Balanced, but Not at Ease

I find little comfort in the fact that the rock has been balanced on its point for ages. Firstly, it can't move or be moved without a shattering fall resolving into uncountably-many microscopic, glass-like fragments. Despite the obvious capture of kinetic energy along with the illusion of a freeze in time, a slow, inexorable deterioration of the balance of forces is occuring. Eventually, balance will be lost and the rock will fall.

My reduced intensity allogeneic bone-marrow transplant from a matched but unrelated donor is at the same time in a similar, frustrating, and dangerous state of balance. The amount of cancer in the blood (light chains of plasma cells broken off from too many malignant plasma cells) is astronomical, so high that it has to be treated (reduced). But treating the cancer at this point requires high-dose dexamethasone, the only known drug to still be effective in reducing the cancer ("tumor burden"). The risk is that dex lowers the ability of the body to resist the various viruses that need to be dormant for the transplant to succeed (e.g., not kill me). Too much cancer floating around impedes kidney functionality, which raises the specter of tumor lysis syndrome. Treating the cancer threatens reactivation of the viruses that kept me in hospital for seventeen days this year already.

Probably we will restart arsenic trioxide shortly. It may work on the cancer, it may not, but there is little evidence in the literature of a likelihood of its awakening the viruses.

How frightening being in balance can be! We have to shave a bit off of one side of a system that has found it's own natural equilibrium. Meanwhile, every day that passes without proceeding to transplant is one day closer to the possibility that the option will be foreclosed.

Otherwise I seem to be doing better every day. I'm a little stronger despite the dex and my kidney functions are improving slowly. If treating the cancer improves these functions, which have never before been troublesome, perhaps we can proceed.

Meanwhile, I haven't been able to talk to you because Google, which owns and operates Blogger, decided to shut down the kind of blogging ("FTP blogging") I had been doing for more than a year. In my confused state, or their confused state, I blew the conversion. I don't know if any of my subscribers will receive notice of this post. Please leave a comment below if you received some kind of notification, or discover a problem with past posts that I should try to fix.