Day +153

Happy Holidays!
It’s kind of been a real shitty last few weeks. The GVHD battle still rages on.
Gastrointestinal issues, rashes on my chest and back, and just general fatigue.
I’m pushing through it, as it’s all part of the process. I hate taking more meds than I need to, but I gave in and started taking the OxyCodone for the pain in my gut. Man what a relief. Not only for me, but for the people around me!
The good news, my blood labs are looking great and my hair is growing back!
It’s a marathon, and I’m still plodding along.

Day +140

Bleh...Not a good week and a half.
Another GVHD flare up. This time hitting my eyes, as well as my GI tract.
It’s getting better but still not feeling 100%.
I’ve lost about 15 lbs  from this last battle. It’s not like I’m not eating, but apparently just not eating enough. It’s not a diet plan I’d recommend. Going back to multiple high calorie meals to see if that helps.
The good news is that all my blood labs are looking good.!

Day +133

Yuck

Perhaps I spoke too soon. Started to get what I thought were graph versus host symptoms over the weekend (gastrointestinal issues, dry / red eyes, sore throat, weight loss, fatigue)
Turns out it may be a virus, and Mayo is running some tests.
Had to bump up the steroids a bit (.5mg), got a prescription for my dry eyes, and maybe something for the stomach irritation. This sucks. It's like 5 steps forward - 3 steps back.

The good news, ( which makes the doctors think it's not GVHD) , is that all my labs are on the up and up.

Sucks not having a working immune system!

It didn't stop me from getting Xmas light up. ( no ladder climbing of course)

Day +130

All is well!
Triple lumen portal has been removed, and platelet counts are slowly increasing.
Now it’s just weekly labs, Dr. follow ups and other tests.
Still need to avoid crowds, watch what I eat and just be generally careful about not exposing myself to germs! Not sure when I’ll ever get off of the handful of meds I’m taking.
Unless any setbacks occur, I’m thinking about ending this blog soon.

Day +116

Doing great! Just waiting for these platelets to bounce back. Last lab results on Tuesday  did show they were on the rise. (They were at 30 on Tuesday up from 16, still a fall risk) All other lab results look good.
Since all is on the up and up, I’m finally getting my three lumen power port removed on Wednesday. I’ll get a bag of platelets before the procedure.  I’ve had this thing on me since July! I don’t really notice it any more except for having to cover it before jumping in the shower, and the weekly dressing changes / line flushes.

Now it’s just routine labs, and visits with the primary care doctor. Another pulmonary function test in a couple weeks. Still on a handful of meds every day. Probably will be for awhile, until my immune system comes back.

Day +107

Doing well!👍
Blood labs (metabolic panel & CBC) are looking great. Platelets are slowly coming up, but since they are still under 50, I’m still a fall and bleeding risk. So I can’t do my usual risky behavior!
The slow recovery could now be the scarring in the bone marrow, which will go away in about a year or so. Think about it as a rock garden, can’t really grow anything there, but my body is trying.

Hemoglobin at 11.6! (Normal range is 13.2 - 16.6. ) Cant wait to be normal! ( insert your own joke here 😁)

Still on 2 visits a week at mayo, while they monitor. Mostly for labs, talk to the doctor, and dressing changes for the power port.
Energy is great, and I’m back down to my fighting weight. 💪

Marathon no where near over, but feeling great at the current pace!

Day + 101

Yep 101 days!
All is well. 

Dr Palmer found out that an anti-fungal med was causing the thrombocytopenia. (Eating my platelets).
There’s only a 10% chance that the med would do that(voriconazole), and apparently I fell into that 10%. (BTW I don’t have fungus, it’s just to prevent any fungal infection. What’s funny is I used to take Fluconozole, the same stuff my doggos take for their valley fever.)

Still battling some GVHD symptoms, but nothing major. Platelets  are now on the rise, and hemoglobin (red cells, are in double digits!)

 No extra Salt now, and steroids have been decreased so I’m not feeling or looking like a bull walrus,
The natural diaretic I’m taking is working great (Uva Uris leaf, Dandelion leaf, ginkgo, horse chestnut and Hawthorne Berry). Ya, it makes me pee a lot but it’s better than the alternative.
Daily excersize helps with that and the occasional “roid rage”. The kids just look at me and laugh and say, “uh oh, he’s raging again”

I should be getting my multi-luman  power port out soon, as soon as my platelets stabilize.
My hair is coming back too! Not sure what color yet,  Lauri is waiting for the blonde hair and blues eyes.

Day +90

Feeling great!
Still some minor GVHD issues, but the steroids are working on that.

Had  a bone marrow biopsy yesterday, I’ll be excited to see the results in a few days.
Even the Tech that did the procedure said he noticed  an improvement in samples of what he pulled. That sounds very encouraging.

Day +85

All is well!
Platelets dropped again so I got a fresh bag on Wednesday. Doctors are not concerned.
The prednisone (steroids) and sodium supplement is causing some water buffalo type fluid retention. Liver labs are coming back to normal, so hopefully they will back from on the steroids.
Attempting to manage that with hydrochlorothiazide and staying active. No need to turn into a baluga whale.

Day +80

Another awesome day / week!
Blood labs looked great, but platelets are low. Doctor’s are not concerned. It could still be a small GVHD battle going on, (graft vs host, those old Joe cells are not going without a fight)
Could be some chemo still in my system, or a small infection . Since the count is below 50, I’m a fall risk, but I’m constantly under supervision.
The good news, my hemoglobin counts are in double digits, which haven’t been there in at least a year or more.
Taking it easy, and focusing on healing both physically and mentally.

Ahhh, just relax and listen to the chagrin river.

Day +75

Doing well and feeling much,much,much better!
Blood levels bounced back to expected levels and the Mayo visits are short and sweet now.
Had a CT scan last week on my sinuses, just to check a pre-transplant issue. Haven’t heard anything back. All my other tests last week came back normal, no issues.

Due to the GVHD bouts , they put me on some strong steroids. They are really messing with me, and hopefully they will back down the dose or stop them. They make me jittery, and I have a hard time staying asleep, even though I take them in the morning and early afternoon. ( an occasional ‘roid rage   over stupid  things too.)
Working out and I just keep moving every day to try to keep my muscles relaxed.


Go cells go!

Day +70

Ugh... not a good week.
GVHD (graph versus host disease) reared it’s ugly head . Gastrointestinal issues, coughing, nausea. Not much more but when my belly aches, I’m a whiny little bitch. They said this would happen,  but you know me, “ not to me it won’t!”.
Yesterday, had to deal with  a bag of platelets, a liver ultrasound, chest X-ray, and scoping  and biopsy of upper and lower tracks. ( my most favorite part was having to give my self enimas) luckily they knock you out for that biopsy procedure . Last thing I heard was “let’s give him another dose”. Woke up and they were done.
Everything was fine. They found minor stuff. But nothing to be concerned about. Still waiting on the liver and chest X-ray results, not due back until Sunday,
I feel great today!

Day +66

ugh, another set back.
Platelet level dropped again. If it gets to 10 or below, I’ll need a transfusion
Since it’s below 50, I’m considered a fall risk. ( There’s a risk of bleeding out if I bruise or cut myself).
So needless to say, I’m in lockdown, and being closely watched.

Apparently there is Bulsulfin (chemo drug) still in my system, and the doctors know that this is the issue. They said this happens to 80% of transplant patients around the 30 to 60 day range.

Got into a bit of a funk the last couple of days,  but my caregiver helped me snap out of it!
Plus, I have my therapy dogs!

Day +62

All is well!
Minor set back today as my platelet count took a nose dive by about 20 points
Doctors were not at all concerned, it’s a common occurrence , but I was still a bit frustrated.
It could be that I’m fighting a virus. ( Cesar was sick a couple days, I’ve been out and about at soccer games, so who knows where I picked it up.)
I’m already on an anti-viral med, so hopefully they will just increase that.

Received some great results on my chimerism analysis.
(Chimerism Testing for Engraftment Analysis. Chimerism testing (engraftment analysis) is performed for patients who have received a hematopoietic stem cell transplant.)

 The CD3-positive fraction contains approximately 80% donor DNA and approximately 20% recipient DNA. 
CD33-positive myeloid cells:  The CD33-positive fraction contains approximately 100% donor DNA and approximately 0% recipient DNA.

I’m almost 100% donor DNA, with no graph vs host rejection so far.

Day +56

Feeling great,. No issues to report.
Blood labs were excellent on Tuesday, so much so, that they cancelled my Friday visit.
Now I’m down to once a week visits to Mayo.

Well,  I may have been a little too ambitious  about going back to work half days. My care giver thought otherwise and I was denied. She wants me to wait at least until the end of September.

Perhaps she’s right.

Day +50!

All is well! Can’t believe it’s day 50!
No major issues to report, still battling the potassium thing but we changed graph vs host rejection meds so hopefully that fixes it. Blood counts were up as well, they tend to bounce around, but the higher number are encouraging.
Still have no hair. Depending on the person, it could be 3 or 4 months before I start seeing any noticeable growth. Oh well, I guess that’s what hats are for.
Finally able to go watch Cesar play soccer this weekend. (Night and early morning games)
As long as I stay out of the sun, I’m good. ( no prolonged exposure)

Day +46

Feeling great!
Not much to report.
I can return to work, half days at first, and only working from home. Looking forward to it, (yes), as it will also be good therapy!

Check it, I finished the Stranger Things s one was a real finger cramper!

Day +42

All is well!
Apologies for the lack of updates, but there isn’t really anything to report.
The twice a week Mayo visits are going well, just need to watch my potassium intake for a bit. (I’m getting switched to a new rejection med which should help.)
Blood labs are bouncing around but they say that’s normal.

Day+60 will be this month and I’ll go to 1 visit a week.

Eating well, drinking plenty and working out more which is good.

Day +100 will be Nov 1st!

Then there’s the hair thing. Haven’t had much growth, in fact it seemed like it was still falling out a bit. Could be 2-3 months before I start getting it back.

Day +38

All is well!
Just hangin and watching some college ball.
High potassium is still and issue, I’ve done everything I could do on my end to lower it so now it’s on them.
They are changing my rejection meds to resolve that issue.
I’ve been cleared to drive (not alone), and to ride my bike outside. Yes!
Now I can help Lauri run the doggos in the morning.

Day +35

All is well.
Eating, sleeping and working out and keeping very very hydrated.
Next Mayo visit is Friday. Hopefully no issues and I’m in and out of there.
Although I should not complain, a two hour visit is much better than being admitted!

Day +33

All is well!
Just battling to keep the potassium levels down and my magnesium levels up because of the meds I’m taking.
One day it will be within range, and I think I’m doing great, but then the next Mayo visit labs say otherwise and I have to have and IV or fluids and/or magnesium.. (Which adds 2 hrs to the visit ugh!)

Other than that, I feel great!

Here’s an interesting test they do. (Chimerism analysis). For all you Biology majors.

Interpretation

Peripheral blood, chimerism analysis: CD3-positive T-cells:  The CD3-positive fraction contains approximately 50% donor DNA and approximately 50% recipient DNA. CD33-positive myeloid cells:  The CD33-positive fraction contains approximately 100% donor DNA and approximately 0% recipient DNA. 3 informative loci were used in the analysis of this sample. Signing Pathologist: Matthew T. Howard, M.D. The pre-analytical cell sorting was performed on a research basis only. The analytical sensitivity of this assay is approximately 5% in a posttransplant specimen (donor and recipient DNA mixed chimerism). T-cells and myeloid cells were enriched to a purity of 95% or greater. Markers analyzed: D3S1358, D8S1179, FGA, SE33, vWA, D21S11, D22S1045, D10S1248, D16S539, D18S51, D5S818, D1S1656, CSF1PO, D2S441, D13S317, D12S391, TPOX, D19S433, D7S820 and D2S1338  

Day +30

All is well! I feel good!

There is a minor issue with high potassium levels, even though I’ve been watching/checking those amounts on the stuff I eat. Dr said that of all the things they check, a high potassium level is no bueno. (It’s because of the meds).
So...the only way to eliminate potassium, is to... well eliminate. He gave me something that’s gonna make me poop all afternoon. I can hardly wait. Even the nurse was laughing  at me after I drank it. Telling me to have a wonderful afternoon!

Shared this with my family the other day. Attempting to grill brats in 115 degrees;

My brats, my brats, my brats are on fire, burn mother f*ckers burn!

Day +28

Still chugging along, nothing major to report!
Focusing on healing.

Day +24 & 25

Nothing new to report!
Just keeping busy and focusing on healing.
Eating well, keeping busy, active and napping when I need it.
It’s tough not being able do the stuff outside I’d like to do, ( I try but then I get yelled at)
I’ll get there.

Day + 23

Another excellent day.
No issues at the Mayo visit, In fact they have reduced my visits to just two a week now.
All labs looks good. Potassium was high, so I need to lay off the bananas when drinking other high potassium protein drinks.
Got the ok to start some light resistance training in my excersize routine.
Here’s a pic of my constant companion, and her pink bunny she uses as a pillow.

Day +22

All is well.
Another restful, healing day.
Looks like I’m down to just two visits a week at Mayo starting next week.

Check out what I just started. Not sure who’s into Stranger Things, but this looked pretty cool.

Day + 21

Smooth sailin’

Another day closer to 100 days. Since every transplant patient is different, I’m hoping it will be less than 100 days when I’m cleared to get back to my awesome normal life.

I’m  crossing my fingers that during my next Mayo follow up on Friday, they back me down to only two days a week visits.

Before all this started, Mayo research asked if I’d like to be a guinea pig and participate in studies, I said sure why not, and signed up. Today, we were asked  to participate in a study that ASU and Mayo are doing, and they are going to pay us $85 each .  ( it included the care giver as well) Not a bad deal just to answer a few surveys.

Day +20

All is well.
Walked the dogs this morning. Well, walked with the dogs, as Lauri wouldn’t let me have one yet. Felt great. Also hit the recumbent bike for 30 mins later that day.

Hydration, hydration, hydration. Since I’m still on the pro-graf  meds, (prevents host vs. graft rejection)it’s rough on the kidneys and they want to make sure  I’m flushing them out. Also, makes my visits to Mayo short if I don’t need to get an IV for fluids.

Day +19

All is well
In and out of my Mayo follow up today. Blood labs continue to rise.
Haven’t had such a high hemoglobin count in over a year.That alone is promising news that the transplant is working.
Got permission to be outside, which means I can now walk my doggos!

Day +18

Ahhhh, relaxing Sunday.
All is well, feeling better day by day.
Energy levels increasing, road the bike for 30 minutes and it felt pretty good.

Wish it wasn’t so fricken hot out.

Day +17

All is well.
Back on track with hydration and eating.
I was yelled at by my nutritionist, the doctor and my wife about keeping hydrated, and eating more.
(In all fairness, I did have very irritating sore throat)
I feel much much better.

Day +16

Ahhhh, home sweet home.
Feeling good! Blood counts continue to rise. !

Had to go back to Mayo to get labs done,. That will be the schedule 3 times a week as they continue to monitor me. We are fortunate that Mayo is so close to us.

My man cave downstairs is all set up, and it was nice to have some homemade chicken and rice last night for dinner. No more hospital food.!

Day +15

I’m outta here! Will continue this journey from home!

Feeling good. Have a nasty sore throat, but I’ve been told that it should clear up soon with the increased white blood cells.

Can’t wait to sleep in my own bed, and not get bothered by nurses!

Go cells go!

Day + 14

I’ve been here 3 weeks!
Lab numbers are starting to take off. Platelet numbers doubled. Hemoglobin numbers increased. (First time in 8 yrs I’ve seen those numbers actually increase !)
White blood cells are on the rise, and most importantly, neutrophils were almost high enough for me to go home. (Needs to be .50 or higher, and mine were at .40 today)
So....I’m assuming I’ll be out of here tomorrow.!

Go cells go!

Day +13

All is well,  no blood products needed today, and my counts are continuing to climb.

I had one more side effect show up yesterday as I was taking a shower. My hair started to fall out!

So I just had the nurses finish the job:

Go cells Go!

Day +12

Feeling good!
Started my morning with a pint, a cup of of coffee, and an OxyContin. Breakfast of champions!
Platelets and white blood cells are starting to increase.
I’m starting to see the light at the end of the tunnel.

Go cells go!

Day +11

Howdy, Howdy, all is well, still waiting for these blood counts to up.
Nothin exciting planned for the day.  Maybe except for some LEGO time:

Day +10

Still here! Still chillin’
Just waiting for the numbers to start increasing.
Some good news , platelets did increase, even though I got some platelets yesterday, they didn’t spike that much last time. Doctor said platelets are the first to increase.
Still holding out for a mid-week release.

Go cells go.!

Look at this bad boy waiting for me. Can’t wait!

Day +9

Happy Friday!
Feeling good, even better now that I’m no longer connected to my IV pole. I can now move freely around the cabin, and It definitely makes showering and sleeping a lot easier . One step closer!

Received an awesome snack gift basket from the Oliversons yesterday. (Thanks Gary & Jill, you guys rock!)

Today is bingo day,  for a chance to win coupons from the gift shop. I know, sounds lame, but at this point it’s the highlight of my day on Fridays.

My babies are still waiting. :(

Day +8

I’m officially stuck in Ground Hog Day. Thank god I’m able to leave my cell and walk around the pod. My favorite time of the day is doing a Facetime dinner with the family.  Of course what they are having always seem to look better than what I had!

The doctor confirmed that it’s probably gonna be another 7-10 days before I’m released. (From yesterday) So hopefully by next Wednesday. I figure it’s best that my blood labs are where they should be before going home. 

Still minimum side effects from the chemo, well except for this:

Doctor said it should clear up in a few days. 

Go cells go!

Day + 7

Doing good! Looking good!

Two weeks in captivity, haven’t lost my mind yet. Hopefully only one more week or less.

Getting a cold pint of blood today, other than that just chillin’.

Check out this cool Kellogg’s shirt. I’m stylin’ Up in here.

Day + 6

Doing well, really well.
Doctors and nurses impressed that I am doing so well and tell me to keep it up. The key is getting out of bed and staying active throughout the day. (Well, as active as I can be in a hospital room) I take daily 20-30 minute walks around the 4th floor pod.
So far (knock on wood) , I have not been that  impacted by the horror show of symptoms I could have gotten from the chemo.
A little indigestion, like heart burn and feeling tired here and there. Nothing that some Malox, and a nap can’t fix!
My goal is to be outta here by Saturday, but that might be a little aggressive. (According to the nurse)

Had a fresh bag of platelets for breakfast, and may get some blood tomorrow depending on labs.

Go cells go!

Oh, and thank god for Shark Week!

Day +5

Oil pressure is good, but I’m low on some transmission fluids. (Platelets and white blood cells)
Kind of makes me a bleeding and infection risk. No worries , I’m super careful.

A 30 minute walk yesterday surprisingly got me a little exhausted.

My amazing wife bought me an incumbent stationary bike for when I get home. It should slowly whip me into shape in no time.

Gonna get started on this today

Go cells go!

Day + 4

Still plodding along on this marathon. Feeling fine.

Doctor tells me that typically I should be sent home between day +10 and day + 14. I’m shooting for day +10. (Next Saturday)

Go cells go!

Day +3

10 days in captivity. My captors although polite, will not let me leave.

All is well. Doctors and nurses keep telling me to just keep doing what ever it is I’m doing.

Still trying to find away to sneak my dogs up!

Here’s my next project: it’s over two feet tall.

Day +2

All is well!
Just waiting on these blood labs to improve. (Now I’m asking the doctors everyday if I can go home!)
I know it’s gonna be a week or two, but hey, I can ask.

I have been semi-productive. Check out this Apollo Lunar lander:

Day + 1

Go cells go!
Feeling good today!
Now it’s just a matter of watching my blood labs bounce around. Drops in numbers are expected, as some die off, but new ones are on the way.
Needed a fresh cold packet of O pos this morning. (Which come with hourly vitals taken. With the nurses, doctors, house cleaning etc, my room should have a revolving door. )
I’m eating healthy and staying active both physically and mentally. Can’t wait to bust out of this place!

DAY ZERO

Here we go.  I get my new cells today!

The Chaplain is coming by for a quick blessing around 9am-ish.  Then I get the transplant at 10.  Then I’ll have my own nurse assigned to just me all day.  (oh joy)

The conditioning was rough, I don’t wish that on anybody.  Thanks for all the encouraging wishes, and positive vibes.  Now let’s go build some new marrow!

A special shout out to my donor today:

Your selfless act humbles me, I can’t believe that a complete stranger would take the time and go through the discomfort of donating their stem cells to me.

Thank you for my healing!

Update on the day:  Chaplain came in around 930am and did the blessing which was very nice.  Keegan, Damian, Jacob and Cesar were here for the transplant.  They started the transplant at 10:07am and it ended at 11:30am.  Joe did really well during the entire event.  Now the nurse will monitor him for the next hour and he will rest for the remainder of the day.  Special cheer for those stem cells:  “Go forth and multiply and create the marrow that will restore Joe’s cells. – Go Cells Go!”

Day -1

Rest day today! Like what else am I gonna do?
Antithymocyte Globulin Rabbit today - prevents and treats your body from rejecting transplants.
It doesn’t sound like anything I’ll be holding or petting.

Keeping the mind and body focused!

Day - 2

Day - 2
All is well! Slept great, probably at least 7 hrs.
Starting the Tacrolimus today ( prevents organ rejection). This one I may be on for quite awhile.

The good news , no more chemo. That last dose was a tough one to push through, but I powered through! There could still be some side effects, but at least I’m not getting more.

Feels like I’ve been here forever, but it’s not even been a week. It’s a marathon, not a sprint!
Just keep plodding along.

Day - 3

4th and final round of chemo today! Feeling alright.
What ever it is you guys are doing, it’s working, keep it up, keep it up!

Day - 4

Starting my 3rd round of chemo today!
Slept a little better last night, it’s not the meds , it’s the shitty bed and attentive night nurses. Nap time later!
Last round of chemo tomorrow.!
All the kids are coming up today, should have a room full, I’ll take pics or the party

“Where is my Dad!”
Bell checking out the clothes Lauri brought home. Hello! He’s not in here!

Day -5

Good morning!

Started the day off with a cup of coffee, a protein drink , some water and a bag of chemo!

Woot woot round #2!

Feeling good, moved to a bigger room, so we don’t  feel so cramped when Lauri and the kids come by.

Hemoglobin is down to 6.6 so a fresh bag of blood is on order as well. I think the last transfusion I got was when I was just a few hours old, right Mom?

Still eating, drinking stretching and walking!

I got this.

Don’t get me wrong, I miss Lauri, the kids and chaos at home, but most of all I miss my babies;

Day - 6

Actually slept ok, once I fell asleep. Got at least 6000 steps in before bed.

Here’s what’s on today’s drug menu;

Ondansetron - prevents nausea and vomiting

Levetiracetam - treats seizures (ya, apparently the chemo could cause that, wtf)

Acyclovir- anti-viral actually used for treating herpes and genital herpes. ( good news ladies!, I’m clean!)

Ursodial - Dissolves gallstones, and to prevent biliary cirrhosis. (Liver will be hit pretty hard)

Fludarabine - chemo - treats chronic lymphocytic leukemia

Bulsulfan - chemo - treats certain kinds of leukemia, and pores body for stem cell transplant.

I should start glowing any minute;

Today is gonna be a good day!

Day -7

    First day of admission to the hospital.  Joe had a procedure this morning to provide central line for ease of giving medicine and drawing blood daily.  The whole process took about 3 hours and it went very well.    

    He is now in his room doing fine on floor 4 East #77.  (He is already asking for a bigger room, but who can blame him when he is spending the next few (4-6) weeks of his life here.)  They are going to try to move him tomorrow to a corner room.  

    He will have a few more tests this afternoon and get use to the hospital routine of being checked every 4 hours.  He starts Chemo tomorrow around 6am through an IV in his room.  They think he should feel ok for the first week.  

    Thanks for all the warm wishes, thoughts and prayers.  Keep them coming as this is a marathon not a sprint (good thing he stays in shape.)   

    

Day - 9

All the tests are done, and I’ve signed my life over to Mayo Clinic! (Consent forms)
Dr Palmer says I’m super healthy which qualifies me for stronger doses of chemo, not sure that’s good or bad.  She says it will result in a clean rock garden to plant my marrow garden.
We are ready.

Here’s what my schedule will look like this month;

Day -16

Told friends & family-  tons of positive vibes, thoughts and prayers headed my way - Thank You!

Day - 21

Bone Marrow Biopsy today, they now use propophol , never felt a thing!
I woke up and they were done!

Day -22

Day -22
More tests!
Electrocardiogram , Echocardiogram (got to see my own heart working. That was pretty cool)
CT (sinuses, chest and abdomen, the iodine solution I had to drink sucked)

Day -23 (23 days until day 0)

A day filled with testing and consultations.
Met with my BMT Coordinator, research specialists, financial and social worker experts.
Topped that off with blood labs (17 vials worth), urine tests, chest and jaw imaging and pulmonary baselines.
Looks like it’s happening!