October 2026

Hi Phin phans! Dustin here with an update on Phin for October, 2026. 

I've been trying to figure out why we like fall so much. Neesha, Phin, the girls, and I, that is. It's a really busy time here. No matter how much planning or preparation we do, it always seems like we're pulled in a thousand different directions with activities and events and commitments, and every year the whole season flies by. We haul ourselves up from the autumnal leaf pile onto the decorated porch of the holiday season feeling physically exhausted.

Physically. But not emotionally.

I think it's because autumn is the only season Phin was never succumbing to leukemia, receiving treatment for it, or recovering from it. The typical October phantoms are not the same as those that crowd the rest of our calendar, lurking in wait with their grim markers and anniversaries and reminders, their grief ambushes and trauma triggers. Halloween-themed spectres abound, but, so far, the king of monsters has never terrorized us at this time of year.

Autumn sometimes feels like a corn maze for us. We scramble back and forth chasing our own shadows around blind corners and down dead ends. We wear ourselves out.

But, at least so far, nothing scary has jumped out at us.

Medical Updates

Neesha took Phin for his bi-monthly bone marrow transplant (BMT) clinic at CHOA the week before last. I’m not sure if we’ve ever really talked about what happens at these BMT clinic visits other than the results that come back, but here’s how they go: Check in, ride the elevator to floor 8, fill out forms in lobby, wait. Get measured for height and weight, get blood drawn, go to patient room, wait. Get checked over by nurses, go over medications and recent illnesses and concerns both general and specific, wait. Get seen by physicians or PAs — always one who specializes in oncology and bone marrow transplants, but sometimes dermatologists, too — as well as the occasional nutritionist and/or physical therapist, wait. 

During the waiting, we are constantly refreshing the patient app for Phin’s counts from the blood draw. The CBC-DIFF.  There are 24 fields on the CBC-DIFF, each with a floating oval containing a decimal amount over a line that is yellow on each end to indicate “abnormal range” and green in the middle to indicate “normal range.” All of these lines are important, but the four that we, as parents of a leukemia

survivor, scroll directly to are white blood cells (WBC), red blood cells (RBC), hemoglobin, and, above all, platelets. There is little nuance in these lines, from our experience in both Phin’s initial diagnosis and his relapse. When he had leukemia, those were the lines that announced it — specifically, the platelet line, which, at one point just before his relapse treatment began, was falling by double digits every single day.  

The tricky thing about the CBC-DIFF is that it, like any medical report, is only a snapshot. It doesn’t reveal what his blood was like the day before or the day after, and since it’s a measure of the level of various kinds of blood cells, the levels it reflects wobble tremendously based on factors that might have nothing to do with the thing we most dread. A cold, for instance, can spike or collapse these counts, as Phin’s donor’s bone marrow marshals blood cells to attack the invading pathogens and as those blood cells fall in battle. Here we could also get into the various kinds of white blood cells this involves — the neutrophils, lymphocytes, monocytes, eosinophils, and basophils — depending on the type of infection, each of which has its own level that the CBC-DIFF captures.

This is to say, the CBC-DIFF is an imperfect measurement of Phin's overall health. It is, however, one we are conditioned to dwell upon, obsess over, meticulously pick apart, and, from the moment he gets his blood drawn at the clinic until the moment it pops up in the healthcare app, wait for with bated breath.

It is also to say, at his BMT clinic visit for October, Phin's CBC-DIFF counts looked good. 

Also, the BMT team told Neesha that Phin can discontinue taking Bactrim, his sole remaining routine medication. An antibiotic, Bactrim was prescribed to bolster Phin's immune system and fight infections when he was taking an immunosuppressant drug intended to address the Graft vs. Host Disease issues in his joints. With Bactrim gone, Phin will now be oral medication-free for the first time since early 2004.

Let's just say he's pretty excited to take a break from swallowing pills.

Another big development is that starting in 2027, Phin won't need to go to Atlanta nearly as much. Neesha and I expect to bring him for one final regular BMT clinic appointment at CHOA, in December, after which his care will transfer back to CHOS in Savannah, and he will only need to go to Atlanta on a yearly basis after that. 

"Kind of like a homecoming," Neesha told me on the phone as she and Phin were leaving CHOA to begin their five-hour drive back. 

"Kind of like a homecoming," I repeated. 

Phin On the Daily

Neesha here! If we had to sum up Phin in one word these days, soccer is the word: soccer after school until there's no more visibility (which will happen sooner now that we're falling back an hour — thanks, Daylight Savings), soccer for his Halloween costume, soccer for our Halloween decorations, soccer at recess, soccer kits on dress down days and picture days, and most days, soccer talk on our way home...soccer. This is Phin's current obsession (which, if you've been following, you know isn't that current, but is prevailing as time goes on). And Phin's soccer team — Chaos — is currently undefeated and heading to the playoff tournament next weekend. He is one of the three youngest on their team, but enjoying his first winning season (to be fair, it's only his second full season and his last team didn't have enough players to field a match many days, so he's 50-50 on the team standings). He's learning so much about sportsmanship and fair play and how to be a good teammate, team player, and competitor.

Phin is also still very much into geography. Having now learned the identity of most of the flags of the countries, he's moved onto the states and capitals (sorry, third grade parents, if you're now hearing Yakko and Wakko Warner's geography-themed Animaniacs songs). His sisters have absolutely had enough of them, but they're working and he's able to ramble off quite a few now. 

That's really all there is to report for October. 

Thanks, Phin phans.