Hit him while he's down.

It feels like there is more to write when I'm back in hospital, probably because the Doctors are giving me daily updates.

Round 2 is well under way. I had the news today that, after Round One, I became Minimal Residual Disease (MRD) negative.  This means the cancer cells are not detectable on a molecular level. It's the best result I could have hoped for at this stage and shows the suffering was worth it.

Tuesday the 4th of March was my first full day back on the Ward. I was greeted by a charismatic Doctor whose first words to me were: "The King has returned." What a greeting! He then explained most of the risks with APL are at the beginning. Your platelets, plasma and white blood cells are on the floor and there is a very real risk of catastrophic bleeding, be that internally or externally. It makes me very glad I got to the hospital when I did and didn't continue to power through the symptoms, as I had been doing. That stage is behind me now.

He went on to say that my body was getting used to the ATRA medication and the dose of Idarubicin would be about 40% of what I'd had before. My blood counts would be starting a lot higher. This all amounted to (hopefully) less side effects. The best part - I might be able to go home again by Friday.

I had my first dose of chemo later that day. In my case, any after effects seem to be slightly delayed so I felt no different. I went for a walk round the grounds and did a gentle workout in my room. I felt on a bit of a downer afterwards. I'd started to get bored and wondered how the hell I'd managed 5 weeks of this!

I had a video call with my Daughter and immediately felt better. It was pancake day and she informed me she would be having 144 pancakes. I'm told she managed 2. 

I then watch PSV Eindhoven roll over and get their bellies thoroughly tickled by Arsenal. 7-1 at home. Ouch!

I slept well that night despite the necessary interruptions. Mum visited me on the 5th and I was starting to feel much more positive again. It would only be 4 or 5 days in hospital after all.

The Doctor came round in the afternoon. He introduced me to another word I'd never heard of. Neutropenic means your body has abnormally low neutrophils (the white blood cells that fight infection). This happens after chemotherapy and is the reason you have to be more careful for a couple of weeks after treatment, while your blood counts recover. Although I'd be in a neutropenic state by Friday, I would be trusted to go home. I'll obviously have to be sensible and will need to be able to get back to the hospital within an hour if I start feeling unwell. They call this 'Ambulatory' and it's a way of giving you all the positive benefits of being at home, rather than keeping you in hospital. 

By the 6th of March, I'd started to notice the sores were coming back under my tongue and inside my lip. It wasn't causing me too many problems but I mentioned it to the Doctor. Hopefully they'll be able to nip it in the bud. 

The Doctor explained the MRD negative result I've mentioned above. Bone marrow samples have to go to a lab in London where they have some kind of super microscope that can detect cancer cells with much higher accuracy. My latest sample showed no detectable cancer cells.

He explained there would be about 3-4 weeks until Round 3 of treatment when I'd need another hospital stay, similar to this one. There would be another 3-4 weeks after that until Round 4 when I'd only have to come in for a day or so. Effectively, rounds 3 and 4 will be kicking the fucker while he's down and I could be looking at my chemotherapy treatment being done and dusted by the middle of May. 

I'll have ongoing follow up appointments and bone marrow tests but I'll be able to properly focus on my recovery and getting back to full fitness!

I had a lovely visit from my Daughter. We went outside for a walk and she played on the outdoor gym equipment. We sat and had a cuddle in my room and did some colouring in together. It was tough when she had to leave though. She got upset and kept saying she wanted to stay and look after me. I explained that, because she'd looked after me so well, I'd be home soon.