Saturday, February 16, 2013

Proposed Transplant Schedule

Here is the summary of the transplant schedule I sent out to those that requested it last Wednesday


Several of you have asked about the schedule for the stem cell transplant. I did have a couple of unexpected setbacks in January,  two hospitalizations, one for pneumonia which turned out to be a yeast infection, and therefore didn’t respond to antibiotics and one for dehydration, an after effect of the first.
I began the transplant process last week with a number of pre-transplant tests, however the actual process begins tomorrow. Then I will begin receiving injections of a drug which stimulates the production of blood cells in the bone marrow. The following week I will receive injections of a drug that mobilizes those extra blood cells from the bone into the bloodstream. We will also begin the process of stem cell collection which involves running my blood through a machine to extract the stem cells. This is very similar to being on a kidney dialysis machine and will involve 6 to 7 hours per day. Most patients complete the stem cell collection in two days but this could stretch out for as long as four days. This process is scheduled for February 19 through the 22nd.

The following Tuesday, November 26 I will check in to the hospital for the beginning of the actual transplant process. Tuesday will be devoted to the injection of high dosage chemotherapy. The high dose chemotherapy is toxic to the bone marrow cells, so after it is completed marrow cells need to be returned. The stem cells harvested the previous week will then be injected on Wednesday the 27th. In all the literature they described this as your rebirth day or day zero on their calendar. It is expected that I will be pretty much nonfunctional until day eight. At that point I'm expected to begin to feel some return to normality. Stem cell transplant patients usually remain in the hospital from 3 to 4 weeks so were looking at a go home time anywhere from day 21 to day 28.
I will then continue to be on close monitoring until around day 100 as my immune system will be very comprimised. There is the possibility that if the expected response does not materialize a second transplant will be recommended. Sufficient stem cells are collected initially to allow for this second transplant.

Generally it is expected that it will be six months after the transplant before you return to normal. At this point the doctors are expecting that I will need to take monthly chemo shots to keep the cancer under control. However the expectancy of the control period could be in excess of five years where without the stem cell process life expectancy was less than two.

So I'm bracing myself for this process, not looking forward to it but it's better than the alternative. Eileen has been very supportive and I don't know what I'd do without her.

I hope this answers most of your questions if not let me know and I'll try to provide any additional information you might want to know about.


Thanks for all your thoughts, wishes and cards. Wish me luck and I'll be letting you all know how things are going.

Al
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