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
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