transplant details

Hello friends!  I hope your holidays were merry and bright.  I was able to see lots of family, which was a blessing, since this people person is about to head into several months of not being around people!

The stem cell transplant process is now in full swing.  I have already completed the first two phases: testing absolutely everything (I passed) and patient education (I learned).  Bobby and I are very happy with the Northside Blood and Marrow Transplant Group so far.  They’re well-organized, friendly, helpful, and they get things done quickly.  Not to mention they are the number one group in the nation for this type of transplant.  Good thing we live so close to Atlanta!  Everything will be done on an outpatient basis, which means I get to sleep in my own bed at night and will only be admitted to the hospital for an infection or other complication.

Here’s what I’ve done so far…

Step One: Testing.  That was a really long day.  It started out with a bone marrow biopsy…in office.  With no anesthesia, pain meds, or Xanax.  Just a Lidocaine injection.  That’s a post for another day.  Then we did an echo, an EKG, a brain CT scan, a pulmonary function test, lots of blood work, and met with the nurse, the psychologist, and the blood services group.

Step Two: Education. Another long day, but it didn’t start out with anyone shoving giant needles into my backside and removing pieces of bone and vials of marrow, so it wasn’t as bad.  I had PT and OT evaluations, then we met with the nurse, the midlevel (nurse practitioner), and the doctor.  And the clinical research people.  And the blood services rep.  And the pharmacist.  Lots of info.  Brain stuffed.

Tomorrow, I’ll start with Step Three: Mobilization and Collection.  Tomorrow morning I’ll get a central venous catheter placed in my chest.  It has three lumens, so they’ll be able to do multiple things at the same time.  With my port, you can only put in one needle.  After tomorrow, I’ll be able to, say, get fluids and have blood taken at the same time.  Very convenient, but I’m not looking forward to looking like an alien with three tentacles sticking out of my chest.  Though I guess it doesn’t matter much, since after tomorrow I’ll only be able to go to Northside and my home for the next three months.  Seriously, guys, no Super Target or Starbucks for THREE MONTHS.  Sure, people can bring me Starbucks.  But you can’t put a Target in your cupholder and bring it home!

Anyway, after I get my central line, I’ll start mobilization chemo, which will move my stem cells from my bone marrow into my peripheral blood stream.  This will involve IV chemo (Cytoxan), then twice-daily Neupogen injections.  They’re going to teach me how to give them to myself so I don’t have to drive all the way to Northside just for a shot.  Although some days I will have to go in for labwork.  Once my labs show that I have enough stem cells in my bloodstream, we’ll start collection.  They’ll take my blood out, run it through a machine that separates out the stem cells, and put it back in.  Then they do some magical science-y stuff to the stem cells  to make sure they only have good ones and cryogenically freeze them.  It can take up to four days to get enough stem cells for the transplant.

Step Four is High-Dose Chemo and Transplant.  After they collect my stem cells, they’ll do a test dose of Busulfan, another chemo drug.  Then I’ll take it orally for a few days.  Then I’ll do two days of extremely high doses of chemo, which should kill all remaining stray cancer cells in my body.  However, it will also kill my bone marrow and most of my white blood cells and platelets.  Which leads us to the transplant itself.  The last step is to re-infuse my stem cells back into my blood stream.  They will migrate into my bones and rebuild my marrow.  So essentially, I will be saving my own life after the doctors try to kill me.  Okay, not exactly, but I like to think of it that way because it feels very superhero.  And superheroes are a big deal in my house.  🙂

After the transplant, I will go to Northside every day for about a month so they can check my levels and make sure I’m doing okay.  Then it moves to every other day, then every third day, etc.  After 100 days, I should be released back to my oncologist.  And if I’m doing okay at that point, I should be able to go back to work next fall!  Hooray for a normal life!  Something to look forward to.

So that’s the whole plan.  I’ll be spending a lot of time just sitting around hooked up to IV’s for a while, so hopefully I’ll have the energy to keep writing to you all.  I’ll try to update again after this week and let you know how mobilization is going!

Love and light to you all.