Monday, July 25, 2011
GOD IS GOOD
So I have to share my exciting news! Today we went to UAB for pre-transplant tests (EKG, Chest X-ray, Labs, Echocardiogram). Those went great. While waiting in the waiting room for the nurse, Dr. Forero walks by. As always he hugs me and says "Hello Anita" and "How are you, Mr. Kirshkoff". Lol...Love him and his Colombian accent. I asked him if he would have time to show me my PET scan images and he said of course. I proceeded with all of my tests and then went back to his office. He already had the images on the screen and didn't have to say a word. I gasped when I saw them and all I could say was WOW. To compare the two, the image taken in May showed the tumor in my chest the size of a golf ball and now the image taken in July showed it to be about the size of a grape. I politely asked him, "So the radiologist who read the images was a complete idiot, right?" He smiled and said, "We clinicians just see things differently. This is why it is important not only to rely on the report but also see the images for yourself". To clarify, I was just told last week that my tumor didn't reduce at least 50% based on the Report....Now I'm seeing for myself that it indeed has reduced at least 50% or more. This is such great news because it means that the cancer is responding better than we thought. All I can say is that GOD IS GOOD. I couldn't stop smiling and still can't. Crazy the things that make me happy these days :)
Thursday, July 21, 2011
Meeting with the BMT team......
Yesterday we met with the bone marrow transplant team. What a scary day. Me, being the cheerful person that I am and all smiles was in tears by the time we left. Everything seemed so surreal until yesterday. Everything was brought to light. I have done my research and through my nursing experience knew about bone marrow transplantion and the process. However, when a doctor is sitting in front of YOU telling YOU all of the things that YOU will go through and what to expect it's a whole different ballgame.
Dr. Shelton politely came into the room and introduced herself to Mark and I. With her were her assistant and clinical coordinator. She started out by explaining my scans and moved to what her plans were for my care. She said that my PET scan that was taken a week ago was good but not where she wanted it to be for transplant. It needed to show at least a partial remission to proceed with transplant. Unfortunately, I am not there yet. So plans were made for another chemo and hospital stay. I will be admitted to the hospital on August 4th to recieve Cytoxan and VP-16. During this hospital stay I will also have another "line" placed in my chest called a Permcath that will be used for stem cell collection. The type of transplant I will have is called "autologus" because I will be my own donor.
Once home from the chemo treatment I will give myself 9 days worth of Neulasta shots. Remember, it is the white blood cell stimulator but it also pulls the stem cells into the peripheral blood. The dose I will be giving myself is much higher than the normal dose because I need lots of stem cells in the blood stream for collection. I have been told to expect "bone pain" because of the large number of stem cells coming out of the bone marrow in such a short period of time. On the 9th day of shots I have to go back for labs and stay in Birmingham until my bloodwork shows that there are enough circulating stem cells for collection. Hopefully this will only take a day or two. Collection requires being connected to a machine (similar to hemodialysis) and having the stem cells collected and what isn't used going back to the body. This process is call aphresis and can take several hours. Once enough stem cells are collected they will be frozen and stored until transplant. Sounds fun, huh? Not even to the good part!
Sometime around September 4th I will have another PET scan. Hopefully it will show a great response to the chemo. I pray it will amaze me and show remission. That would be wonderful! If not, we will discuss that then. If the scan shows that I am ready for transplant we will proceed, probably mid September.
Once admitted to the hospital, I will recieve approximately 10 days of "high dose" chemotherapy. The drugs Busulfan, Cytoxan, and VP-16 will be used. This chemotherapy will completely deplete my bone marrow of all cells (Red blood cells,White blood cells, and Platelets). In turn, my immune system will be wiped out. This is where the transplant comes to play. I will be given my stem cells back and once transfused they will migrate to the bone marrow and start to produce healthy cells. This process called engraftment, can take 2 weeks or more. During this time I will be very vulnerable to infection and bleeding. When my blood cells show that they are high enough to leave the hospital with no complication, I will be released from the hospital. However, I will not be allowed to go home because we live too far away. I will be released to a townhouse nearby the hospital because I will have to follow up with the doctors daily for a while and in case of fever or infection. Hopefully I will only have to do this for about 2 weeks before I can come home.
That's really all I know for now. I hope it didn't overwhelm or confuse you. You may wonder why I have to do all of this. The reason is I have no other choice. It is a lot to go through but I have to be around for my Allie. The consequence of not having the transplant is near certain death from cancer. Sorry to sound so harsh, but it's the truth. The transplants main purpose is to rid the body of cancer and all of the minute cancer cells that may be undetectable and to prevent another relapse. The high dose chemo can do this for some. The scary part is that there is only a 50% chance that it will cure my cancer. Heads or tails. I'm determined to be a part of the 50% that call themselves survivors. I was once, and I will be again.
Dr. Shelton politely came into the room and introduced herself to Mark and I. With her were her assistant and clinical coordinator. She started out by explaining my scans and moved to what her plans were for my care. She said that my PET scan that was taken a week ago was good but not where she wanted it to be for transplant. It needed to show at least a partial remission to proceed with transplant. Unfortunately, I am not there yet. So plans were made for another chemo and hospital stay. I will be admitted to the hospital on August 4th to recieve Cytoxan and VP-16. During this hospital stay I will also have another "line" placed in my chest called a Permcath that will be used for stem cell collection. The type of transplant I will have is called "autologus" because I will be my own donor.
Once home from the chemo treatment I will give myself 9 days worth of Neulasta shots. Remember, it is the white blood cell stimulator but it also pulls the stem cells into the peripheral blood. The dose I will be giving myself is much higher than the normal dose because I need lots of stem cells in the blood stream for collection. I have been told to expect "bone pain" because of the large number of stem cells coming out of the bone marrow in such a short period of time. On the 9th day of shots I have to go back for labs and stay in Birmingham until my bloodwork shows that there are enough circulating stem cells for collection. Hopefully this will only take a day or two. Collection requires being connected to a machine (similar to hemodialysis) and having the stem cells collected and what isn't used going back to the body. This process is call aphresis and can take several hours. Once enough stem cells are collected they will be frozen and stored until transplant. Sounds fun, huh? Not even to the good part!
Sometime around September 4th I will have another PET scan. Hopefully it will show a great response to the chemo. I pray it will amaze me and show remission. That would be wonderful! If not, we will discuss that then. If the scan shows that I am ready for transplant we will proceed, probably mid September.
Once admitted to the hospital, I will recieve approximately 10 days of "high dose" chemotherapy. The drugs Busulfan, Cytoxan, and VP-16 will be used. This chemotherapy will completely deplete my bone marrow of all cells (Red blood cells,White blood cells, and Platelets). In turn, my immune system will be wiped out. This is where the transplant comes to play. I will be given my stem cells back and once transfused they will migrate to the bone marrow and start to produce healthy cells. This process called engraftment, can take 2 weeks or more. During this time I will be very vulnerable to infection and bleeding. When my blood cells show that they are high enough to leave the hospital with no complication, I will be released from the hospital. However, I will not be allowed to go home because we live too far away. I will be released to a townhouse nearby the hospital because I will have to follow up with the doctors daily for a while and in case of fever or infection. Hopefully I will only have to do this for about 2 weeks before I can come home.
That's really all I know for now. I hope it didn't overwhelm or confuse you. You may wonder why I have to do all of this. The reason is I have no other choice. It is a lot to go through but I have to be around for my Allie. The consequence of not having the transplant is near certain death from cancer. Sorry to sound so harsh, but it's the truth. The transplants main purpose is to rid the body of cancer and all of the minute cancer cells that may be undetectable and to prevent another relapse. The high dose chemo can do this for some. The scary part is that there is only a 50% chance that it will cure my cancer. Heads or tails. I'm determined to be a part of the 50% that call themselves survivors. I was once, and I will be again.
On another note, I am thankful to be given to opportunity to fight. Some people aren't so lucky. I'm thankful for everything I have been blessed with and I'll do my part to beat this horrible disease. I have faith in the Lord and pray that he will use me for his purpose. All I ask for is prayers from everyone. Thank you in advance.
"For I know the plans I have for you", declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future". --Jeremiah 29:11
What Cancer Cannot Do
Cancer is so limited...
It cannot cripple love
It cannot shatter hope
It cannot corrode faith
It cannot destroy peace
It cannot kill friendship
It cannot suppress memories
It cannot silence courage
It cannot invade the soul
It cannot steal eternal life
It cannot conquer the spirit.
It cannot cripple love
It cannot shatter hope
It cannot corrode faith
It cannot destroy peace
It cannot kill friendship
It cannot suppress memories
It cannot silence courage
It cannot invade the soul
It cannot steal eternal life
It cannot conquer the spirit.
Author: Unknown
Chemo......I'm gonna smile :)
I wanted to touch on chemotherapy. The dreaded chemotherapy. After confirmed relapse I began my 2 cycles of ICE chemotherapy. Three drugs: Ifosfamide, Etoposide, and Carboplatin. Three little devils. First I had to have a port placed again. Luckily, the radiologist agreed to put it in the same spot as my previous one so that we could minimize scaring. After it was in the chemo began! The Etoposide was given over an hour for 3 days. The Ifosfamide was given after the first dose of Etoposide over 24 hours. After it was finished a drug called Mesna was given over 12 hours to prevent bladder bleeding, a side effect of Etoposide. Also, on the second day a single dose of Carboplatin was given over 2 hours. Have I lost ya yet?? I was in the hospital for a total of 3 1/2 days the first cycle and 2 1/2 day the second cycle. The cycles were 3 weeks apart. All of the doctors and nurses at UAB were amazing! While in the hospital, I was given an infusion of Decadron and Zofran each day to combat nausea. Thankfully they did their job and I had no trouble while in the hospital. I just rested a lot and would take walks with Mark. Coming home was a different story. The first days home I felt very tired and just blah. I took my oral Zofran 8mg every 8 hours and it helped with the nausea. I had no appetite at all and had to force myself to eat something. Totally not me. The second day home was always the worst. Went from feeling blah to feeling like I had the worst hangover known to man. Not sure if it was from the chemo or from the Neulasta shot I had to give myself on the first day home. The Neulasta shot is a white blood cell stimulator. By the third day I had more energy and felt better.
I had to be on "neutropenic" precautions 8 days after the chemo was started for 5 days. This meant no fresh fruits or veggies (everything had to be cooked), had to avoid crowds, no flowers, no sharing food or drinks with Allie. Its just a precautionary thing because this is the time my blood cell counts would be the lowest, increasing my risk for infection.
That's pretty much ICE chemo in a nutshell! It sucks but is well worth it to be healthy again. That is all :)
*The photo above was taken my first hospital stay on 06-01-11
*The photo above was taken my first hospital stay on 06-01-11
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