Day +15

"I see my light come shining
From the west unto the east.
Any day now, any day now,
I shall be released. "
Bob Dylan

I dream of the day I'll be discharged from here. Luckily that eventuality has been mentioned by the doctor today. My white blood cell count is 1.6. Other numbers appear to be on track. After the doctors usual poking around, listening, and looking in my mouth, he said I should start commuting soon, no date specified. Commuting means going home and returning for thrice weekly visits for blood test, poking, listening, and looking. When my whites reach an unidentified level, I remain active walking the halls, and I show that I can eat and swallow pills, they'll release me. But it'll be more like a parole after time off for good behavior. Whatever it is I'll take it!
I'm stoked that engraftment of the new stem cells is fully underway. This was a major milestone. From here, the battle will be fought on 2 fronts. First, prevent opportunistic infection. Second, respond to and mitigate and gvhd (graft vs host disease). These 2 threats are considerable but management of them has improved drastically over the last few years. They have drugs to effectively control all but the most severe cases of these buggaboos.
I have been told that the marrow production of red blood cells may take another week or 2. Over the last 10 days I've had daily transfusions of RBCs. I think this may have been due to pre-chemo RBCs dying. But today, my RBC count was 8.6, the same as yesterday. My next big hope and wish is that this number will not drop, but start increasing without help from any more donated blood.
What WILL remain over the next few months as I recover at home is fatigue and some nausea. The old body took a big hit with all the chemo. It will be very weak for a time. The nausea will most likely come from some of the drugs I will have to take.
Cathie and the kids have visited every day and made my hospitalization sufferable. Dad came in today for a couple hours since he doesnt feel a sore throat anymore. My mom has phoned in a couple days to wish me well and to make sure I'm eating my vegetables. I'm afraid I'm going to be a big bump on a log the next 2-3 months so I feel lucky to have such a great support team.
The reason I havent posted in 5 days is fatigue. I felt more energy today.
Thank You all for you continued support, well wishes, prayers. I am forever grateful for your daily inspirations to me and my family.
I might be dischargable from here by Monday! Yipee!

Day +10

A stem cell transplant is not something someone should lose one's hair over. This was my philosophy until as recently as last Wednesday. Unfortunately, in my case, it has happened. I suddenly started losing head hair a couple days ago and now am down to maybe 20% coverage. Viewed from the top,The non-loss areas seem to form a head shot outline of a bearded man. I was kinda hoping for a two-ended lightning bolt. I've now determined that the bearded head outline looks like that well known poster of 'Che', the latin liberator. Tomorrow he should be gone, fallen out. Then my head will look like a cue ball for several months. I've taken to wearing my beaney hat again.

I got the remote EKG device removed from my torso today. It was just another piece of hardware that I now wont have to lug around.

Today the doctor gave a good report. The manual blood count done after the machine counts shows an absolute neutrophil count (ANC) of 10. It also shows a WBC count of 0.1. The manual counts are done by hand but the ANC is more accurate.
The WBC count for a healthy person ranges from 4.5 to 11.
I'm on the board! My stem cell graft appears to be taking place!

Cathie and family hung with me today, once again lifting my spirits. Dad had a sore throat and is making sure he has fully recovered before coming back to my room. He phones me twice a day now. Bless his heart for his unwavering support. The nurses do not want anyone on the floor with any symptoms of infection.

Thanx to all of you!

Day +9

Yesterdays ultrascan showed perfectly functioning liver, kidney & spleen. Since I asked to see the screen during the ultrasound I had some concern about the spleen. At one point I saw a large round crater in the organ containing the clearly visible image of the head of a bearded man. I should have asked for a printout but did not even call the technicians attention to it. Since there were lots of strange images on the screen I'm not the slightest worried about it. I'm sure it was the morphine.
Last night I had an episode of cardiac arrhythmia, irregular heartbeat. They did an EKG and then a couple shots of Dijoxan. They say its normal to have such things happen after a major chemo assault on the body. The only other thing going on was rising levels of bilirubin. Most of the morphine I was pushing personally was due to stomach pain. Yesterday I decided to give Malox a try thinking that the problem may be rooted in stomach acid. The result was that I had to push the morphine button a lot less through the day and night. My early a.m. blood test report rewarded my patience, bilirubin levels were down by half. At this morning's doctor meeting I was told I was right where I should be in the process. In the next couple days I hope to see that blip in the blood counts indicating that WBC production has started. The new WBCS will automatically drift their way to my stomach, esophagus and mouth lining to fix the mucuscosis and resulting pain. I cant wait!
love you all!

Day +8

Feeling about the same since day 5. At this point the war in my marrow is resulting in the deaths of a lot of A-pos blood and platelets. I've been getting 1 unit of each per day. This also might be the reason for the occasional fevers. The blood I need to be rid of cuz the new B-pos will begin to replace it. A-pos and B-pos blood dont mix well. They say this period will end shortly. The mucusosis situation that causes the pain will get resolved when the new white blood cells are produced in high enough numbers and send repair cells to repair damage. To hasten this, they give daily shots of Neupogen. This evening I spent a half hour getting an ultrasound of the organs in my stomach area. The results will be evaluated to see if there has been any damage.
I'm still sleeping a lot, from 8pm last night to 8am today, and then several times through the day. Cathie came twice, the second time with Dylan and Maddie. I can see the relative calm that you have bestowed upon Cathie with your prayers, thoughts, inspirations, and good will. I feel very humbled and strengthened by your efforts for me too. I thank you from the bottom of my heart. I'm not sure one family alone would have enough strength emotionally and spiritually get through a time like this.

Day +5

Today they hooked me up to a PCA, Pain Control Apparatus. This is a fifth pump added to the pump panel. The slot contains a huge syringe full of morphine. Click on the picture to get an appreciation for this puppy (997k). The PCA pump is programmed to drip morphine slowly into the patient. Additionally, the unit has a button. So, when I feel the pain coming on I can deliver my own dose. However, the button can not be used more than once per 6 minutes. I'll have to make sure I dont wait too long, cuz it could take 1/2 hour or so to get the needed relief. Also notice how the whole unit is locked with a key! Smart fellows these biomed device workers.

The other picture I posted here is of the round bag of stem cells from Wednesday. The collection actually has more than just myeloid stem cells.
My white blood cell counts are officially zero now. When they start going up in a week, they will be new white cells, not the old. Meanwhile the doctors must keep my system supplied with Red and Platelets, cant let these even close to zero.
When the white blood cells start appearing they will, as their first task, repair the damage to my stomach, esophagus, and mouth. For this reason, I'll be provided with morphine until then.
My Dad will not be visiting for a couple days because he thinks he may be coming down with a cold or flu. Cathie visited today, made me feel better just by being there. I'm not very talkative in my morphine haze but Cathie is forgiving.
Thanx everyone.

Day +4

I wasn't much good the last couple days. But feeling better today.
It started Friday when I got a very nasty stomach ache. Turns out is is most likely Mucositis, a common side effect of some of the chemo. The result of M. cover the gut to the mouth. In the mouth, it's called mouth sores. This can go on for a week or so.
No one had really spoken about pain management here so I didnt know much except they like to horde their tylenol (I'm sure for good reason). Friday afternoon I suddenly knew that tylenol wasnt going to help. It turns out, and maybe I shoulda known, that one should build a lag time to get prescribed a new drug. By the time I got a pill of Vicodin I was well on my way to doubled over in pain. 1/2 hour later... relief. I took a second Vicodin to finish off most of the pain. So... out with tylenol... say hello to my new leetle fren; Vicoden. Friday night I tried the Ativan/Vicodin combo. All well and good except I could not stay awake all day Saturday, which was my Day +3.
During the day I was conscious enough to realize that the old drug combo sukd. Consulting with the Doc and the matrix oracle I decide to switch to another 2 drugs. So... out with Ativan/Vicodin, say hello to my newest friends; Patch and Morphine. I now have a common fisherman's nausea patch behind my ear to control nausea, and I get a small shot of morphine every 4-6 hours to deal with the pain of mucusitis. This combo works well now. I had a good day. Hopefully I've seen the worst of the mucusitis. The doctor thinks there is a good chance it wont get worse. Today I was able to eat half of all 3 meals, took my required walks around the floor and was able to stay awake all day.
Plluusssss, a certain sporting event went well for San Diego... Yay!
I will now have some kind of fond memories, of sorts, from my stay here. As a matter of fact, I'll be here for the next Charger game on the 19th. After that, on tap is the Buick Invitational starting the 21st, which I can watch live (through some tree branches) below on the golf course. Oh! life is good! But wait... what if the Chargers lose next week? Ouch. Well, I guess I'll still be getting morphine. ;-)
Kinda funny about that today. Around an hour before the game, the nurses made rounds and gave all the patients stronger shots of morphine. The nurses disappeared until after 2:30. mmm... Patients were roaming the halls crying out "Nurse! Nurse! Nurse please!". Ok. NOT.
Back to whats real. Cathie, family and my Dad visited much the last 2 days and continue to give me a light to look for at the end of this tunnel. Cathie was there when I was in pain. She rubbed my feet and back, gave me encouragement galore. It was hard for her to see me in that state and I hated to let her see me like that.
Thank you for all your support!
Doctor says I'm progressing well.

Day +1

In the plus column now! I have pix of the stem cell event and will have to get the energy to transfer them from my camera to the laptop so I can post a couple. The infusion of stem cells was from one round bag. The cells were collected the previous day from the donor and transported from somewhere to here on ice. The infusion itself only took around 10 minutes. There was some normal reactions to the cells for a few hours, but today that has passed. The hosp staff is very compassionate and attentive but they dont hand out tylenol like m&ms. Even though I'm not a tylenol abuser its a good thing they guard their tylenol stash.
I am happy that the worst of the chemo is over. They will give me 4, including one today, more small injections of Methotrexate over the next 20 days. There should be no side effects from this chemo. It is normally used in large doses but I guess they found that 4 small shots after a sct keeps the new stem cells from growing too fast. I wont go into the many other non-chemo drugs I am starting to get. Come to think of it I really dont know how to describe how a chemo drug differs from any other drugs. They're throwing a lot of new pills my way and I will be taking many of them for the next few months. They will ALL trail off by 6-9 months if everything goes well. Kinda weird, but that's the story.
At my asking, Cathie came today early and stayed for most of the day, only leaving to take care of necessary things, and come back with Maddie. My Dad also came and stayed for several hours. My family is so great. I am not close to being myself mentally yet they are so supportive. I feel kind of like I must be the stranger to them that I feel I am to myself. But they continue to recognize me somehow.
Well, it's 10:30pm now. Nights are very long in my room. I'll be hanging here in this room for another 2-3 weeks as the new stem cells start regenerating and doing what they do. Between now and then my old white counts go to zero then start springing back with white cells from the new stem cells. A positive WBC improvement is the main key to getting discharge from the hospital. I cant wait to go home. I'm starting to eat a little now. Mouth sores and hair loss have been negligible so far.
Long road ahead.
Thanx everyone for your many inspirations.
Jim