Patience pays off...part 2

So on Wednesday, 12 August, I received those stem cells. And it wasn't 24 hours later when I felt like I just been hit by a truck. Fatigue . . . loss of appetite (who, me?) . . . nausea and the works (you're going to have to use your imagination on that one) . . . developing mucositis     . . .  and a general sense of "I feel like &/!@."

I've never been so sick that I'll that I lose my appetite . . . I joked with the doctors and nurses early on that I might just order carry out from Jeff Ruby's rather than eat hospital food . . . but the joke was on me because just the thought of meat, shrimp, crab legs or even a steak smothered in blue cheese was enough to roll my stomach. Truth be told, I was lucky to keep down 2 ounces of water at a time.  

And frankly even though I'm at home now, I don't have a large appetite whatsoever. Small bowl of cereal and milk this morning more than sustained me for most of the day until I whipped up a little something for dinner tonight. The good news is not so much that I was able to eat, but just that I kept everything down. Descriptive enough?

Friday morning I returned to the hospital for some bloodwork and a consult with Dr. Tse and his staff. And let me just say that those are some of the most outstanding healthcare professionals I've ever run across. Their attention to detail is not like anything I've seen before.  

So the game now shifts from waiting for the stem cells to grow and develop into healthy marrow and cells to feeling more like my 100% self . . . see, I told you I wasn't very good at this patience game . . . I want to be back to 100% yesterday, ha.  

But I appreciate your ongoing prayers and support because without them I have no idea how I would've gotten through the last couple of weeks!!

Patience pays off ....part 1

What a couple weeks this has been! Of course it's not like I didn't know what was about to happen . . . but even with all the warnings about side effects and how I was going to feel, as well as the general anxiety of rebuilding one's immune system, I admit I wasn't totally prepared for what transpired.

That cute little bag of what appears to be jello, is actually one of 3 bags of stem cells that were reintroduced into my body. Using a large syringe, Nurse Catie pumped those little rascals back into me so they could begin the process of growing and developing into red and white cells and platelets.

Waiting . . . and waiting . . . and waiting

I so appreciate the role that our nation's farmers and agriculture specialists play in getting food grown, harvested, and on the table at home. You have to have the patience of Job I'm sure, and guess what, I clearly do not. Ha.  

So, since last Wednesday, when the stem cells were actually transplanted back into my bone marrow, I have been playing this waiting game, patiently looking for signs that the graph is taking hold and that this will put me into a partial remission, which was the goal. But alas, nothing yet, short of my white counts and platelet counts predictably dropping toward their nadir of 0.0.

And of course the nurses and docs have sensed my impatience with this whole process and are having more than a little fun at my expense . . . "Only a couple patients took the entire semester for their counts to increase, I wonder if you could be the third?" Comedians. They belong on Jimmy Fallon, not the 6th floor here at University Hospital.


But the transplant itself went just fine. I even experienced a couple "hot flashes" when they were reinjected back into my blood stream. OK, ladies, never again will I make a joke or laugh about hot flashes that you might experience. Been there, done that. And take a look at that bag of stem cells in the picture . . . looks like raspberry gelatin doesn't it? But oh, the secrets of science are in that very bag. Amazing.




Nurse Catie slowly injects the stem cells back into my blood stream. Slow and methodical is the best way. Five minutes into the process, they take your vitals just to make sure you're not going to faint or experience a bad reaction.

It's Monday of Week 2 in the hospital. I have work to keep my attention and the financial markets are open. I hope you have a good week. Thanks for your ongoing support and prayers. Without them, I am not sure where I would be at this point. I am very grateful that God has blessed me with such a great support group of friends, family, and well wishers.

It's TRANSPLANT Week . . . finally!!

Well, this is the week that the doctors have been pointing to. After multiple rounds of chemotherapy, and after lowering the plasma cell in the bone marrow to less than 5% (from 76% back in April), it's time to take the next big step, which is the stem cell transplant. These used to be called "bone marrow transplants," but at some point in the recent past, doctors simply referred to them as stem cell transplants because that more accurately reflected the process of transfusing the cells back into the patient's body.   The bone marrow simply was the eventual location where these stem cells would take up residence and begin producing red and white cells as well as platelets.

So Monday August 10, I will check in at University Hospital. I'll receive a central line catheter that will not only deliver the stem cells back into my blood stream and eventually to the bone marrow, but also serve as a port for them to withdraw blood for testing and lab work, etc. That will be better than getting poked every day for the next 2-3 weeks.

I will receive a high dose of chemo called "malphalan" on Monday and Tuesday. The actual transplant will take place on Wednesday sometime.  And this transplant is nothing more than a transfusion of my own stem cells that were harvested about a month ago. I must admit that the whole procedure has me on edge, simply because complications such as infections or the like could set in while my white blood counts are non existent. That's the LAST thing I need is to catch a cold or get sick when my immune system is so compromised.

But barring any incidents such as that, things should go smoothly. I have plenty of books to read, I have investment periodicals to pore over and absorb, and I am sure I'll have plenty of emails from work to answer. Despite being in the hospital for 2-3 weeks straight, it should be anything but boring.

Thanks again for your ongoing prayers and support as we continue this battle. There is uncertainty we face each day, especially for me right now, but faith and prayers are the cornerstone helping me through that uncertainty.   

Visitors are always welcome, so if you find yourself downtown, feel free to drop in. I will be on the 6th floor of University Hospital.

TGIF...that means Chemo Drip Round 3 is Complete

I am just about an hour away from the last few drips of this chemo cocktail entering my bloodstream. It's been a relatively subdued week, with minimal side effects short of some swelling in my legs and ankles, which was caused by a little water retention. Nothing that a 20 mg shot of Lasix couldn't handle. Lasix forces you to remain in close proximity to your bathroom, unless you prefer a catheter . . . which I sure as heck don't want. Ha! Thanks Dr. Kute!

This now completes another full 5-day hospital stay, my third since May 4th. In that time, I have been surrounded by and treated by the absolute best health care professionals I could ever hope for. The doctors, nurses, aides and staff are so incredibly helpful, informative, nurturing, and empathetic. Plus, they all seem to share the same positive and upbeat attitude that I have . . . maybe that's why we all get along so well. This week, my nurses Megan and Angela, and Rachel have coordinated day shift, while Mark and Kim anchored the night shift. Absolutely consummate professionals, each one of them! And the aides who take my vitals like Meghan and Paige demonstrate the energy and commitment they have as they pursue their nursing degree and gain great practical hands on experience.

I have been so incredibly lucky and blessed thus far with minimal side effects from each treatment. Plus, to be surrounded by such caring professionals as the ones I've come across has made my experience so far a tolerable one, considering the disease I'm fighting. These professionals are making a true difference in my life, and for each of them, I am truly thankful.

Thanks to everyone who continue their ongoing prayers and support on my behalf. God is in charge of this operation, and His plan is my plan. My prayer each day is to continue to grow and strengthen in my walk with Him. And selfishly, I ask for lots more time so that I can be an inspiration and testimony to others so that they too can experience His grace and glory.

How did you spend your summer vacation?

Don't you just love last minute vacations? With the upcoming chemo regimen as well as the pending stem cell transplant, I asked my doctors if they would be ok if I got away for a few days of rest, reflection, socialization with friends as well as a little solitude. I thought they'd poo poo the idea, but to my surprise, they said, "Great idea. When?" So, after redeeming a few rewards miles, 3 days later I'm on a plane to Pawleys Island.

Sorry for the time between blog posts, but frankly I've  felt so good the last two weeks that there wasn't a whole lot to report in the first place. Hence, the desire to scamper out of town and enjoy a change of scenery.

A gorgeous sunset after dinner at K Rae's.

Early morning kayak trip through the tidal creeks and marshes of Pawleys Island.

On the tennis court for the first time since March. I played like it too.

This week though, I am back in the hospital for a 5-day stay, and the chemo is dripping again. This will be the exact regimen as the 2 previous rounds of chemo. That is a 4-day, continuous 24-hour drip of various amounts of cisplatin, etoposide, adriamycin, and cyclophosphamide. Complicated formula, but it is working, and both Dr. Zhong and Dr. Tse are happy and satisfied with progress to date. The week before vacation, we completed the stem cell harvest, so that was a success, garnering 14 million stem cells over a two-day period. Dr. Tse was looking for 10 million, so we over-delivered on that expectation . . . a good result.

All in all, it's been a hectic couple weeks. But the real test is the chemo this week as well as the actual stem cell transplant in early August. I keep praying that things go just as well in the forthcoming weeks as they have in the past couple months. Thanks so very much for your ongoing prayers and support. I feel them working and the power of God's grace and goodness is on full display.

It's harvest time!! UPDATE

This is the week we've pointed to for some time. And talk about a structured regimen. Here's what the week looks like from a schedule standpoint:

7:30 am - Arrive at Brown Cancer center; vitals measured

8:00am - Lab work

8:15am - Injection of growth stimulating factor (GSF), which is Neupogen 

8:30 am - Vitals measured again to be sure no negative reaction to the GSF injection

9:00 am - Stem cell harvest begins. The technical and medical name for this is known as Apherisis. This collection process basically goes all day, as in 9am - 4pm . . . kind of like a full time job, except you don't get paid . . . rather, we pay them. That's not a bad setup, huh?

So today is Day 1 of this regimen, and as of 11am, I am actually still waiting for lab work to return. Once it does and once the doctor has determined there are sufficient cells to harvest, they will take me down to the Vascular area of the Cancer center to insert a port, referred to as a "Shiley." That port will serve as the access point to remove and harvest the stem cells as well as the entry point when the blood is returned to my body. Think of this harvesting procedure similar to what a dialysis patient goes through.

And if all goes well, by Friday afternoon, we should have enough stem cells to do TWO possible autologous transplants. That's the objective here this week.   

So a lot of hurry up and wait so far. Thank goodness Wimbledon is going on right now . . . that's a very pleasant distraction from all these tubes, needles, and machines.   

Day 1 - Monday

Wouldn't you know it? Injections of the GSF the last 3 days have had no material impact on the quantity of stem cells available for harvest. Using the multiplier formula that the docs and nurses use, shows a final number of 2.85%. As Dr. Tse and Dr. Chao said, "We could hook you up, but it would probably be a waste of time and money." So Monday turned out to be more of a "failure to launch." At 6pm, I received an injection of mozubil, which is designed to mobilize and increase the stem cell harvest process. Today is now officially in the books.

Day 2- Tuesday

Arriving at 8am, I know for sure we are doing something today. By 9am, I am down in the lower level of the Brown Cancer Center, receiving this port, called a Shiley. A fun, little 20 minute procedure where a central line catheter is inserted at the base of my neck and will serve as the entry and exit points for the stem cells to be removed from the circulating blood and that blood returned back into my bloodstream.

This is the machine used to process and collect all the stem cells. My med tech, Helen Fields, and maybe Starship Enterprise navigator Mr. Sulu are the only ones capable of operating this rascal.

Lab work was completed and shows a WBC of 24.7, which is a good number. The med tech doing the procedure today is optimistic we will have a good day. That multiplier number that needs to be ideally above a 10, is actually standing at 29.2 so they have reason for optimism. 6  hours later, and after all the tubes have been unhooked and the sample stem cell vial tested, the doctors declare it a good day, harvesting more than 6 million stem cells, on our way to 10 million total, which would be sufficient for TWO auto transplants, just in case. A shot of mozubil at 6pm, and I am done for the day.

Day 3 - Wednesday

It's 9am, and blood work is already back. My WBC is now an astronomical 45.2. I have never had a WBC that high, so doctors again are encouraged that we will have a successful harvest again today. Amazing what the power of a couple of injections of mozubil will do. 

This is not a painful, nor uncomfortable procedure at all . . . just boring. The machine hums along pumping blood from the central line, where it's centrifuged and separated and the stem cells harvested. Then the blood is returned back to my circulating bloodstream.   At 2:30pm, the machine is unhooked and the tubes removed from these ports in my neck.    By 4pm, the results are back . . . an astonishing 8 million stem cells have been collected on this day, bringing the two day total to 14 million stem cells, far exceeding the 10 million the doctors had hoped for.   

So the harvest is now complete. No more mozubil, neupogen, or uncomfortable central line ports . . . at least for now.  

Dr. Tse and Dr. Chao are extremely pleased and confident. Not everybody has a good response to a collection procedure like this, so I am thankful for a great and encouraging outcome. Two days being hooked up to that device and we collected 40% more than expected.  I am elated, but frankly, we all know there is a higher power at work here. Thank you, Lord, for Your grace, care, and unconditional love as you continue your daily walk with me and give me the encouragement I need to beat this disease and be a testimony to your power and glory.