well then

Um. I really didn't mean for it to take over a week to post this news, but the week slipped away from me, and suddenly here it is, Tuesday.

And tomorrow is Wednesday. Which means tomorrow afternoon I'll be making my way to the hospital in the afternoon to get a PICC line (which is like a long term IV) placed, after which I'm going to be admitted as an inpatient to prepare for the stem cell transplant procedure.

As I found out last Monday, my doctor in the transplant unit spoke with my oncologist, my surgeon, a radiologist, and who knows how many other physicians and came to the conclusion that it would be best to move forward with transplant immediately.

I have tried to write this post roughly five times now, and each time I've found myself many long paragraphs in wondering when exactly I'd be able to finish. The whys and hows of transplant are not only very complicated, they're hard to explain (at least in a nice, concise fashion). Now I have to check-in at the hospital tomorrow and I'm not even finished packing, so I really need to keep it short. I promise to provide a much longer and more thorough explanation later this week, unless of course I'm not well enough to do so.

So, this is my best attempt at a quick and easy explanation.

I am going to undergo high dose chemotherapy with peripheral blood stem cell rescue. Another way to describe this treatment is tandem autologous stem cell transplants. The first term is more accurate; the second term, however, will assist you if you want to do your own research.

The intended but not guaranteed purpose of this treatment is to kill any remaining cancer cells in my body to prevent the cancer from coming back in the future. The doctors put the odds of this working for me at about 60%.

To that purpose, I will receive extremely high dose chemo for 6 days. This chemo will destroy my bone marrow to the extent that it cannot recover by itself. Since I could not survive very long in this state, on day 8 (or day 0, in medical terms), I will receive an infusion of my own stem cells. These were collected from my blood a few months ago.

It takes about 2-3 weeks on average for the stem cells to take hold and start doing their job, which is to produce blood cells. In the meantime, all my white blood cells are dead, so I will have no immune system.

This obviously places me in a pretty dangerous position. To keep me safe until I recover my immune cells, I will go into isolation. As in, one room, lots of strict rules isolation. And while I'm stuck in that one room for 2-3 weeks (or more), trying not to expire of boredom, I'll be dealing with side effects. The mouth sores and mucositis I've already had experienced will be back, but many times worse. They expect I won't be able to eat longer than a few days after the chemo ends. I'll be carefully monitored for signs of infection, and I'll receive regular blood and platelet transfusions. However, any pain will be managed with help of a PCA, and I expect my doctors to be very much on top of my care. Even the doctors say the worst part will likely be the boredom of isolation.

After my stem cells take hold and my blood counts improve, they will scan to make sure that the treatment is working and there is no progression of disease. If the scans show no disease, I will repeat the entire process for a second transplant. Hopefully, I'll get some time at home in between, but it's hard to predict at this point.

Wow. So that's the short version. I'm going to end here, and will hopefully be back with more in a few days. For those of you fond of inquiring about my emotional state, I have a mental exercise. Imagine you have to face six grueling days of chemo, followed by 2-3 weeks stuck in the same not-so-large room. Think about how you would feel, and I imagine you'll have a good idea of how I am feeling.

(Did that come across as snarky? Sorry, but like I said, imagine how you would be doing. I'm not exactly at my best.)

Wish me luck, and the next update will be from the hospital!