The Incredible Journey to Houston

 It’s Monday morning and I’m back in Houston - somehow I made it despite the storms and such. You see, my wife Rebecca is highly skilled when it comes to flights, credit card points, hotel deals, flight changes, airport perks (due to credit card points), and all things logistics. Great for me because those elements of life stress me out. I’m much more of a “book a flight, show up to the gate really early, and wait it out” type of guy.

This is what I-94 looked like yesterday

So, I started my snowy, subzero journey along I-94 yesterday around 9:30am, trying to get to Detroit Metro Airport for a 1:30pm flight to St. Louis, where I would catch another flight to Houston later in the afternoon (Becky got a great deal on this flight, by the way). As I was putzing along, somewhere near Jackson, MI, Becky called me to inform me that the flight to St. Louis was delayed by like 6 hours, which would mean missing the Houston flight, which would throw everything off. So she got me on a 12:30pm flight to Chicago (who, according to Becky, “knows how to handle this sh*t”), and a subsequent late afternoon flight to Houston. I was surprised when the Chicago flight left on-time(ish). I got to “Club MDW” for a free meal (credit card perk I would have otherwise been oblivious to), and somehow got onto my on-time flight to Houston despite the Chicago blizzard.

Landed in Houston (Hobby Airport this time, not the usual HW Bush) on time, and it turned out the forecasted “Icepacalypse” was more bark than bite. Cruised to the hotel with an overly chatty Uber driver, caught the end of the Rams/Seahawks game, and here we are! Monday morning in Houston. All morning appointments were pushed back to the afternoon due to the storm that never happened, so I have a few hours before I head over to MD Anderson.

How to spend this time? Well, after I crank out this blog, I have some ideas. I have this unproven theory that getting my blood pumping will amplify the effects of the drugs that are, and will be, in my system today (and every day throughout 2026). Here’s my hypothesis:

1. I have already taken pirobrutinib today (about an hour ago). Its role is to block BTK signaling by the CLL cells - these signals tell the cells to multiply and to hide out in the lymph nodes and bone marrow. By blocking this signaling, pirtobrutinib prevents CLL proliferation and flushes the cells into the bloodstream, where they are sitting ducks for another drug to destroy them - that’ll be obinutuzumab today AND (starting next month) venetoclax.

2. Obinutuzumab’s role is to flag the CLL cells for destruction by my immune system. From what I understand, it’s tricky for the obinutuzumab to get into the lymph nodes and bone marrow, but it can go gang busters in the blood stream, particularly if my NK cells (part of the immune system) are fired up and ready to go.

3. According to my (unproven) theory, exercise will help pump pirtobrutinib through my body, lymph system, and through bone marrow by way of an increased heart rate (I have an especially strong marathon runner heart), blocking the BTK signaling of all those punks trying to hide out, and forcing them to drift out of their protective niches. 

Further, exercise signals to my NK cells to flood the blood stream and start looking for punks. There, they will team up with the obinutuzumab and blast cancer cells away.

Again, it’s an unproven theory and maybe the exercise does nothing more than improve my mental/physical health. But it seems like a low risk, potentially high reward strategy so I’m gonna get it going. I have a blood test early this afternoon, so stay tuned to what those #s show. Remember, the normal range for a white blood cell count (WBC) is between 4 and 11. I started treatment on January 12 with a WBC of 260(!), and my most recent blood test (January 19) showed a WBC of a mere 27. Anticipating some more good news today.