Warning......Long Post

There isn’t much new to report, but I figured typing a lengthy blog would kill some time for me. And since a few of you may be wondering why I am sitting in an apartment doing nothing in NY, I thought I’d spend a moment explaining the medical side of things for anyone that may be interested.

But first….the news…. I have had some really good days, like yesterday, and some blah days, like Sunday and today. Most days I venture outside at least once to stretch the legs. Today is pretty cold and since I don’t feel good I am staying in. Mom decided to do a little cleaning, and I’ve been kicked out to the lobby until she’s done vacuuming.

I know I say it all the time, but I miss Brant and the kids terribly. Tomorrow is two weeks since I left home and it is by far the longest I have ever been away. I look at the picture of the three of them them constantly (my Valentine's gift from Brant). We talk daily and Brant is doing so awesome, he definitely gets the Superman award this year. He is juggling work and school and two baseball teams - he even helps coaching Chris' team. His mom is a great help and he says the days fly by with so much to do, which is such a blessing for them. He is so positive about this process and manages to lift my spirits every time we talk. I can't wait to get home.

Yesterday we went to the local branch library which was fun. As a non-resident, I couldn’t get a library card without paying $100, so we opted for a several items from the used book sale which were much more reasonable at total of $6.75! Later mom hit a Barnes & Noble (can you believe it!!) and bought Bookopoly (no Park Place Monopoly available) and an interesting book on New York.

Speaking of Mom and her outings, she did get a little cocky the other day and hopped on a bus headed in the wrong direction. Instead of getting off, she figured she would just “loop around” on it. Well, 20 minutes later the driver was saying “Last Stop”. She managed to make a transfer, see the UN, and make her way back home. She just said it was a cheap sightseeing tour!!

So for my Stem Cell 101…..It is frustrating to just be sitting here in NY when I feel like I could recuperate in Chesapeake. But the doctors prefer to keep me close during this recovery phase (in case of fever or complications which would require readmitting), and I would have to be back for stem cell collection next week anyway.

I have now completed two rounds of ICE chemotherapy, one back home and one in New York. The chemo drugs work by killing any cells that are dividing rapidly, which cancer cells typically are doing. Unfortunately, the body also has some regular cells, like hair follicles and the lining of your mouth, that are also dividing rapidly and get killed by the chemo. That is the reason for the unpleasant side effects. But the most important innocent bystanders that get killed are the rapidly dividing cells in your bone marrow that make all of your new blood cells. The amount of chemo given is limited by how much they can “damage” your bone marrow and still have it recover. This is called the toxicity limit.

In an effort to kill more cancer, Stem Cell Transplant was developed as an option to enable giving higher doses of chemo. In this scenario, they have figured out how to “trick” your body into making lots of the stem cells that will eventually become the new bone marrow cells. While these little guys are circulating in the blood for a few days, they can collect them in a process that is very similar to dialysis. They store the harvested stem cells for later use. Then they can give a dose of chemo that is so high that the bone marrow can’t recover. Once the chemo is over, the patient is given back their own stem cells (that were in cold storage) where they find their way back to the bone marrow and start making new blood cells.

Right now I am in the “tricking” my body phase. I finished chemo and it has damaged my bone marrow cells. As the regular blood cells start to die off, there aren’t any new cells to replace them because the bone marrow is still being repaired. This is what I keep referring to as my blood counts are dropping. Instead of just waiting for things to repair on their own, those clever scientists found a way to jump start the process. They isolated the hormone that your body naturally makes when it needs to start making new stem cells. They can genetically manufacture the hormone with some help from E. Coli (yuk!) and give it back to me in shots of Neupogen (the brand name). This shortens the period I will stay with low blood counts and also helps my body to overproduce stem cells.

So mom hits me with two shots each day of Neupogen and my body is working to crank out the new cells. My bones ache (think flu) while all of this is kicking in gear, but Tyelnol helps. Although the counts of white blood cells (and with them, my immunity to germs) are still dropping, the new stem cells that will eventually help make new white cells are ramping up. By Monday I should be able to go to collection and have the stem cells removed from my blood through a special dialysis type machine. The goal is to collect six million of them to save for my future transplant step. My white blood count should also be recovering by then.

Ok, so not that all of you wanted that much detail, but it was in my head and I thought I’d share. Tomorrow I have a doctor’s appointment just to check my blood counts and make sure everything is tracking well. I will post results of that tomorrow night.