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.

Drips and the Electric Chair

I had the third and last of my chemo-drips yesterday, but from today we're on to an extended regime of multi-drips instead.  Two different drugs (Cyclosporine and Mycophenolate) which assist in preventing the body from rejecting the Transplant.  This of course is a Good Thing (don't want my body rejecting the transplant without considering the alternative options properly; and I am rather relying on it to come to the sensible conclusion), but it does mean that I'm hooked up to the Drip Machine for 6 hours a day.  That's 3 lots of 2 hours, the last one starting at half past midnight tonight.  So a new skill required, sleeping while being dripped.  The nurses assure me it's no problem, so who am I to disagree?

And thank heavens for the Hickman line (see Hickman & Marrow post of 3rd Feb), which makes these drips easy and painless, and without which I'd have more punctures than the Tour de France.

Only side-effects so far have been wooziness and tiredness from the chemo (glad that's over then) and a very slight headache from the Myco-whatsit last night.  Nothing that a couple of paracetamol couldn't deal with though.

Which reminds me:
Q: Why aren't there any painkillers in the jungle?
A: Cos the parrots eat 'em all...

And the Electric Chair?

Not the US Death Row version, happily, but a very comfy Recliner which changes position at the touch of a button and makes sitting about all day a veritable pleasure.  However, I have had to evict Julia from it most ungallantly because it's not big enough for two.  Nothing to do with the fact that I can't get a look-in on my new iPad cos Julia is addicted to playing Harbourmaster on it.  Not entirely inappropriate for a one-time shipping executive, I know, and it's keeping her quiet, but also increasing her stress levels, I fear.

Had time to get out for a walk in the countryside with Julia this afternoon in between drips.  Grey, drizzly February day, but great to get out of confinement for a while.  Until/unless my neutrophils drop below a count of 1 (official definition of neutropoenia), I'll still be allowed out from time to time, which is v nice to know.

D-Day tomorrow: TBI (Total Body Irradiation - a 20 minute burst of radiotherapy) followed by the Transplant.  But the timing is still uncertain and won't be fixed till tomorrow morning (Wed 16th), so I'll try and get time to post a comment to this posting tomorrow when I get the schedule.  So that you can target all those Luuuurv Lasers.  I'm not expecting any pain (thank goodness) but my poor old Bod is in for a Biiiiiiig Surprise.  It's coping well so far.  Long may it last.

In and Out

Julia took me in to the Marsden this morning at 11.30 as scheduled.  I checked in to my room and then had my first dose of chemo administered through the Hickman line.  63mg of fludarabine, to be precise.  All went smoothly, though I felt a little light-headed and slightly disconnected from Reality for a while (so what else is new?).


In and Out in quick succession

And then they let me out again!
Hooray!
So I was home in time to watch the rugby before having a few zzzz's this afternoon.

Very civilized.

And we should be able to perform the same routine tomorrow, so my proper incarceration won't start till Monday.
That's the plan anyway.

The chemo is of course essentially Poison.

Targeted poison, but still poison.
The idea is to reduce my immune system to rubble with three days of fludarabine, then give it a final nuking with a single burst of radiotherapy on Wednesday, immediately before the Transplant.
That clears the battleground for the new troops to move in, i.e. the new blood stem cells from the transplant donor.

During this initial bombardment of my old (and malfunctioning) immune system, I am also being given lots of prophylactic medicines to prevent all sorts of likely infections taking unwelcome advantage of the lack of a resident defence force before the new one moves in.  That's the Theory.  Now for the Practice...

Radioactive Pincushion

In the Marsden again today for heart and kidney tests to make sure my system can take the stress of the Transplant.  Scanned, blood-tested and injected, not necessarily in that order.  Six needles in all during the day, which is definitely my record.  The most interesting was an injection of radioactive tracer which they then followed through my heart and kidneys.  I have been advised to "avoid prolonged close contact with children for the rest of the day to prevent exposing them to unnecessary radiation".  Julia will be watching closely to see whether I glow in the dark when we turn the lights out tonight.

Tattooed!

In the Marsden today for the first of four appointments on consecutive days this week.
All sorts of interesting preparations for the Big Day.

The dragon tattoo I didn't have

Today they were setting things up for the single dose of radiation that I am due to have on the 16th Feb immediately before the Transplant itself.  The idea is to zap my old (malfunctioning) immune system just before introducing the new one from the donor.  So I had a CT scan (lying on a bed going to and fro through a giant ring of shiny humming machinery) so that they can determine exactly how much radiation to give me on Feb 16th and where to aim it.  And in order to ensure that everything's lined up on Feb 16th exactly as it was today, they moulded the bed around me with a vacuum bag filled with polystyrene granules and then tattooed my chest and stomach.  I asked for a dragon, but was only given a couple of very central freckles.  My first tattoos though.

Back tomorrow for kidney and heart tests.