After months of putting it off, I finally went to a new dentist last week. He told me to see another endodontist to get a second opinion about the root canal and fistula that never resolved after the retreat 18 months ago. The endodontist told me he's stymied, that it's not good to let the fistula linger because of possible bone damage, and to get the tooth (#14 molar) pulled. Since the tooth extends into my nasal cavity, they may have to sew in some new bone to make it heal faster. Once it heals, they'll install a post and a false tooth.
Oh, and my dentist found a cavity under a cracked filling.
The tooth extraction and filling cover the first week of December. The following week, Dr.K is going to restage my progress in case they need to retreat with another round of Rituxan, which means another bone marrow biopsy (#6) on the 13th.
My good friend Mr. T would like to have a few words:
Prediction? ... Pain!
The protocol has officially been ammended to allow two rounds of Rituxan for the delayed Rituxan cohort (the one that I'm in). It's a simple one-line addition: "Also may repeat for those with blood MRD six months after delayed Rituxan." My flow was negative at 6 months post-Rituxan but has now been positive for 3 months, and will likely still be positive when I restage, so I'll probably receive another 8 rounds of Rituxan starting in January. I'm very hopeful that this round may be even more effective than last year's since my counts are in good shape and my neutrophil level is much higher.
A high neutrophil count has been shown to correlate with improved antibody-dependent cell-mediated cytotoxicity (ADCC). In other words, the more neutrophils you have when you start Rituxan therapy, the more they can help kill the cells that are tagged with Rituxan. I'll be interested in seeing if I have another incidence of Rituxan-Related Late Onset Neutropenia (RRLON) at week 14 this time around.
I had a physical at my PCP on the 3rd. Everything checked out fine. My liver enzymes are holding steady at 22 for both the AST and ALT and my HDL is back up to 40 for the first time in 2 years! I received 3 vaccinations: tetanus, pneumonia, and flu. I couldn't move my left arm for 4 days, but now I feel great.
Aside from that, I've been dabbling in some new favorite hobbies: studying organic chemistry, molecular cell biology, genetics and bioinformatics so that I can better understand some of the papers I've been reading on antibody research and lipid rafts. I wish I could go back to school full time.
(12/2/2010) Tooth Extraction Follow-Up: Had the tooth pulled. Everything went fine, and the major bleeding stopped within minutes, although there was a very slow trickle afterward. I'm hoping this means that there is continued improvement in my platelet count. I was able to go without any gauze within 3 hours (probably sooner if I hadn't been so cautious). There were several cysts (about 1 to 1.5 mm) that had formed at each root tip and had to be rigorously scraped off the bone after the roots were extracted. The worst part was the high pitched squeal of the drill used to segment the root sections so they could be pulled individually. 1 day later, everything feels fine. I just need to eat soft foods and avoid that side of my mouth for a few days. In 2 to 3 months, I'll have an exam to verify the bone has grown back and then get a post installed.
A high neutrophil count has been shown to correlate with improved antibody-dependent cell-mediated cytotoxicity (ADCC). In other words, the more neutrophils you have when you start Rituxan therapy, the more they can help kill the cells that are tagged with Rituxan. I'll be interested in seeing if I have another incidence of Rituxan-Related Late Onset Neutropenia (RRLON) at week 14 this time around.
I had a physical at my PCP on the 3rd. Everything checked out fine. My liver enzymes are holding steady at 22 for both the AST and ALT and my HDL is back up to 40 for the first time in 2 years! I received 3 vaccinations: tetanus, pneumonia, and flu. I couldn't move my left arm for 4 days, but now I feel great.
Aside from that, I've been dabbling in some new favorite hobbies: studying organic chemistry, molecular cell biology, genetics and bioinformatics so that I can better understand some of the papers I've been reading on antibody research and lipid rafts. I wish I could go back to school full time.
(12/2/2010) Tooth Extraction Follow-Up: Had the tooth pulled. Everything went fine, and the major bleeding stopped within minutes, although there was a very slow trickle afterward. I'm hoping this means that there is continued improvement in my platelet count. I was able to go without any gauze within 3 hours (probably sooner if I hadn't been so cautious). There were several cysts (about 1 to 1.5 mm) that had formed at each root tip and had to be rigorously scraped off the bone after the roots were extracted. The worst part was the high pitched squeal of the drill used to segment the root sections so they could be pulled individually. 1 day later, everything feels fine. I just need to eat soft foods and avoid that side of my mouth for a few days. In 2 to 3 months, I'll have an exam to verify the bone has grown back and then get a post installed.
No comments:
Post a Comment