T-Day

Drip, drip, drip.
A veritable Day of Drips.
Not content with six hours of Cyclo and Myco (see yesterday's post) again today, I've also had eight hours of drip either side of the Transplant (four before and four after) to boost the fluid content of my blood, as well as the Transplant itself.  Lots of Simultaneous Dripping to reduce the overall time connected, but still a total of 13 hours in the day hooked up to the Drip Machine.

Two new skills learnt today: sleeping and dressing while connected to a drip.  Neither as difficult as they sound, so long as you're careful...  Thought about attempting a drip-
connected shower too, but decided that would be just too much Excitement for one day. Got to have something to look forward to.

The TBI was a breeze.  Lined up by my tattoos (see Tattooed post of 1st Feb) with lasers, so that it was accurately targeted, I just lay on my back and meditated for 20 minutes to the strains of Jeff Buckley singing Hallelujah!  They turned me round once at half time, so that both sides were evenly cooked and done to a turn.  Mustard, anyone? 

The TBI is the medical equivalent of a Tactical Thermo-Nuclear Device.  It kills all the fastest-dividing cells in the body, which takes care of the stem cells in the blood and bone marrow, but also includes the entire lining of the digestive system, from mouth and throat, all the way through the gut to the Other End.  So the most likely side-effects arise anywhere along that tract, from Mouth Ulcers to Montezuma's Revenge.  Can't wait!  Happily the damaged cells are replaced fairly quickly, minimising long-term harm.

Nurse Helen,
the Stem Cells (in the bag at the top),
my Spoons and Me

And then at 440 pm the Transplant itself, which was another drip, though that took just 55 minutes, the least time-consuming part of the whole treatment so far.  But the most colourful.  All the other drips are colourless.  The Transplant cells were a Life-Affirming, Health-Giving, Rejuvenating Blood-Red.  Actually they were rather more like chilli sauce or watery ketchup, but allow me a little poetic licence.  Just astounding to think that they were a vital part of someone else's body less than 24 hours ago.

So far my body has proved amazingly resilient to all this Rough Treatment and apart from a little shortness of breath when the stem cells went in and some fatigue at the end of the day (hardly surprising), I have felt no side-effects.  Astonishing how my heart immediately recognised the difference between all the chemicals we've been pumping in and these alien stem cells; hence the slight shortness of breath.  Anyway, the Alien Invaders are the Home team now, streaming into the system, weapons at the ready, settling into their new bone marrow home (which we hope they find very comfy and well appointed) and ready to deal ruthlessly with any surviving members of the Old Guard who were so brutally bombarded and disarmed this morning.  No, Dixie, I haven't joined the army; I am the Battlefield.  But the worst of the Destruction is over now.  Let the Rebuilding begin!

My Marrow Spoons have been by my side throughout the day, a constant reminder of their mysterious message of Hope and Meaning from beyond this temporary life.  Temporary, but not too short, we hope.

Finally, a big Thank You to everyone sending vibes from their Lurv Lasers.  Or just plain thoughts and prayers.  Not to mention all the texts, emails and blog comments.  All very gratefully received and surely a Valuable Reinforcement of the medical procedure.

St Valentine's Day

Boom boo-de Boom

An appropriate day to pay homage to the Generosity and Altruism of Bone Marrow Donors, one of whom is having the stem cells harvested from his blood tomorrow for my benefit.

The donation process involves having a short course of injections to stimulate the stem cells from the bone marrow into the bloodstream so that they can be collected more easily.  These jabs can cause flu-like symptoms temporarily.  The actual collection of the stem cells typically takes about four hours, and involves taking the blood from one arm, passing it through a machine which separates and collects the stem cells, and then replacing the blood into the other arm.  So the donor is sitting for several hours with a cannula in each arm while this process takes place, before taking a few days off for recuperation.

So it's certainly not as simple or as easy as giving blood and requires the donor to take several days out of his or her normal life in order to accomplish this undeniable Labour of Love for someone he or she has never seen and doesn't know.  The whole process is conducted anonymously, so all I know about my donor is that he is a 25-year-old male from the UK.  I can only guess at his motives, but am enormously impressed and grateful in equal measure.


Sorry........couldn't resist it



All my three siblings very generously volunteered to be tissue-typed to see if their bone marrow matched mine and all were prepared to donate their marrow for me.  But since it turned out that none of them was a match, the Marsden contacted the Anthony Nolan Trust and found that I had no fewer than 722 matched donors on their register.  This is a much higher number than normal (typically a recipient will have matched unrelated donors in double or single figures) and enabled the Marsden not only to pick a donor whose tissue type matched mine perfectly but also to choose one with other medically useful matching characteristics.

And if his golf handicap is lower than mine and he can pass on that ability too, it would be a welcome bonus...

There's more information on www.anthonynolan.org

The Marrow Spoons

Well, here they are at last, as promised.
And here's the story.

In July 2004, some nine months before I was diagnosed with CLL, my godfather Tom died and left me in his will what appeared to be a rather strange bequest, namely two silver marrow spoons.  Once a rather more common sight on dinner tables than today, marrow spoons are used for extracting the marrow from the bone in meat dishes, the classic example being osso bucco.  When Tom's wife sent them to me, she said she wasn't sure why he had chosen them for me, and although I daresay he wasn't sure himself at the time, they have now assumed a very evident significance.

Aside from the obvious bone marrow connotations, the silver is symbolic too.  First, because silver is traditional for gifts from godparents to godchildren; indeed, some 54 years ago Tom gave me a silver christening mug to celebrate my arrival on the planet.  Second, silver has long been known for its healing properties and is a powerful killer of microbes, both bacterial and viral.  Since Hippocrates first commended it in the 4th century BC, it was widely used for the prevention of infection before antibiotics were discovered, and hospitals, including the Marsden, use it even now, especially for the treatment of burns.  And third, Tom, a distinguished physicist at Cambridge University, studied, wrote and taught about the physics of liquid metals.  Although I don't know whether that included silver, it would be nice to think so.

For more on the healing properties of silver, this is an excellent website:
http://www.uk-cs.co.uk/index.htm

The actual transplant procedure that I will undergo involves no scraping or probing with marrow spoons, I'm glad to say.  However, it will now be clear how charged with Meaning and Mystery those spoons have become.  They are very special to me.  I keep them on my desk and think of Tom often when they wink at me.  He and the spoons will be with me for the Transplant.

Hickman & Marrow

Hickman & Marrow.  No, not a gardener's seed merchant, but a couple more medical procedures enjoyed today.  I won't go into too much gory detail, but if you're squeamish about hospitals or ops (only minor ones), probably best not to read beyond this first paragraph.  Unsurprisingly I find the medical stuff quite interesting because it's happening to Little Old Me, but I do appreciate that it's not quite the same reading about someone else's surgical experiences.  Less on the medical front after today with luck, because I don't have any more hospital appointments between now and admission on Feb 12th, barring a couple of quick visits to check the Hickman Line (see below).  And I know I still owe you the story of the marrow spoons.  Coming soon, I promise.

The Hickman Line is an intravenous catheter which is used when the docs need longer-term intravenous access.  They can put drugs in or take blood out without having to keep inserting needles.  It's a few inches of tubing inserted into a vein in the chest, just below the collar bone.  I'll spare you the picture here, but if you're interested you can Google 'Hickman line' and see what it looks like on someone else.  So a dose of sedative and some local anaesthetic, and ten minutes later I had my very own Hickman Line, including a couple of stitches to hold it in place.  It'll stay there until I'm out of hospital and on the mend, unless some joker pulls it out by mistake or I catch it in the mangle (ouch).

And while they had me on the table and under sedation, they took a needleful of bone marrow and a small sliver of bone as well, both from the back of the hip bone.  I've had this done before several times, though not sedated, because analysis of these bone and marrow samples is the best way to measure the progress of the CLL.  More accurate than blood tests.  So today's samples will serve as the baseline for my pre-transplant condition.  Again, if you're interested, there's a good diagram of the procedure here: http://www.healthline.com/adamimage?contentId=1-003658&id=1129

Personally I prefer this picture of a marrow: