I haven't had my bloodwork done in over a year now. After the HSCT and the six extra bi-monthly doses of rituximab, my white blood cell (WBC) count never exceeded 3,800/ml. Low-normal for me is considered to be 4,000 - 11,000. I was told this was not dangerous because my neutrophil count was normal, and they are the body's first line of defense against infection. They also told me that some people who do HSCT never return to 4,000+, so 3,800 might be my new normal.

Well, surprise. A recent blood panel now shows my WBC to be 4,000. It just goes to show that it can take a few years for a body to return to normal. Still, it does continue to heal after HSCT, hopefully indefinitely. Undoubtedly, I'm better in many ways than I was a year ago. And a year ago, I was better than I was a year before that. How many people with MS can say that they are slowly getting better?

Regarding the pain, I don't think the Lyrica CR is helping much anymore. I decided to try something new. I hypothesize that part of my shoulder/arm pain is due to tightening muscles from a vicious cycle of nerve/muscle interaction. I tried adding baclofen to my medication cocktail but couldn't tolerate everything together. I cut my Lyrica CR dose by a quarter (82.5 mg), and now I can tolerate the addition of 10 mg of baclofen. I'm even more fatigued now, but I think there's better relief. I'll maintain this change for a month, then try to drop another 82.5 mg Lyrica CR and replace that with another 5 mg baclofen.

I should mention that UCSF Pain Management Center performed two diagnostic nerve root blocks on my cervical medial branch nerves. The hypothesis was that these nerves were being irritated, triggering pain. The first diagnostic was positive, but the second was negative. So this whole line of reasoning was a bust. Too bad. It was expensive and painful. But even if a diagnostic test like that fails, you still learn something. Those nerves aren't the cause.