T + 50

I realize the blog entries have slowed down and hopefully that's a sign that life is trending back towards normal.  Today marks day 50 past the transplant and everything seems to be headed in a positive direction.  My visits to the clinic have been dropped from three to twice weekly and each one continues to show good results.  My restrictions on driving, restaurant food, and large crowds are still in place and I expect them to remain through six months due to the immune suppression drugs I'm taking to keep the transplant in check.  My fatigue level is improving such that I only need a nap 1-2 per week now verses every day.  I've been able to exercise more with bike rides and some basic stretch and strength exercises.

I've been talking to another guy at the clinic with the same diagnosis as me and approximately the same age.  He's at day 112 and was getting his central line removed.  That puts me around the start of October to get mine removed.  That will be a great step forward as it's still uncomfortable to sleep on the leads at night and I will be able to get back to the tennis court.  Other than that and dropping to one visit per week and having another biopsy (fun), there's technically no other big changes at 100 days which was a little disappointing to me.  It seems more that 180 days is the big mark as that is when they can remove many of the drugs (I'm still on 9-10 different meds) and really allow you some additional freedoms.

As for the non-medical life, we're going to back up and move back to Vero at the end of this week.  The kids start school soon and we're already missing soccer practices.  It will be good to get back to our house and see the ocean again.  Joanne is really looking forward to it as she can return to Crossfit and start seeing a few patients.  The girls are looking forward to not having to share a room any longer - the charm has apparently wore off.  And Tyler will have his refereeing job starting back up.

So full steam ahead for now!

T + 30, Return of the Taste Buds

It wasn't a day after I wrote the last entry when I broke out in hives all over my body.  Very itchy and almost a burning sensation.  In addition, the last two weeks have seen a few bouts of nausea, chills that pop up at irregular intervals, and some major blisters on the bottoms of my feet simply from walking around the neighborhood.  So my body is still at war with itself as the new cells take up home. 

All of the trips to the clinic have been fine.  I receive a bag of IV fluid to continue to keep my body hydrated.  But other than a little magnesium yesterday, I haven't need any other transfusions.  Most of the battle is dealing with the side effects of the transplant.  In talking to the doctors and sitting in the clinic hall with other patients, nothing I'm experiencing is unexpected, just unpleasant.  Yesterday they took a marrow biopsy at the clinic, so add a shank wound to my lower back to my list of ailments.  From this biopsy they'll test that the AML is still in remission, and they'll also test to see the percentage of blood inside the marrow is from the new cells vs. the old cells.  A high count from the new cells is expected which shows that the engraftment was successful.  From here I continue with my office visits 2-3 times per week up through 100 days when they will take another (and hopefully final) biopsy.

My taste buds are slowly returning although food still tastes dull.  Joanne continues to make all my meals as I'm still on a restrictive diet and I'm not allowed to eat restaurant food for fear of contamination.  I was doing a pretty good job walking a few times each day until the blisters developed on my feet this past weekend.  My skin is obviously more sensitive than usual since walking two miles should not have normally caused such damage.  They're feeling better now, so I hope to resume my exercise soon.

The kids have stayed busy with camps here in Orlando.  Brenna is even going back to Vero to stay with her best friend this weekend.  We've been someone limited to watching TV / Movies since I can't really go out into crowds.  But we've managed to entertain ourselves so far.  Our plan is to remain in Orlando through mid-August, then head back to Vero when school begins.  I will be up around day 60 by then and hopefully will be down to two visits per week to the clinic which we can commute to from Vero.

T + 17, Independence Day

I had a great week after being released from the hospital.  The kids were all away still with camps, it allowed Joanne and I to get into a routine out of the hospital.  The best part of course was eating my wife's great cooking rather than hospital food.  I was also able to start with some mild exercise and stretching as I begin to rebuild.

I had two follow-up visits to the clinic and both went well with no need for any additional fluids to on-board.  My mouth and throat were the last sore spots remaining from the chemo treatments, they are healing slowly.  I'll continue to visit the clinic 2-3 times per week with the next big milestone coming up at Day T + 30 when they'll take another marrow biopsy.

All the kids will be back today, really looking forward to seeing them and being together for the fourth.

T + 13

I woke up early from another broken night of sleep at the hospital. Hopefully my last one as I'm scheduled for release today.  It's been 21 days since I checked in which brings my total for the year to just over 60 total days in the hospital.  This one was both mentally and physically challenging.  The first week of chemo and anti-rejection medications made me sick.  The transplant itself was smooth, but I took on several of the typical symptoms post-transplant.  Sore mouth & throat, upset stomach, and fevers all featured in the week following the transplant.

The blood numbers have progressed as planned, first zeroing out then starting their comeback generated from the new cells.  By Friday (T+10) they had recovered to release levels.  I just needed to hold them for three days to get the official word.  Today is the third day and everything is still in line.  I do still have some mouth sores and I'm experiencing Engraftment Syndrome where parts of my body feel warm and itchy.  This is another sign the new stem cells are taking hold.

Once I'm released, I move to the next phase of the process which is to get to day T+100 which will involve several visits per week back to the Cancer Clinic where they will continue to test my blood levels and transfuse any liquids that are off.  At day T+30, there will be a test that will determine what percentage of my blood is getting produced by the new cells verses the old.  They will also perform another bone marrow biopsy to test for any return of leukemia.

Cliff Hanger

Sorry for the Cliff Hanger, I'm still here.  The transplant took place on June 17th without incident and I've been recovering as expected so far.  There have been some sleepless nights, two bouts with high fevers, and continued GI discomfort.  I spent most of the first two days post transplant in bed feeling like I'd been run over by a truck.  I'm catching up with the fatigue now and the fevers have stopped.  We're still waiting for the WBC counts to zero out which allows the new cells to take up home in the marrow.  After that, they will begin to make blood cells again and recover my counts.  That's all suppose to be around 12-14 days post transplant.

Tricky Rabbit

T minus 2 (June 15)

Well the good news is that I'm done with the pre-chemo, but after getting sick overnight my stomach was not feeling any better.  I had to switch to bland diet of soup stock and crackers to get through the day.  I still have to continue the Rabbit through tomorrow and I'm assuming it's the thing causing the problem.  Of course, I'm stocked up now with so many meds, it could be a combination of them.

T minus 1 (June 16)

All meds are in and now it's mostly waiting around until tomorrow for the cells to show up.  I have flashes of my donor calling in sick or some freak storm causing a traffic backup that doesn't allow the Currier through.  I asked my doctor if they fly the stuff in via helicopter, he says no, just standard overnight delivery.  Crazy.

I'm still not feeling 100% on the digestive track but I've been able to eat a little at each meal.  The kids are getting tired of coming to the hospital, but have been making the best of their Orlando time.  Joanne bought them all passes to Aquatica park and tonight my sister is coming over with their cousins to hang out for a while.  I was able to top off a week of soccer by watching the USA v. Ghana World Cup game.  I took a walk after the game as my exercise has fallen off a little with the upset stomach, then a quick shower and to bed.  I could already tell it might be a long night.

Counting down the days

T minus 5 (June 12)

Joanne and the kids finished packing up the house for the summer and drove to Orlando.  They made it up in time to bring me some dinner and then stay on to watch the kickoff of the World Cup in Brasil. Tomorrow they had their eyes on going to Sea World's water park called Aquatica. At the hospital the second round of chemo well by without any problems.

T minus 4 (June 13)

I started my day with some more extensive exercising.  I'm determined not to let the stay affect me as much as my first one here.  There's no general restriction on exercise except that I have to always take the stand.  The central line rules do not allow any time off if for walking around freely.  The family stopped by after their Aquatica adventure, they had a good time there and now have passes to return all summer.  The World Cup had three games so no wasting time on soap operas.

T minus 3 (June 14)

The last day of pre-transplant chemo, there's more to come after the transplant to make sure my old cells don't grow and the new ones are allowed to take hold.  The chemo was going find, but today there would be an additional medication called Thymoglobulin, it's derived from Rabbit protein and is nicknamed the Rabbit.  Seems cute a fuzzy enough.  They did tell me that shakes and chills area  common side affect.  They weren't kidding.  My the midafternoon I felt like I was in a full-blown cold with aches, pains, and chills.  I lost my appetite for dinner even though Joanne had made a great homemade blueberry dessert.  I did manage to get that down, just like Lard Ass in Stand By Me...

My suffering became worse during the night and I started to experience some nausea.  Several times I fell to sleep to stave it off, but it was no use.  By 2:00am I was reaching for the plastic bucket and calling for Tylenol for my head.  I spiked a fever, which triggered additional blood cultures and a check X-ray.  I'm feeling much better rolling to T minus 2 but pretty tired.