The Light at the End of the Tunnel

Even though my neutrophils are pretty low (660), I decided to go on a bike ride this past weekend up to the Paw Paw Tunnel in West Virginia. I planned the trip about a week ago, after talking to a Park Ranger at the Lock 8 gatehouse on the C&O canal. Initially, I only planned on doing 6 miles because I didn't want to push too hard, but once I got going I didn't want to stop. I ended up riding 15 miles and loved every minute of it. There's a beautiful view of the Potomac River, and the entire path is shaded by towering trees.

The solitude and grinding of the greystone beneath the bike tires takes your mind to another time. With the faint smell of decaying leaves and campfires in the breeze, thoughts about the legend of Sleepy Hollow entered my mind. I was racing away from some unseen adversary. I found the tunnel website about a day before the trip and that's when the metaphoric irony of where I was going hit me. The description mentioned the "light at the other end", and I knew I had to go.

The drive up was beautiful. The sky cleared about half-an-hour before I got there, then I toured the tunnel and boardwalk for about 45 minutes on foot before riding. The weather held out, although I had to race some storm clouds, and a train on the other side of the river, on the way back. The train won, but I beat the clouds. If you decide to go, make sure you take a flashlight or preferably a headlamp if you're riding.

Enough self-indulgence for one day. Now for my latest medical status. I received the results of last week's FACS (2 months post-chemo). The number of hairy cells in my blood is still going down, but slowly. The green 'FACS' curve below shows the numeric density of my hairy cells (cells per micro-liter) and is the most important factor as far as I'm concerned. The red curve shows the percent of mononuclear blood cells which are hairy cells, which is essentially meaningless unless you know the WBC count. The x-axis values are days since start of chemo.

My HCL FACS Data

The 'FACS' curve shows that the numeric density of hairy cells has decreased 65% over the past month (days 28 to 56) and 98.1% since the peak value 2 days before chemo started. I was hoping the number of cells would be even less and only detectable via PCR, but as long as the numbers keep going down, I'm happy.

Side Note: A two-year Phase III clinical trial using Cladribine (the chemo drug for HCL) to treat Multiple Sclerosis (MS) is showing lots of promise for effectively controlling the relapsing-remitting form of the disease. The approach uses a pill form of the drug. I believe the underlying theory is that MS (and most auto-immune diseases) are caused by overactive B-cell lymphocytes, which Cladribine kills very well. A fairly innocuous chemotherapy (with respect to physical effects like vomiting and hair loss) in pill form can effectively reduce the severity and relapse rate of the disease. This will provide relief to many MS patients since current treatments require injections with drugs that are difficult to tolerate.

I go in this Thursday for another CBC. As always, I'll keep you posted.