transplant plus one

It is Thursday and I am on the other side of the stem cell transplant procedure. It all feels a bit surreal since the effects of the chemotherapy that I received on Tuesday will be experienced between three and seven days after the treatment. It means that in the meantime I am living in limbo between the treatment and its effects on my body. Yesterday, while waiting for the stem cell transplant, I felt quite healthy and had to remind myself that my life was about to be rescued by a small bag of cells that had been taken from me four weeks ago. It was such an ordinary day and yet a day on which my life was about to be saved.

four days

News today from the bone marrow transplant centre that there has been a cancellation next week which means that my transplant will not have to wait until the following week. I am now scheduled to have chemotherapy on Tuesday, September 13 followed by the stem cell transplant on Wednesday, September 14. Both of those procedures will last all day. After that I will visit the centre every other day for a few weeks (unless I have a fever that will require me to be at the centre daily in order to receive intravenous antibiotics). I can expect to be at the lowest ebb in terms of white blood count on the weekend of September 18, with things beginning to improve once the stem cells graft back onto my bone marrow in the two weeks following. It is good news that we can get on with the transplant procedure in four days. I will enjoy the good weather and my good health this weekend and then buckle down to the task at hand next week.

the bright field

"I have seen the sun break through
to illuminate a small field
for a while, and gone my way
and forgotten it. But that was the pearl
of great price, the one field that had
the treasure in it. I realize now
that I must give all that I have
to possess it. Life is not hurrying

on to a receding future, nor hankering after
an imagined past. It is the turning
aside like Moses to the miracle
of the lit bush, to a brightness
that seemed as transitory as your youth
once, but is the eternity that awaits you."


- R.S. Thomas

rescheduled

The good news is that I have a new date confirmed for my stem cell transplant. That means that I am cleared to move forward. I am in good health. The recurrent fevers that bothered me throughout the month of August have disappeared. The effects of three months of taking large doses of steroids have worn off. I have received a ten day treatment of intravenous antibiotics to make sure that there are is no lingering infection in my bloodstream. The doctors are satisfied that my immune system can be shut down and then jump-started again without great risk. That is the good news.

another postponement

Another week that has not gone as planned. Another postponement of the stem cell transplant. Another week of waiting. Last week my stem cell transplant was postponed for one week because of a continuing and mysterious fever that showed up again on the Tuesday night before my scheduled chemotherapy treatment last Wednesday. Everything was moved ahead one week to today and tomorrow. Many tests were undertaken to make doubly sure that no bacterial infection had been overlooked. Along the way multiple blood samples were taken to see if bacterial cultures could be grown in those samples. While I was having fevers none of these samples tested positive. Alas, after the fevers had subsided (I have not had a fever for a week) two of the many cultures that were taken tested positive for a staff infection. This is a bit of a mystery since there are no fevers accompanying these positive results. My doctors suspect that these test results may have been false positives resulting from contamination. However, all agree that we must be absolutely sure that my immune system is not reduced to zero by chemotherapy when I am harbouring a bacterial infection that would then be free to multiply. As a result I am undergoing a full round of intravenous antibiotics that requires ten days of treatment. Today I completed my seventh day of daily trips in to Vancouver General to receive the regular dose of antibiotic. I keep reminding myself that this is now my full-time job and that the drive to VGH is now my commute. Once the ten days are complete and I have no more fevers or signs of possible infection I will be rescheduled for chemotherapy and the stem cell transplant as soon as a spot comes open.

becoming a patient

Well, this week has not gone as planned. The mysterious fevers that have recurred on and off recurred again on Tuesday night. The medical team responsible for the stem cell transplant wisely decided not to move forward with chemotherapy on Wednesday. Instead, it has been postponed for one week and is now scheduled for next Wednesday, August 31 with the stem cell transplant set for Thursday, September 1. In the meantime, we have gone on a search to see if it is possible to determine the source of the fever. The good news is that the fever hasn't returned again since Tuesday. The important work is to be absolutely sure that it is not being caused by a bacterial infection as this would leave me open to a serious infection after the chemotherapy destroys my immune system. It may be the lingering effects of a viral infection, which would be much less problematic. So, I have spent three long days at the hospital on Tuesday, Wednesday and Thursday. Most of the time has been spent waiting for tests. On Tuesday I had a Hickman line inserted into my chest. It is a nifty three way portal which means that I don't need to have an IV inserted into my arm whenever I need to have a blood test or receive an infusion of blood or antibiotic or fluid. The line is to remain in place for the next month or so. On Thursday I had a fascinating test in which some of my blood was removed, the white cells were spun out and and irradiated before being returned to me. Later in the day a gamma camera took pictures of my body to see if there may be an infection somewhere in my body that the white cells move to. I find out the results later today. In the meantime one of my multiple blood cultures came back as positive for infection. While this may be a false positive the medical team is treating me with antibiotics to be doubly sure. This means daily trips to the hospital right through to Wednesday's scheduled chemotherapy. Fortunately I am feeling quite well right now and so am able to drive myself to and from the city.

the props assist the house

The Props assist the House

Until the House is built

And then the Props withdraw

And adequate, erect,

The House support itself

And cease to recollect

The Augur and the Carpenter –

Just such a retrospect

Hath the perfected Life –

A Past of Plank and Nail

And slowness – then the scaffolds drop 

Affirming it a Soul 

- Emily Dickinson