Archive for June, 2012
As with most large companies, quarterly or annually, it’s best to stop and assess where your business is and where you want it to go. I work for a small periodontal company and we do the same. But instead of meeting in some boring board room with a dull paint job and a conference table strewn with electronic gadgets and smudged coffee cups, we headed to a palm tree lined beach.
We meet at 9 am at the Jupiter Island Beach Resort for breakfast. I’m sure that sometime between bacon and eggs, pancakes, and hash browns, we mentioned the business. This resort we chose is just south of the Jupiter Inlet and has a rock ledge that runs in front of the hotel extending north and south for about a mile. The reef is close in shore, 50 feet from the beach, and at low tide the depth ranges from eight to fifteen feet. The off-white colored beach is narrow, but has room for blue lounge chairs, white oversized umbrellas, and plastic tables for cold rum punches. At the water’s edge is a series of rectangular boulders, perfect for sitting and splashing the ocean with your feet. There are several sandy cuts so entry into the blue water is easy. Perfect for snorkeling.
They took me down in a wheel chair, I could have walked but they insisted that I ride. There is a tunnel that runs between the Cancer Hospital and what they call the north tower. After an hour wait, they laid me on a table and did an ultrasound around the CVL line. No blood clots. I could have told them that . Not that I’ve ever had a blot clot but this pain wasn’t that severe. So it was a late night that night. For the last 4 days my Absolute Neutroplhil count has been rising. It was supposed to go down to zero and the donor’s bone marrow stem cells were supposed to graft in and the count would start rising as the donor cells grafted in and begin to get to work. But mine never bottomed out. They got as low as 160 which is pretty low but it’s not zero. Your normal count should be between 2,000 and 7,000. If your count is below 500 you’re considered neutropenic and have to eat a neutropenic diet which means no fresh fruits, especially thin skinned ones. A banana that you can peel is normally alright but Shands goes a step further and says no fresh fruit. Or lettuce or tomatoes. They want to a avoid all germs. You have to wear a mask whenever you leave your room and you can’t leave the hospital floor.
My neutrophil count began rising from the 160 level for the last four days. I actually got into the 500′s yesterday. The question is, whose neutrophils are they? Mine or the donors? They would have expected that I would show some signs of Graft vs Host Disease (GVHD). In fact they like to see a little of that as it indicates the donor cells have began to graft in.
I have been feeling pretty good, just very tired, but everyday I walk a mile in laps around the floor. All of the doctors and nurses here say that walking, staying up, moving around, biking, (yes I have a stationary bike in my room) all promote faster healing and prompt the bone marrow to produce its product in a shorter time frame.
Then last night my platelet count dropped to 18. Platelets are the blood cells that produce clotting of the blood at sites of injuries. Normal platelet count is between 150 and 450 so you can see 18 is pretty darn low. So at 5 am this morning they gave me two bags of platelets. I wondered what blood types the platelets were because I am A+ and my donor is B+ and they are not compatible. They split the difference and gave be platelets from some one that was AB+.
I have some more to post on the Haleigh Cummings case but that will be later. Right now here is the breaking news. Ronald Cummings has been moved to the Santa Rosa County Jail. Below is a screen shot of the booking photo. It clearly is “our” Ronald Cummings. Note that no charges are specified so I suspect he’s there for an appeal or maybe a hardship transfer but I don’t know. We’ll have to wait and see. I checked the Clerk of the Courts site in Santa Rosa but didn’t find him listed there.
With BMTs the doctors and staff count the day you receive the BMT as day zero. Then each day after day zero increases by one. So today is day 6. Not a whole lot to report however I have a hunch that my temperature is starting to rise. This is normal as my immune system approaches zero. Your immune system is measured by the amount of white blood cells in your body. To be more specific, there are several types of white bloods. Kind of like bees in a hive, there worker bees, drones, and queen bees. The white blood cells that actually fight infection are called neutrophils.
The normal neutrophil count is 1.7 thousand per CC to 7.00 thousand per CC. The blast of chemo given right before the transplant is designed to bring the neutrophil down to zero. Right now mine is at 0.15. I expect they’ll all be gone within another day or so.
One of things they do to you is put in what is called a trifusion CVL line. That is line that goes into your chest and dumps into your Vena Cava, the large vein that dumps directly in your heart. I’ve had a few issues with mine. Usually only two of the three lines work. At the beginning it leaked some and now there is some pain around it, even though it has been in there over a month.
The nurse just came in and said they’re taking me down for an ultrasound to make sure there is no blood clot in it. This is at 10:04 pm. I’m including one photo of the CVL. I hope it doesn’t gross you out. The whole thing creeps me out.
One of the best parts of being here at Shands (yeah there is one good part) is Danielle Decosmo. She originally was a volunteer that would go to patients rooms, and to the infusion room (where there are a bunch of chairs with folks getting chemo infusions) and sing to them. She was so good that the hospital hired her. She’s terrific. I had her sing Somewhere Over the Rainbow. Here it is. Enjoy.
I was supposed to have the transplant on June 14, but the donor’s product was delayed in flight because of bad weather. I think the product was coming from Germany but nobody will confirm that. They said it’s just like you see on television. The guy with the blood product gets on a plane with the stem cell’s in a hand carried cooler and flies directly to the US and then to the Gainesville, Fl airport. He brings it to the hospital and it goes to the bone marrow lab where they “clean it up”. Not sure what that means, but I think they try to extract any extraneous red blood cells. Especially in my case the donor is B+ and my blood type is A+ so they are very incompatible and they were expecting some serious rejection problems.
They had the crash cart, oxygen, and suction standing by just in case. Had me a little bit worried. I was given a bunch of “pre-meds” and including steroids starting about 8am. Finally about 10 am we started the transplant.The room was full of people, nurses, doctors, lab techs, watching the procedure. Below you’ll see a photo of me during the transplant. Actually it turned out kind of boring. They don’t want any excitement during the procedure. Boring is good. I was feeling pretty good afterwards and later in the afternoon was able to walk 4 laps around the ward. Fourteen laps is a mile.
My blood counts should drop considerably over the next 5-7 days until my immune system is totally down to zero. About that time, hopefully, the stem cells will began to graft. Then we have to fight what is known as Graft vs Host disease. I’ll save that for a later blog. Over the last two days my immune system has dropped in half and then in half again last night.
During this whole chemo thing prepping for the BMT I’ve felt pretty good except for Wednesday where I felt really crappy and all of the intense chemo was catching up with me. What’s funny is the nurses come in to the room to began a chemo drip and they don all of this protective gear, goggles, mask, chemo gown so that they don’t get accidentally splashed with it. Yet it goes almost directly into my heart via a CVL line, which I’ll go into later. Makes me wonder if it’s so hazardous to them, what is it doing to me?
The nurse today told me about a guy who walked over to the other Shands north tower across the street pushing his IV cart with him. He didn’t realize that he was dripping chemo all the way and they had to call in the hazmat team to clean it up. Makes me wonder.
I was feeling well enough later in the afternoon to go back to writing a book I’m working on.
It’s hard to know where to start this blog. So let’s start with today. Today is transplant day, and also Flag day. June 14, 2012. In April 2010 I was diagnosed with Chronic Lymphocytic Leukemia (CLL)and Small Lymphocytic Lymphoma. While by name CLL is chronic, mine was quite acute and has been very aggressive. The first CT scan showed that all of my lymph nodes were engaged, the spleen was twice it’s normal size and the cancer had most likely metastasized throughout my body.
After two years of chemo we’ve gotten the spleen back to only slightly enlarged and the leukemia into remission. The only cure for this leukemia is a Bone Marrow Transplant (BMT). The BMT has to be done while the leukemia is in remission. My initial investigation into the BMT process revealed a particularly high mortality rate. Forty percent die during the procedure and an another 20 percent don’t make it to the first year. No way, I thought. Better to dance with the devil I know than with the devil I don’t know.
But here I am, receiving immature bone marrow stem cells from a MUD–Matched Unrelated Donor. This donor is probably from overseas somewhere. They won’t tell me where. I know his blood type is B+ and mine is A+ so we expect there to be some rejection issues. They are flying the donor cells in today to the Gainesville Florida airport. The courier will bring them to the hospital where the BMT lab is standing by, working late, to “clean them up” before they are put into me.
I have been taking very heavy doses of chemotherapy for the past 5 days which is designed to pretty well kill off my own immune system and make room for the donor cells to graft in. These donor cells are collected through a process known as Apheresis. That procedure is preceded with 5 days of twice a day high dose Nuprogen shots to encourage the bone marrow to release these immature stem cells into the blood stream. Then the Apheresis machine is hooked up to you and the blood flows through the machine and back into your body. The machine filters out these stem cells and Viola!
As a backup, they collected some of my own stem cells using the same procedure just in the event that the donor cells don’t graft they can hopefully graft mine own back in and I won’t be any worse off. Above is a photo of me hooked up to the Apheresis machine for 3 days straight.
I’m posting here some of the interview with Jane. I’ve posted two videos below that were taken of the mobile home on Green Lane. These are courtesy of Kim Picazio. If you watch them closely you’ll see that there are other cinder blocks on the property. Also note the vehicle parked behind the mobile home. This vehicle would not have been visible by Jane and Greg Page if they parked in front of the mobile home as was the usual manner then.
Below is the final installment of my interview with Jane. This deals with her time with Misty in the St. Johns County Jail. I wouldn’t put much faith in Lisa Croslin’s theory concerning Haleigh being taken by a Mexican drug cartel. But you evaluate it as you wish.
Steve: go ahead
Jane: OK. Then when I went to jail this recent time in St. Augustine.
Steve: Wait, wait, wait, when you went to where?
Jane: St. Augustine Jail.
Steve: St. Augustine Jail. Uh hun, when Misty was in there. Why were you in the St. Augustine Jail?
Jane: I went there for stealing. A little stealing charge.
Jane: Yeah, they ended up putting me in the same pod as her and I was talking to her and she had told me she was crying and she was going through it and stuff and she was like, “Jane”, he did it, he did it. And I’m like, who did it? And then she was like my cousin. He’s done raped me before, he told me he would put, um would kill me, put a knife to my throat, he told me he took her. I know he took Haleigh. And I said, “He took Haleigh? So why didn’t you tell the police that?” And she said, “I did, I did.” And that’s when I went and told the police, I said, I need to write an Affidavit because this girl just told me who took that little baby. And like I said my kid died. I know how it feels to have a baby loss and when she told me about Haleigh that’s when I wrote an Affidavit.
Steve: And you gave it to?
Jane: And then the mother.
Steve: Crystal Shefield?
Jane: Um, Misty’s mother.
Steve: Oh, um, Lisa Croslin?
Jane: Lisa Croslin. This is something that I didn’t say when I was in here. She said that she owed a bunch of Mexicans money. She said it had to have been the Mexicans that take Haleigh. I said well Misty never mentioned Mexicans to me. And she said yeah, but her momma owed a bunch of Mexicans and I’m pretty sure that the Mexicans got that little girl because they owed them that for the drugs. I said I don’t know about that.
Steve: So how long ago did you share a cell with Misty at St. Johns County?
Steve: For how long?
Jane: Five days.
Steve: OK. Alright. Did you know Misty before that night when you and Greg were over there selling them drugs?
Steve: You didn’t used to run with her or anything?
Jane: No. Well her and Nay Nay did.
Jane: I met her a couple of times through that.
Steve: Her and Nay Nay ran with Greg, you mean?
Jane: Yeah. Well I never met her through that but I know her through Nay Nay. Like I’ll see her and say, “Hey, what’s up?” and then leave.
In this video above you’ll see cinderblocks around the mobile home. It was stated by Misty and Ron that they knew of no cinderblocks around the home. But I saw a pile of them behind the mobile home, maybe 10 feet into the woods. The mobile home itself, of course, is raised and supported on cinder blocks.
Below is the signed statement that Jane wrote. I wanted to post the original but I don’t have a scanner hooked up to this computer here in my hospital room so you’ll have to make do with this on that I typed. Misspellings belong to Jane.
I “Jane”, was with Gregory Page the night of Halegh Cummin disappearance. Me and Gred had came to see Missy Croslin cause Greg was selling her cocaine and extacy. We went to the trailer on green ln 3 times that night. each time Misty, Tommy her brother and Joe Overstreet were there. They were all doing the drugs Gregory sold them. I did not see Hailegh but I never left the cart.
Each time they come out the trailer they come out the side door. This all occurred from 3 pm to 8 pm. Ronald was not thee. I spent 5 days in the St. Johns County jail with Misty and she told me that Joe her cusin use to rape her and put a knife to her throught. That he was the one who killed haliegh.
This was witnessed by myself and by a deputy in the Putnam County Jail on 12/21/11.
I’ll be posting another follow-up on the Jane story and what happened at the mobile home the night Haleigh disappeared. This will go up on Sunday June 10.