As July and all the preparatory testing comes to a close, and by the way, all the tests say: "Full steam ahead" for the transplant. We move forward!
August 2023, heretofore, shall be known as "Bone Marrow Transplant Month,… and all that that entails"! The dates are set, so "Here. We. Go."
"So let it be written, so let it be done." (Name that movie)...
How am I feeling, scared, nervous, optimistic, positive, eager, and supported... or S.N.O.P.E.S - although the details below are no #NoCap You can expect that I may be offline for a bit while I'm recovering, so here's the timeline, with some color commentary…
July 28:
Prep meeting with Oncologist and Pharmacist and sign consent docs.
July 29-31:
Hyperproducing Stem Cell Meds Injected each morning (at home). These meds cause the marrow to create the gobs and gobs (that's a technical term) of stem cells that will be harvested for the transplant. As a result, I can expect some minor bone pain, and I will be counterbalancing that with some Claritin… Did you know that it helps with bone pain? No? Me neither!
Oh, and also, on the 31st, we're having a fire restoration company come in and disinfect/sterilize the whole house... #DeathToBacteria
August 1:
More Stem Cell Meds, and then the central line is installed (not a port but similar in concept). They'll also take labs to see if the stem cells are in the bloodstream or chilling out in the marrow. If it's the latter, they'll add another med to "kick 'em out into the bloodstream for the harvest." Kinda like a momma bird with her babies… Let 'em flow, let 'em flow, let 'em flow.
August 2 (and maybe 3): Harvest time – a.k.a. Apheresis (that actually is a technical term – sort of like dialysis). So everyone, do your Stem Cell Harvest Dance! The goal is 8-10 million collected (enough for two transplants… just in case I need another in the future). I'll be hooked to an Apheresis machine for 4-6 hours. If they get them all on day one… then nothing to do on the 3rd.
If not, we go back for a second harvest.
August 4: Labs, meet with the Dr., and a covid test.
August 5-7: Stay home and don't get sick while the wizards at Duke continue to process and freeze the stem cells (my new marrow) for the transplant the following week.
August 8: Chemo drip that will wipe everything out. This is the first step in the transplant process. And apparently, I'll be chewing a metric ton of ice to avoid mouth sores. We now own stock in popsicle manufacturing companies as well. It's just a short-term pump and dump.
"You're.supposed.to.push.WEBISTICS!" #SopranosFTW
August 9: New Marrow (Stem Cells) are reinfused. This is known as "DOT" (Day of Transplant), and the team will refer to each day as DOT+, and I will go to the hospital daily for labs. Depending on what they show, I may be there for just a couple hours, or if I need medications or blood products, up to 6 hours. Also, this begins the great temperature reading of August. Essentially, during waking hours for the rest of the month, I'll take my temperature every 4 hours to stay ahead of any potential infections. Anything 100.5 and up, and I've got the equivalent of a Disney FastPass to admission. #PinkTicket
August 10-16 – DOT+1-6:
I've been told that, in general, I'll be tired but not feel "too terrible" as the Chemo continues to do its job of beating up the Myeloma plasma cells (and every other cell in my blood – wiping out my immune system at the same time). Daily trips to the hospital for monitoring and rest are the majority of the days… that and trying to play "dodge 'em" with every kind of bacteria or virus. Lots of masks in the house, Purell, Clorox wipes, and Netflix.
August 17-23 – DOT+7-14:
Say hello to "Neutropenia". This is supposed to be the worst of it. White cells are at an all-time low, and so are platelets and red cells. Therefore, my ability to fight off illness is nil. I will be most susceptible to infection at this point, and the team said it's highly likely that despite all the care and precaution, I will catch something and spike a fever. At which point, I'll be taken to the hospital, use my #FastPass and be admitted for care with broad-spectrum antibiotics and whatever else is needed to address the ailment. The admission could be 24 hours, or it could be a few days… "It just depends."
August 24-30 – DOT+15-21:
Since white cells are the fastest to rebound from the chemo, I've been told I should start "feeling better," but I still have a long way to go before I'm "back to the new normal." Platelets and red cells will still be low and take a long time to rebound… so it's still likely that during my daily trips to the Blood Cancer Center, I may still need red cells or platelets infused. And the plan is to "graduate" from the Bone Marrow Transplant Center in Durham and return to regular care at the Cancer Center in Raleigh.
Upon graduation, I'll have weekly labs and meetings with my Oncologist to ensure "good cell" counts continue to rise. And roughly 60 days post-transplant, we'll take the first Myeloma cell count readings. If everything has gone well, I would exit Phase 2 and move to Phase 3, which is ongoing maintenance and treatment to keep Myeloma in remission.
It takes a year to recover and have a "fully functional" immune system. I'll be grounded (no flying for six months). At which time I'll start to get immunized again.. and for the first time in 20 years, have "EL CRAPPO Status"! Hoping that #DeltaAirlines takes pity on me. :)
But I'm not going to get too far ahead of myself. Eye on the prize, yes, but as Tobias says in Sweeney Todd, "work to be done, so much work to be done."
I hope it goes as smoothly as possible and that it's ONE time thru the grinder and not three! #SondheimHumor
Again thanks for all the support, love, prayers, vibes, etc.! When I'm up to it, I'll keep everyone posted on my progress and how I'm feeling. So until then...
Go, MIke
You got this Mike….your attention to detail and putting it in writing for us to enjoy like reading like a good book will keep us thinking of you daily and then saying prayers and sending good vibes your way!