Day Zero

Day two of the transplant procedure was much better than day one. We were at the clinic for seven hours. I handled the amifostine and melphalan with no difficulty. The most annoying part was having to suck ice chips for one hour prior to and during infusion of the melphalan and then for an additional four hours afterwards. That got to be very boring. Due to the drugs I’d received, in particular Benadryl, I was sleepy. Thanks to my caregiver (Marilyn) I remained diligent. Clinical trials have proved the effectiveness of this ice treatment in minimizing the degree of mucositis following high dose melphalan. I sucked ice until 7:30 PM. Then I had dinner.

The powerful melphalan dripping into me along with my jar of 'little things' on the tray table.

The powerful melphalan dripping into me along with my jar of 'little things' on the tray table.

I slept well Tuesday night, taking zofran and antivan before lying down. Wednesday, I went to the clinic for blood work and visit with the team. Basically, though, it was a free day. Today is Day Zero. Half my stem cells will be thawed and infused through my Hickman catheter. I can’t wait!

This week I’ve crossed paths with a couple of acquaintances from the clinic. Twice I met the guy, C, who carries the coconut sized golden orb with him wherever he goes. He has Hodgkins disease. He received an autologous transplant five years ago. The cancer returned and his best chance was for an allogenic transplant. Such a transplant requires a donor. The opportunity for a cure/remission improves but the mortality rate is significantly higher. One of his brothers provided the stem cells and it has been 41 days since the transplant. Like me, he is well informed about the treatments and drugs. He likens his experience at the SCCA and the Hutch as being science fiction. I agree.

Another guy, G, I’d met on the infusion ward when I received my first chemo back in early July. He has an aggressive and rare Adult T-cell leukemia and has been under treatment for some time, long enough that the options are diminishing. Recently, he received an allotransplant. When we first talked his white cell count was zero. We couldn’t even shake hands. “Yeah,” he said, “I’m crawling with bugs. I’m a short-timer.”

When we spoke this week, he mentioned that the blood numbers from his transplant were improving but his team was disappointed at the pace. He half smirked and smiled, as if to say, “Whatever.” Evidently, this Friday they will determine what the next step, if any, would be.

This happy face watched over me in the infusion room.

This happy face watched over me in the infusion room.

I am at the beginning of my science fiction experience. We are all so probed and assessed; at times it is hard not to feel like a specimen. All of us are experiments from which statistics are derived. Pre transplant treatment such as the drugs I received during the winter and spring are called induction therapy. The chemo to induce my stem cell production and yesterday’s chemo is known as conditioning therapy. Maintenance therapy is the name for post-transplant treatment. The options abound. The determination for which direction I might go comes about three months after the transplant is complete. That is one reason why today is Day Zero.

In a future update, I will define the types of responses and the timing for optional treatments of the maintenance variety. I try not to get ahead of myself but my contacts here at the clinic remind me that blood cancers persist. I can live day-to-day knowing that decisions about my illness must continue to be made. I am comfortable with that.

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