Remission!

Talked to the doctor this evening and he informs me that the results from the recent bone marrow biopsy reveal that I have "remission marrow." In short they can no longer detect with a microscope any cancer in my bone marrow.

Now, I'm tempted to overuse the exclamation point because I'm ecstatic about this news, but I must warn that they now get almost everyone with A.L.L. into remission and the trick in Leukemia treatment is making sure it doesn't come back (relapse).

The real miracle is that doctors have figured out that even though they can't find the Leukemia, it still lingers, and have found that by intensifying treatment with a whole new cocktail of toxic drugs that they can often prevent a relapse. So, I still have a long, hard road of treatment ahead, and there are no guarantees.

Now that I've gotten through that necessary caveat, back to the good news.

Doctors believe that the faster one goes into remission the better the chance they have of being cured of A.L.L., and all indications are I went into remission as fast as I used to climb hills on my bike compared to my cycling buddies -- that's fast. Eight days after starting treatment, a bone marrow biopsy revealed I had next to no Leukemia left in my body. According to the New York Times, which is the definitive authority on all matters in my opinion, "responding well to early treatment is a good sign regardless of risk category" when it comes to A.L.L.

Also, I'm on a clinical trial that varies treatment depending upon how well and quickly you respond to treatment. My doctor is now quite confident that I fall into a category that is known as a "rapid early responder" as opposed to a "slow early responder." The intense chemo treatment for rapid early responders is roughly ninety days shorter than that for slow early responders.

Furthermore, rapid early responders usually don't require cranial radiation, treatment that can have some rather nasty side effects and I would certainly like to avoid if possible.

So, If all goes well -- meaning I don't have a relapse and the doctors don't off me with treatment (which I trust that they won't) -- by my math I should be coming off of the most intense chemo in mid-June, just in time to watch Lance Armstrong ride the Tour again.

On that note, I'm also very excited tonight because I now have my bike set up on a trainer in my apartment, and can happily report that I now have discovered two things make me feel invincible -- being on Prednisone or being on my bike. Today I spent a half hour on my bike and could shut my eyes and envision I was riding my bike down Wilson street in the Sun to work at Clean Wisconsin. It felt great, but I held myself back because I wasn't sure how much energy I should expend on exercise while getting blasted with chemo. Tonight while talking with my doctor, I had a funny conversation that went a little something like this:

"I'm concerned about the fact that I've doubled my caloric intake in the last month, realized last night that I've lost about half the muscle mass in my legs, and I'm just maintaining my weight. I've set up my bike in my apartment, and it feels great to ride, but should I be burning the calories exercising?"

"Of course."

"How long and intense should I exercise."

"Ideally I'd like to see you on your normal exercise routine, as you were before treatment... I suppose I should ask, how much did you exercise before treatment?"

"Well, I biked about 150 miles a week and enjoyed climbing mountains when on vacation."

"Oh... Well, I'd like to see you on your bike for 45 minutes to an hour every day you can."

It's a strange feeling when you can't live your "normal" routine in the treatment of a disease because your lifestyle was too healthy before treatment. Suddenly, doctors are telling me NOT to eat fresh fruits and vegetables or natural foods, to eat MORE mayonnaise, butter, whole milk, ice cream, milk shakes, meat, cheese, eggs, Peanut butter and processed food, and to exercise LESS. Only I would struggle with such suggestions.

So, to wrap this all up, the treatment for A.L.L. is one of the most intense chemo protocols around and I have a long road ahead. On Friday I'm back in to start the next, more intense, stage of treatment that to quote my protocol is designed to "deliver a 'knock out punch' to any remaining leukemia cells."

But, for the time being, I'm feeling great and planning on spending a few days enjoying Christmas with my family, feeling invincible on my bike, and being in remission.

To my friends out there tonight, enjoy a drink for me!

-Sam