One Step Closer to Transplant

It has been very nice to be at home in between my many trips back to Richmond.  The only day I wasn't in Richmond this week was Thursday. But the roundtrip drive isn't too bad and well worth it to be at home in the evenings!  Earlier this week I did the majority of my pre-transplant testing that included CT scans, pulmonary function, nuclear medicine cardiac stress test, and a psychosocial evaluation (no comments, please...haha).  They also did a TON of labwork.  I seriously got lightheaded when I saw the table top full of tubes lined up for the blood draw.  The lab stickers to go on the tubes was easily 5 feet long.  I later found out that it takes between 6 and 10 of these tubes to fill up one shot glass, so that made me feel a little better.  I think they took between 15 and 20 tubes.

Today Brant and I spent most of the day in Richmond for our consult visit prior to transplant.  They went over the results of my testing and discussed my transplant regimen.  We had lots of good news. 

First of all, my labwork looks great with very normal numbers by cancer patient standards.  My platelets were 209 today.  That is normal even for non-cancer patients! The were 20 last Friday, so quite a jump in one week. My bone marrow has definitely kicked back in.

Next, my biopsy was still clear with no evidence of Leukemia.  This is great news since it is critical for a successful transplant to start with little to no disease.

I was most excited to learn that they have selected a reduced  intensity chemo pre-transplant regimen with no radiation.  At first I was surprised and worried that it wouldn't be effective enough.  But the doctor said there was no reduced chance for a cure.  Then I was a little defensive because this regimen was originally developed for older patients who can't tolerate a standard transplant regimen.  I was like "you don't think I can handle it??"  The doctor assured me that for my disease type and being in remission this is the regimen they would select regardless of my previous chemo and current organ function.  I quickly realized I was arguing for more toxic chemo with a man much smarter than myself and got my ego back in check.  Less chemo will be just fine, thank you. 

The consult with the transplant doctor was really awesome the way he explained everything and even made some sketches and graphs.  My tooly personality loved all the data.   It took me back to the couple of physiology and biomedical engineering classes I had in college.  And my doctor even got his undergrad in mechanical engineering like me!  Everyone we met with today was wonderful and we are once again so impressed with VCU-MCV-Massey as we transition from the oncology group to the transplant team.

The only bit of bad news is that my heart and lungs did show some damage from previous chemo treatments. The lung function isn't too bad but the heart issues will require a consult and clearance from the cardiologist.  So back to Richmond I go on Monday.  For you cardio people I had reduced left ventricle ejection fraction and I think something about some heart wall damage that could be related to coronary artery problems.  A lot of that really didn't sink in but he did say that there was a chance I will need catheterization.  I will learn more on Monday and prayers are appreciated that I will not need any procedures.

My tentative admission date is July 24th or 25th.  This may slide back depending on what the cardiologist wants to do.  The inpatient process will last around 3-4 weeks.  Lately I have really been struggling with dreading to go back for more chemo and not wanting to be away from out family.  But today was so upbeat that it gave me some more energy and desire to get on with this and take another swing at cancer.  I hope it lasts!!