Husband's Log - February 18th-22nd, 2026

It has been five days since Angela received her stem cells and entered the neutropenic period of her HSCT treatment.  Just as a reminder, the neutropenic period is the timeframe in which Angela and the other patients are under strict quarantine to their apartments and have limited dietary options.  These restrictions are in place because the chemotherapy drugs in their bodies are obliterating all the white blood cells in her bloodstream.  

During this period, Ang gets a Filgrastim shot every 24 hours and gets her blood sampled every 48 hours to check how many white blood cells remain in her bloodstream.  The friendly Mexican doctors advised us her white blood cell count needs to get near zero before her new immune system can start to develop.  The reason it works like this is because the newly injected stem cells just float around aimlessly in the bloodstream until they can find vacant niches in the bone marrow to call home.  Unfortunately, there are only so many niches in the bone marrow, and most of them are occupied by old or damaged cells.  It's strangely relatable to the struggle of my young millennial peers looking for their first homes in tight Canadian real estate markets.  Thankfully for the stem cells, the chemojuice in Ang's bloodstream forcefully evicts all the old cells from the bone marrow niches during this period so the young stem cells can move in freely without the need for bidding wars or 35 year mortgages and grow happily ever after into new white blood cells.

For reference on how the doctors are counting the white blood cells, a healthy quantity of white blood cells to have in the body is between 4000 and 12000 cells per microliter of blood.  Going into the HSCT treatment, Angela's count was 6900.  During neutropenia, the count is expected to start below 4000 and reduce to near zero.  Angela's first blood test showed her count at 1500 on Thursday.  For a normal person a count like that would be a good reason to shit bricks, but after four rounds of chemo this is a good sign the chemojuice is committing mass genocide on her old immune system.  

On Saturday however, Ang's body decided it wanted to stand out amongst the crowd of patients.  Instead of seeing fewer white blood cells than Thursday, her count rose to 2100.  The doctor advised it's uncommon for patients to gain white blood cells at any point during the neutropenic phase, but there have been patients in the clinic before who have had this happen.  He assured us it's nothing to worry about as the white blood cell count always drops near zero towards the end of the neutropenic period, but is just taking a non-linear approach to get there.  After that consultation we naturally googled the shit out of her result to see what made Angela such a unique patient.  It turns out her white blood cell count rose because going into chemotherapy, Angela's old immune system was doomsday prepping, so it put a big reserve of white blood cells in her spleen and her blood vessel walls.  After the fourth round of chemo, her immune system considered the chemojuice genocide a doomsday scenario, so it released all the white blood cells in reserve into the bloodstream, increasing the count visible in the blood test.  This count rise isn't commonly seen in HSCT patients in their neutropenic phase because most patients go into the HSCT procedure with immune systems heavily damaged over years, whether it be from cancer, MS, or one of the other autoimmune diseases.

Outside of the daily shots and bi-daily blood tests, life is pretty simple during this phase of MS summer camp.  For the most part, we live the lives of potty-trained house pets as we spend our days perched on the couch watching tv, occasionally scratching ourselves or licking our buttholes as the need arises.  We use a pet hair lint roller on Angela's head to get ahead of the chemo shedding from her scalp. We're allowed outside on the rooftop for 20 minutes per day, so we take maximum advantage of that small taste of freedom.  Being the whitest of white guys, I managed to get a sunburn after the first 20 minute excursion to the rooftop.  Angela has intelligently stayed in shady areas each time.  We started an 880 piece puzzle a few days ago, now there are only a couple dozen pieces remaining.  I've gone to the gym voluntarily to give Ang some alone time.  We might even start reading the Dutch books sitting in the lobby.  

A recurring motif we've noticed from the restaurant staff and the medical staff is they have all mentioned how nice we have been during this period.  Although my wife is lovely by default, I don't think I'm being unusually nice to the staff compared to my behaviour back home.  Maybe among the multitudes of American and European patients this clinic treats, the occasional Canadian seems friendly by international standards.  Maybe the other patients just turned into dicks after being trapped in their 500 square foot apartments for almost a week.  I personally don't see what there is to complain about during this period as we're provided decent meals three times per day with zero responsibilities and access to the internet.  If we had our dog with us we'd be living out my retirement dream.  I'll provide another update from our quarantine pod in a few days after Ang has had a couple more blood tests as there is clearly not much else happening during this period of her treatment.