Adventures in BMT: Day -1

“I sustain myself with the love of family.”
– Maya Angelou

I was allowed one last walk outdoors before transplant day. It may be weeks post-BMT before I’m released from hospital, so one of my loving nurses offered the chance to disconnect from my conditioning plan for a short visit with the pups.

It took careful planning, timing and patience, but Gabriel brought them down to Emory and Ramon took them home.

Chris and Katrina made it safely to Atlanta this morning, and Alexis will close the circle as she returns from SCV for transplant day. Together, we are ready to face the next and most significant part of this journey.

Adventures in BMT: Day -5 and -4

“My aim is to achieve sustainable change, not just make a cute little makeover.”
– Jamie Oliver

Today, the nurses organized a mini Lancôme makeover party. We received samples of products, a cute makeup bag and a shower sponge. They served yummy petit fours and sparkling pink lemonade in little champagne flutes. It’s like a cruise around here. But seriously, these amazing nurses make it worthwhile.

I have settled into my new digs and the associated routine of hospital life. The food is the biggest challenge so far. I can’t eat the salads that I love so much nor the fresh plums, peaches and apples I adore. Bacteria in produce makes it unsafe – so I’ve been reduced to oranges and bananas which are protected by their inedible skins. Safe vegetables have to be cooked to within an inch of disintegration in order to be free from bacteria.

On the upside, there are these thick milkshakes available every afternoon at 3 PM in chocolate, vanilla and strawberry flavors. I suspect they’re meant for the post-transplant period when nothing stays down and solids are impossible to chew, but I’ve already made them a habit with chocolate being the flavor of choice.

Two new conditioning drugs have been added to my regimen. In addition to the Fludaramine started on Tuesday, I now receive a 30-minute infusion of Prednisolone (a steroid) to lessen the adverse effects of Anti-thymocyte globulin (ATG). ATG is an infusion of rabbit-derived antibodies against human T cells and is used in the prevention of rejection in organ transplantation. The ATG infusion runs over 6-hours. Stay tuned, there are more drugs coming prior to the transplant.

I know, this is riveting information. You’re welcome.

Adventures in BMT: Day -6

Yesterday, I reported to Emory University Hospital at the crack of dawn to have a triple lumen catheter placed in my carotid artery. The catheter will be the conduit for the chemotherapy infusions needed to kill my faulty bone marrow before the transplant.

After the procedure, they whisked me to my in-patient room which will be my home away from home for the next few weeks. The room has floor to ceiling windows which makes it very bright. I also love my little hospital bed. Really.

I instantly fell in love with the nurses, techs and doctors who will take care of me during my stay.

There’s a gigantic Keurig single-serve coffee maker in the break room which is stocked with all kinds of coffee and tea flavors. There’s also ginger ale, ice cream, Italian ices, crackers and dry cereals.

To wrap up the day, I received the first dose of pre-conditioning chemo therapy at 9 PM without any adverse effects. Fludarabine prevents cells from making DNA and RNA, which stops cell growth and causes the cells to die.

So far so good.

The Time Has Come

“You raze the old to raise the new.”
― Justina Chen, North of Beautiful

In six hours, I will be admitted to Winship Cancer Institute to begin a 6-day regimen of intensive chemotherapy. The intention is to destroy all of my damaged bone marrow so I can receive a transplant. The countdown is measured from day -6 to transplant day 0. In hospital speak, when my whole immune system is reset, I will have a new birthday.

My donor is enduring a five-day regimen of injections to increase her production of stem cells and force the stem cells out of the marrow and into the bloodstream. On the day of the transplant, she will be hooked up to a machine like a dialysis machine. Blood will flow out of one arm through the machine which will “harvest” the stem cells and the remaining blood will be put back into the other arm. This is about a 6-8 hour process for the donor. The stem cells will be stored in a bag very much like a regular unit of blood. Since the donor is outside of the USA, they will put the harvested cells on a flight to Atlanta, and a courier will transport them to the hospital. This precious lifeblood will need to be transplanted into me within 72 hours.

The hope is that the new stem cells will take hold within 30 days and begin to form new bone marrow within my bones. About that point, I will begin to face “rejection” issues — “graft vs host”. Some of this effect is good — the immunity effect of the new “graft” will hopefully destroy any remaining damaged bone marrow and leukemia cells.

I’ll remain hospitalized until my new stem cells engraft and begin multiplying. Needless to say, I am very apprehensive about all this, but at least we are moving forward now.