Day +20.  Casey is feeling a little better today, but really tired and light headed.  His counts continue to climb.  He was able to eat a popsicle, which is the most he has eaten for several days.  He is napping while watching the USA vs Canada hockey game.  His Canadian nurse just came in...she is not cheering for team USA (but she is a cute blonde).  What will he do tomorrow when the olympics are over?  Maybe he will have to start watching Judge Judy.
Peggy

Day +19.  Casey's counts continue to climb, but he is having intestinal problems today.  They took some cultures to check for C diff.  He does not have a fever.  It could be GVH, but we will have to wait and see.  Meanwhile he is just getting a bit frustrated at taking a step back. We have the olympics and ACC swimming championships to watch.  I do miss those swim meets.  Today I got a nice card in the mail with a Starbucks gift card.  The card was not signed, so I don't know where it came from.  Whoever sent that to me, Thank you!  I will put it to good use.  Starbucks is usually my dinner.  It is too hard to try to eat with a mask on, but I can drink latte through a straw.
Peggy

Day +18.  Casey is doing great today.  He white blood count went up to .6 today.  3 days in a row .5 and higher.  I'm feeling real good about the way things are progressing.  We need to get him out of here so he can do his income taxes!  Yesterday he got a card from friends at church.  Somehow they got it signed by a lot of the church members and currently we don't even have a church.  The building burned so we are a nomad congregation, traveling to different churches for services.  It just proves a church is so much more than a building.  Thank you to everyone.  Taxes, burned churches and leukemia are just some of the nuisances we are looking to move beyond.
Peggy

Day +17.  I have to post early tonight so Casey can watch the ACC championships on his computer.  His college coach, who in now retired will be commentating.  That should be interesting.  It will be great to hear Frank Comfort's voice again.  Casey continues to get stronger every day (but not fast enough for him).
Peggy

Day +16.  Casey's white blood count is up to 0.5 today and the bloody spots on his eyes are just about all cleared up.  Things are moving in the right direction.  Normal range is 5 -10, so he still has a way to go.  He needed another infusion of platelets today.  I am told the platelets are the last thing to recover.  Sometimes it can take months before your body makes enough of platelets on their own.  We will be making daily trips up here after he gets discharged to have his counts checked.  For those of you who don't know, leukemia is a cancer in your blood, which is why they pay such close attention to his counts.  Hopefully this is a sign that the his new cells are engrafting!
Meanwhile, I will get ready for another Pennsylvania blizzard.  What is going on with the weather this year?  February 2010 will definitely go down as one of the most memorable months of my life.
Peggy

Day +15.  Casey is having a good day.  His computer is fixed, his white blood count is up to .3, and he was able to eat some yogurt and applesauce.  His platelets and red blood count were real low, so he was transfused with both of them today.  We did 5 laps around the nurses station tonight.  He is talking about going home in a week.  I'm not sure what the doctors say about that, but it is good for him to think of positive things.  His counts have a long way to go, but we are on the upside now.  Yeah!  The mucositis in his throat had him snoring like a freight train (or his Uncle Dale, depending on who you talk to).  I think he was waking himself up.  That has even subsided a bit.  The first 30 days after the transplant are the most critical, and we are half way there.
Whoever put the Starbucks in this hospital is my hero.... A wine bar would make the drive home too difficult.
Peggy

Day +14.  Casey is actually feeling a little better today.  His white blood count went up to .2, so it is still nothing to get excited about.  Hopefully it is a sign of the stem cells engrafting.  He has developed a rash, but that is to be expected.  His body is going through a transition of the new cells taking over and your body sees something foreign and tries to fight off.  That is what they call graft vs. host disease (or GVH).  I am told you need to go through a bit of GVH so your immune system does not reject the new cells.
Meanwhile we are just hanging out, doing daily laps, and looking forward to spring.
Peggy

Day +13.  Casey's counts are still as low as they can go, and he is feeling a little antsy.  Last night he took a sleeping pill which knocked him for a loop all day today.  His computer got a virus (the same one our home computer had 2 weeks ago, so I guess it is back to the computer guy).  I really don't understand people who get a kick out of sending these viruses out.   Casey has been in the hospital 3 weeks now and I think the walls are closing in on him.  Today he said he is disappointed that some of the snow is starting to melt and he didn't have an opportunity to see it at it's height.  I say lucky him.  His dad cleared the snow from his house, I'm sure he is not disappointed he missed doing that job.  His main concern is writing practices without his computer.  He is worried about his swimmers coming into championship season.  I am sure we will be able to get him set-up with another computer and his swimmers will continue to make him proud.  If I had to choose between a computer virus and a colonoscopy, I would take the virus.
Peggy

Day +12.  Casey's counts are still at the bottom of the barrel, but he seems to be feeling a little better today.  Big Bob pulled a good one on Casey today.  Big Bob's wife is a gastroentorologist here at the hospital.  When Dr. Ehmann checked on Casey today he asked about his stomach and bowels (which is typical doctor talk around here).  A few hours later a doctor from gastroenterology came in and said to Casey, "I hear you have been having some stomach issues, so I am here give you a colonoscopy."  Gary said Casey's eyes got big for about a second, and then immediately realized Big Bob was behind it.  Bob's wife stuck her head in the door and Gary and Bob got hysterical.  I seem to miss all of the good stuff.  Gary and Casey are still laughing about it.
Annie and Bowie skyped Casey today.  They were really excited to see him again.  Annie was twisting and turning her head and Bowie was real intent on what was going on.  So I would say today was a pretty good one.
Til Tomorrow,
Peggy

Day +11.  Not much has changed since yesterday.  Casey's counts are as low as they can get.  He got 2 bags of red blood today and his throat is still sore.  They told us the cord transplants take longer to engraft than the traditional transplants.  Last night while Casey was doing his laps, we met up with another patient who was asking him about his disease.  Casey told her his story about how he had to go through 2 years of chemo 3 years ago and now his disease came back and now he had a transplant.  She looked at her chemo and at Casey and said "I can't believe you had to go through this for that many years."  It kind of put it into perspective to me.  Because Casey does not complain much, he just focuses on the end results, I sometimes don't give him as much credit as I should.  This is a tough road he is traveling for the second time around, with a few more twists and turns along the way.  But he is handling it like a NASCAR driver, looking for the checkered flag.
Peggy

Day +10.  Casey is much more comfortable today.  They increased his morphine, but he also gets sleepy.  Big Bob took him for his laps today.  He completed them, but his pace was slow.  Yesterday he got red blood and today he got some more platelets.  His counts continue to fall, but at least he is not in as much pain as he was the past couple of days.  Let's hope those new guys take hold and grow soon.  Meanwhile I will work on teaching Annie and Bowie how to skype so they can talk to him during the day.
Peggy

Day +9.  Casey's mucositis is also in his esophagus, they have him on a morphine pump to help manage the pain.  He can hit the button every 10 minutes.  He sleeps a lot, when he is able. They did warn us that this would be a rough time. Now we just wait for the new cells to engraft and take over.  Too bad the olympics aren't on 24 hours.  I'm not sure if he is up to doing his laps tonight, we'll see.  
He is very proud of the job his swimmers did at leagues.  He had people reporting in to him.  You guys made him smile.  Way to go LAC, you kids continue to be an inspiration to him.
Peggy

Day +8 has been a bit of a pain in the neck.  Casey's mucositis has moved into his throat.  He has a rinse to swish in his mouth to help alleviate the pain, but he doesn't swallow it, so it is no good on his throat.  They give him shots of pain medication to help him cope.  I was trying to call him today, but he wouldn't answer because he was knocked out from the pain medication.  I called in the troops to find out what was going on.   I called Stevie and Big Bob, but they hadn't seen him yet, I called Aunt Debbie.  She left her basement lab and went to his room on the 6th floor and reported in to me.  Thank goodness for Aunt Debbie.  Casey was annoyed with me, and I bet it won't be the last time.  He just doesn't understand when mommy mode kicks into high gear.  Casey got infused with some platelets today too, so he has been busy.
I got a request for Casey's address, so here it is
 Penn State Hershey Medical Center
Casey Coble, Room 6125
500 University Drive
Hershey, PA  17033
Thank you for your continued support.
Peggy

Day +7.  Today is one week since Casey received his transplant and all is well.  He has developed mucositis, which is gives him sores in his mouth.  It makes it hard for him to eat, not that he has much of an appetite to begin with.  Big Bob brings ice cream bars in for him every day.  He has no problem eating them.  Isn't it amazing, no matter how bad you feel, ice cream always tastes good.  I hope you enjoyed the photos I posted of his transplant.  Casey's white blood count is 0.1 which is as low as it goes.  They gave him a shot of neupogen tonight which will boost the growth of his cells, but it will take a few days to take hold.  From here on out it is all new cells taking over.
Peggy

Day +6.  Casey has upped his laps to 3 around the nurses station, so things are going well.  He is having a real good day.  He was able to eat half of his lunch today.  He does have sores inside of his mouth, which is common, but they are not too bad.  It is more his stomach that has held him back from being able to eat.  Casey had some broken vessels in his eyes from throwing up all of the time, and they too seem to be getting smaller.  The swelling in his face has gone down, and his hair is still growing.  In the past it has taken a couple of weeks for his hair to fall out after chemo.  He needs to shave and I forgot to bring in his electric shaver.  His platelets are real low, (the platelets are what causes your blood to clot), so he is not allowed to use a razor. Casey got a small dose of methotrexate (which is a chemo drug), but after what he has already gotten, that's like you and me taking a baby aspirin.  Today has been a great day.  I hope you are having a great day too.  Happy Valentine's Day.
Peggy

Day +5.  Casey is feeling tired and a bit nauseous today.  I think the reason he is feeling so crappy is because he found out the cord blood came from a different place than we were originally told.  Originally we thought both were coming from Germany, then were told one was from Germany and one was from France.  The day of the transplant we found out actually one came from the United States and one came from France.  One has a blood type of A+ the other one is O+.  We are not sure which one is from France and which one is from the USA (we'll see if we can find out), but only one will take over his body, and his blood type will be the one that won out.  Last night we found out the one from the US came from the Carolina Cord Blood Bank.  I saw the blood as it was going into him, and it wasn't Carolina Blue!  I googled the Carolina Blood Bank to see where it is from, and it is from DUKE.  For those of you who don't know, Casey is a UNC alumni, and Duke is their biggest rival.  At orientation they teach the in coming freshman, from now on you spell Duke "D.O.O.K." and you spell North Carolina State "H.I.C.K.".  As I kept reading the Carolina Cord Blood Bank's information, it said they collect umbilical cords from Duke, UNC, NC State's hospital and Wake Forest's hospitals.  No matter where the blood comes from, Casey will always have Carolina Blue Blood.  Way to go Heels for winning tonight!
Peggy

Day +4.  Casey seems to be a bit better today.  He got out of bed and went for a little walk tonight (2 laps around the nurses station).  Last night his friend called to try to make him feel better by telling Casey, he threw up yesterday.  Way to take one for the team Eric, it seems to be working, it definitely lifted his spirits.  His numbers continue to drop.  Monday they should bottom out, and then start the recovery process.  That is if Casey does what is normal.  We'll see, Casey has always been a little weird.  I wonder where that comes from?  Maybe he's spending too much time with Big Bob.
Til Tomorrow,
Peggy

Day +3.  I got out of the house and am up with Casey.  He is having some stomach issues and is tired, pretty much the same as it has been the past few days.  I asked him if he is bored, and he says no.  He is not feeling well enough to want to do anything other than lay around.  But after what he has been through, I think he is doing great.  Last night our church caught on fire.  It is sad.  I got baptized there, confirmed, married, had my children baptized and confirmed there and my grandparents funerals were there.  But like Casey, I know it will come back stronger and better.  There are just going to be some bumps in the road along the way.
Peggy

Day +2.  We have been hit with a blizzard and have not been able to leave our house today, so I was not able to do the 45 minute drive to Hershey Medical Center.  I spoke to Casey and he says he feels fine, just wiped out.  I sure hope I can get up there tomorrow.  I know he would not tell me if he was not feeling well.  I have a feeling he will be feeling bad later tonight after the Duke/Carolina game.  His tar heels have not been having their best year.  But who knows, it always seems to be an interesting game.  We'll keep digging out.
Peggy 

Day +1.  Casey feels okay, just tired.  This is to be expected.  Another snowy day in PA and I will have to cut my visit short tonight.  I think Casey will be fine just laying in bed watching television and doing some sodoku puzzles that the Eckman's gave to him.  Thank you!  Casey's counts are starting to bottom out.  When his counts start coming up, that will be the new stuff taking over, but that won't happen for several days.  In the meantime, we wait and pray, and be thankful for all of the support from friends, family and our swimming family.
Peggy

Day 0.  The transplant is finished and all went well.  Casey feels fine, only a little tired.  We were in the room with him while they did the transplant.  I took photos and will post them when I get my home computer fixed.  I got a virus and it has been acting up ever since, but I have been a bit busy to try to get these little chores done.  Not that I have really been doing anything other than hanging out with Casey.  It just makes me feel better to be with him.  They brought the stem cells in the room in what looked like a garbage can filled with dried ice.  Then they put it into a warm water bath to thaw it out and Dr. Ehmann injected it into him through a giant syringe.  There were 2 people here from the transplant team, Dr. Ehmann and a chemo nurse.  It was really quite uneventful, which was fine by me.  The equipment was the most impressive.  They said the stem cells have already gone into his bone marrow.  So now we wait for them to take over and for his counts to recover.
Tomorrow is Stevie's birthday, so we had a little birthday celebration because we were all together.  That is a rare thing these days.  Tomorrow we start counting up, and they are expecting to see his new stem cells take over around day 14, but everyone is a little different.  As for the odor coming out of Casey, I would not say it smells like garlic.  I'm not sure how I would describe it.  Hopefully it is the smell of sweet success.
Peggy

Day -1 is a good day.  Casey if feeling much better.  He is watching Larry the Cable Guy.  It's' good to hear him laugh again.  It's hard not to laugh at Larry the Cable Guy.  The nurses put out a Super Bowl buffet and Casey ate half a hot dog with sauerkraut.  We are looking forward to the game, but will miss our usual gang who we watch the game with.  One or our annual questions is What is the first commercial after kick-off?  I say Miller Lite, Casey says Boost Mobile.  What do you think? 
Casey is prepping for his big day tomorrow.  The transplant should take place around 11:30 a.m.  We are ready!
Next time I check in Casey will have received his "new life".
Peggy

Day -2 is better than yesterday, but still not great.  He is still having headaches and feeling tired and weak.  They have been able to stay on top of the nausea, so he is able to sleep a lot.   Casey will do anything to get his dad to shovel out his driveway.  They say this is all to be expected, the type and strength of this chemo is wicked.  The bright side is tomorrow is what they call a day of rest.  No chemo.  Just football.
Thank you for all of your well wishes and prayers.
Till Tomorrow,
Peggy

Day -3 is not a good day.  Casey is feeling really bad.  His face is swollen, his head and jaw ache and he is nauseous.  He stops throwing up long enough to let out a few curse words.   Thank goodness this room is pretty sound proof!  They gave him morphine for the pain.  It would be nice if he could just sleep.  He is saying this really sucks.  Can't say as though I disagree.  He just said if I want to try this he will teach me how.  You know if I could, I would do it for him.  They are telling us this will last for about 24 hours.  Tomorrow they will try giving him this medicine at a slower pace along with benadryl, to hopefully avoid him getting this sick again.
Looking forward to a better day tomorrow.
Peggy

Today is Day -4.  We are getting closer to the transplant date of Monday, February 8th.  Casey's doctor was telling him that after the transplant he will exhale a garlic odor, which will encompass the whole room.  We will probably have all the hospital staff stopping in looking for pizza!  It has something to do with the preservative that is put into the stem cells.  Kyle said that is the real reason we are all going to have to wear masks.
Casey's appetite has diminished, but in the previous weeks he ate really well, so he has enough of weight to carry him through.  He really enjoyed being a regular person for the last couple of weeks, but know it is time to get back to being a cancer patient and getting this disease out of his body.
Peggy

Day -5 and the chemo is making Casey feel pretty bad.  At least it is not constant, it comes in waves.  Tomorrow at this time he will be finished with this drug and then on to the next one. Stevie's friend Betsy, from high school is a med student here, she stopped in the other evening to visit.  It was great to see her.  It is nice to see these kids all grown up. 
The puppies enjoyed their first day at day care and have been welcomed back again.  They told us it would tire them out.  Fat chance.  They might have been tired for 2 minutes and then it snowed!  They do have a good time in the snow.  How do they still manage to come in with mud on their feet?
Thank you all for your continued support.
Peggy

Casey's Story

    This is Stevie (Casey's sister)! We have picked up a lot of followers on our journey.  Some are familiar and some aren't with Casey's story.  I wanted to talk about his story so everyone can have a little more of an understanding about my brother. 
    Casey was born on May 3, 1982 (don't worry, I'm not starting that long ago!).  His fighter and perseverance attitude was shown as he grew up to become an Olympic Trial qualifier in the summer after his graduation from Ephrata High School, in the year 2000.  He then pursued his swimming career at the University of North Carolina.  After 5 years in the wonderful town of Chapel Hill, he graduated with a Geography degree.  Casey then started as an assistant coach at the Lancaster Aquatic Club, where he swam growing up. 
    Almost a year after graduation from college, he had mono-like symptoms.  Since Casey was such a great athlete, he learned how to read his body.  He knew something just was not right.  They continued to take several blood tests and were sure he had a severe case of mono, but wanted to do Leukemia, Lymphoma, Hodgkins Disease, etc tests.  The tests showed Casey had Acute Lymphoblastic Leuekemia and was diagnosed on April 21, 2006.  He began chemotherapy immediately.  They had found the cancer early and didn't need a bone marrow transplant because they were sure chemotherapy would be the solution.  It looked this way.  After the first phase, his body was cancer free.  He then needed to continue chemo in the maintenance and preventative phases until April 15, 2008. 
  Casey continued coaching at LAC and I began to work right beside him.  He then was offered the head coaching position in July of 2008 and was now my boss! He continued to mentor me and teach me as we worked side by side.  In August, 2009, he was at Junior Nationals in Seattle, and he knew something was going on.  By the end of August his symptoms have not subsided and still felt anemic and that his spleen was enlarged.  He then got ahold of his doctor and made an appointment.  That Monday of the week, we lost our wonderful dog, Sage to a battle with cancer.  We knew the week held something.  On Thursday, September 3, 2009, Casey and I went to Hershey to meet with Dr. Ehmann.  My mom sent me because she thought she was bad luck since she was with him the first time.  Casey was once again very in-tune to his body.  They found the cancer VERY early and it was once again, ALL.  They had swept me right up to the blood lab to take some blood to see if I was a match for a bone marrow transplant.  The doctors explained even though it is very early, like last time, it is standard to do a transplant when it relapses.  We had a weekend at the cabin planned with our close friends.  The doctors agreed to starting the chemo that next Monday so we could have that weekend together.  We made the best of it!!  That Monday he began Chemo.  That is when my mom began this blog!
    While we were growing up, I was the annoying little sister.  I admired Casey for what he accomplished and was so proud of him.  I was always the loudest cheering for Casey in the stands and never wanted to miss a meet.  I wanted everyone to know that the fast guy was my brother! When he went off to college, I became a HUGE Tar Heel fan as well.  We then became friends instead of just brother and sister.  There were times I would get calls in college to make sure I was making the right decisions.  He often would be with his best friend, Kyle who had the same advice. 
     When he got sick, the first time, I was only a sophomore in college so I was not at home for the most of the time.   This time around, I am right here the whole way.  Casey is truly and inspiration to all of us.  His spirits are extremely high and he makes it easier on everyone around him.  He never complains about what he has to do, he just does it.  If you read this because you have had a loved one go through a similar process or a friend is a friend of family member of Casey, I truly hope you get to meet him one day because he is a very special person.  Once again, I will be loud cheering him on and am so extremely proud to be his sister. 

God Bless all of you! The support from our family, friends, and swimmers have been overwhelming.  Our family is so fortunate to have you all and words cannot express our appreciation of each and everyone of you.

Love you and Thank you!
Stevie

The official count down has begun, today we are at day -7.  Casey has had a full day of chemo and is doing great.  He's all moved into his room with his poster of  his swimmers keeping an eye on him.  (Don't worry, he's keeping an eye on you too, Stevie reports in).  In celebration of ground hog day I going to try to talk him into taking a wheelchair outside tomorrow morning to see if he see's his shadow.  He could be the new Puxatauny Phil.  His hair started coming back in, it's fuzzy like a ground hog's.   The odd thing is through his first time around with the chemo 3 years ago his hair grew back in brown, this time it is growing back in blonde.  It will be interesting to see what color it is after the transplant. 
Thank you for all of your well wishes.  I will keep you posted.
Peggy