — bleeding gums

January 27, 2007 at 10:01 am | Posted in AIG, Diagnosis and treatment history, Initial diagnosis of APML, symptoms of APML | 1 Comment

Tuesday morning, December 19, 2001, I woke up with the feeling of something in my teeth. Have you ever eaten a roll, and have a bit of bread stuck to your teeth? I did that morning, and thought it odd, since I had brushed my teeth before bed. I got a kleenex, and fished out what it was. It was a blood clot. My gums had started bleeding.

That day, I went to my primary care physician, who took blood work. The next day, the physician called me. It was a very strange conversation. He said he got my blood work back, and because of it, he wanted me to go to a hematologist. He had made an appointment the next day with a local hematologist in San Mateo. That’s all he said. I asked him, why? What was my lab results? He repeated, you need to go to the hematologist. Hmmm, I thought, this isn’t good. I asked him, could you fax my blood test results to me? He says he would. Later that day, I get a fax. It was incomplete, only the last page with results that were fine, but with several pages missing, including the main tests. I took that as a sign that the rest was something he didn’t want me to see.

[An aside — This has always been very interesting to me, in that it flied in the face of what I would consider full patient autonomy and disclosure. I understand why he did what he did — there was no way to make a certain differential diagnosis, and it really only could be diagnosed by a hematologist. In retrospect, it likely didn’t work well. I really like this physician, and I still see and respect him. But I wonder if I should have been told the full story my actual lab work and what the possibilities could have been, but I also wonder if I would have been able to handle it. You’d like to think that you’d be able to be brave and understand, but you can’t never be sure.]

That night, the AIG Healthcare group, mainly the underwriting group, had their Christmas dinner at a restaurant in San Francisco. I was invited and I went. I didn’t want to ruin the mood, bringing up what I thought I might have, so I enjoyed the night. And it was a lot of fun. One of the underwriting assistants Karina brought a camera and took pictures. There’s some great ones from the dinner. A lot of wine flowed, and a good time was apparently had. At the end of the night, as a few of us were being driven home, I made comment that I might not see them tomorrow, that I had a doctor’s appointment, and I might be sick. It was an odd way to end, especially with what happened the next day.

Quick: Pick out the person with undiagnosed leukemia from the picture below, from Bacaar Restaurant in San Francisco, December 10, 2001:


History #2 – diagnosis – mid-December 2001 – symptoms in Louisiana

January 27, 2007 at 9:58 am | Posted in AIG, Diagnosis and treatment history, Emily Rhinehart, Initial diagnosis of APML, symptoms of APML, Those who supported me during my recovery | Leave a comment

So, after finding the initial bruises in Vancouver but ignoring them, I continued on with life. I did continue to get bruises, and I found myself having trouble walking up the two sets of stairs to get into our condo in Milbrae, CA. But my consulting work, with its travel and desk work, was still doable.


The second week of December 2001 after the Vancouver trip I went to Louisiana for work. I met my manager Emily, who accompanied on the site visits. I was doing consulting with hospitals, and we went to one hospital. Months later Emily met the hospital staff we met that day at a conference, and mentioned that I had leukemia. They told her they thought something was wrong with me that day, because they had discussed after I left that I seemed pale and my nail beds appeared blue. Creepy.

I must have thought something was up, although I don’t remember it. Emily tells me that at dinner that night I told her I thought I had something wrong, since I was having bruises. She says I thought I had some kind of blood something, but wasn’t sure. She says she downplayed it and told me that she didn’t think anything was wrong. Good thing she’s an infection control/risk management expert and not a diagnostic hematologist.

While in Louisiana, I spent a couple days extra and spent time with my sister Karen and brother in law Rex. That weekend before Christmas they took me to a special dinner at Brennan’s. It was a great event. My sister also remembers me saying something about a blood disorder at that time, but also wasn’t sure what it was. I do remember walking around in New Orleans and thinking I might be sick.

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