The Plan

Ok, so this is the post where I lay it all out and try to explain things so it may end up lengthy, for those that know the stem cell transplant process, feel free to gloss over, lol... for those that want to know exactly what my next  3 months look like... read on!

So we will start with June. I finish up my GDP chemo by the 14th. The 25th I have a bone marrow biopsy and aspiration. This will be done in Vancouver, as will a lot of what follows.

Bone marrow aspiration removes a small amount of bone marrow fluid and cells through a needle put into a bone. The bone marrow fluid and cells are checked for problems with any of the blood cells made in the bone marrow. Cells can be checked for chromosome problems. Cultures can also be done to look for infection.

A bone marrow biopsy removes bone with the marrow inside to look at under a microscope. The aspiration (taking fluid) is usually done first, and then the biopsy.

The 26th I meet with the aphresis team so they can evaluate my veins before stem cell collection. This may be a scary one for me as I have no veins left in my poor arms... hopefully it will go better than I am imagining! I may also see the 'cancer' dentist this day to make sure my mouth doesn't have anything lurking that could cause problems after the transplant.

So before all of this fun stuff I will also have other tests that I don't know the date for yet. These are tests to make sure all my major organs will handle the transplant process. They will include blood work (they cant get enough of that these days, 12 vials yesterday!!), a kidney function test, lung function test, maybe and echo cardiogram, not sure what test they do for the heart yet.

The next step after making sure my body will withstand the transplant is to get ready for the transplant.

June 28th-July 1st I will get a series of neupogen shots. This stuff is pretty cool as it stimulates the production of white blood cells, in particular CD34 cells. This makes more cells available for the harvest of stem cells.

July 2nd and 3rd is off to Vancouver for the actual harvesting of my stem cells. I will be attached to IVs on both arms, one arm will be sucking the cells out to be harvested through a machine, while the other arm gets the remaining blood put back in (apheresis). Similar to dialysis of the kidneys we were told.

July 8th I will go back to Vancouver to get a Hickman Line inserted. good news is after my chemo locally the PICC line can come out. The Hickman Line will come out of my chest and have 3 tubes attached so they are able to have multiple things hooked up at the same time. Sounds like it is better than the PICC, but with my issues I have concerns with everything that has to do with veins!

July 9th is my admission date, go in and get ready. July 10-15 I will be receiving BEAM chemo.
      carmustine (BiCNU®)

etoposide

cytarabine (arabinoside)

melphalan

This is a high dose chemo that will wipe out all the white blood cells in my system, hence the need for the transplant after.

July 16th is day 0, this is the day I get my wonderful stem cells put back into my body. For the next 10-15 days I will be in the hospital in an isolation ward (yes I can have visitors) until my blood counts start to climb up. It takes about a week for the levels to increase, so in the meantime I have no immune system and will be receiving blood transfusions as needed. After my counts have started to climb, I get to go out of the hospital... but not home yet. For another couple weeks I have to stay somewhere that is close to the hospital as I will be in on a daily or semi-daily basis to keep watch on how I am doing. Hopefully if all goes smooth I can be back home mid- August.

At the end of August I will have a PET scan to make sure the transplant was successful. If its all good then it goes to regular scheduled check-ups, if it come back bad then we will go on to radiation.

I think I have included everything that will be happening. As things happen I will update on the procedures and how things went.

So until then I will say goodnight!