This Machine Killed Cancer

Here I am on day six of my bone marrow transplant.  Actually, the doctors call it day -1.  They count down from day -6 (when I came in) to day 0 (when I get my stem cells back) and then start counting up from there.  So far, it’s been six days of chemotherapy and adjusting to living in a hospital.  The first and third nights were both really rough (crazy headaches, mouth sores, all over body aches), but mostly it hasn’t been bad.  Supposedly, I won’t start to feel really terrible until about a week from now (day +5) when the chemo will have depleted my system so much that I’ll be a true wreck.

I had the last of my chemotherapy this morning and I’m dizzy, but tolerating it alright.  There is a mild chance that this was the last dose of chemotherapy I will ever have, so that is something to celebrate (more on this later).  Much has been made of the fact that tomorrow, my transplant day (day 0), is my new birthday.  They even drew a cake on the calendar in my room - that’s how serious they are about it.  I don’t know how I feel about pronouncing it my second birthday.  It seems a little premature.  I’d rather wait for the words “complete remission” before I start celebrating.  Apparently, there is only a 30% chance that this process will cure me.  We’ll see.

I’m not entirely sure what to expect tomorrow.  I’ve been told that the doctors will show up at 10am with 13 syringes of my saved stem cells and dose me with them slowly over the course of an hour.  I’m told that I’ll feel flushed, tired and might throw-up (the only part that makes it seem like it could be a birthday celebration).  Oh, also I’ll smell like fish for two days.  Fish and creamed corn, I’ve heard both.  The smell comes from the preservative chemical that allows them to freeze and store the stem cells they took from me last month.

Adjusting to life in the hospital isn’t too bad.  I’ve been training for this all summer in one week sprints.  I read, watch TV, play guitar, do laps around the hallway, and play Wii when I feel good enough, and just lie around complaining when I don’t.  I still don’t get a lot of sleep at night, but it’s not terrible.  I’m also incredibly lucky to have Rebekah here with me 24/7, keeping me sane and fetching me things when I can’t move.  And just being generally lovely.

I mentioned earlier that there is (only) a mild chance that I’m done forever with chemo.  We went into this process thinking that the bone marrow transplant was the hail mary pass, the nuclear bomb of cancer medicine.  However, we found out yesterday that the team is discussing doing a second bone marrow transplant when this one is done.  The one I’m getting now is called an autologous transplant, meaning they harvest my stem cells and give them back to me.  The one they’re considering in the future is called an allogenic transplant, where I find a donor match and get their cells after future chemo destroys my bone marrow (again).  There is some benefit to getting someone else’s cells instead of your own - in theory my bone marrow has proven to be kind of crappy at fighting cancer and maybe someone else’s can do it better.  But there are also some very serious side effects, called graft vs. host disease, where my body will fight off the incoming cells because they are foreign to my system.  The allogenic transplant requires three months in the hospital instead of one, followed by a six to twelve month recovery period at home.

Either way, the next step is going to be brain and chest radiation (they call it “consolidation therapy”).  We have struggled to avoid brain radiation because of the potential side effects (memory loss, early onset dementia, making that “duhhh” sound a lot), but at this point are too overwhelmed by the possibility of relapse to disagree with the doctors.  The big question is, do we wait and see if the cancer relapses before doing the allogenic transplant, or do we throw everything there is at it now in hopes of a cure (considering, of course, the difficult side effects and overall inconvenience of going through another year of treatment)?  My team will be discussing this on Thursday (day +2) and we’ll keep you updated with what they decide.