2007-March

Plan “B” Starts

After a lot of test procedures were completed I was finally ready to move forward with Plan “B.” It was the beginning of a very long summer.


List of events

  1. March 13, 2007 — More Tests
  2. March 29, 2007 — Time to Harvest My Stem Cells

  1. March 13, 2007 — More Tests
    Now, let me say upfront, many people may think this is crazy, but I strive to conserve my sick days at work. So I asked my coordinator if at all possible to get the next battery of tests I needed scheduled together. As it turned out that plan worked, and today is the big day. I think you might enjoy hearing how my little trip to the cancer center went.

    We started out the door this morning just before 8:00 a.m. and loved driving east from our house towards the Interstate. The sun was so bright perched just above the horizon. I put on my sunglasses and enjoyed every ray I could see as I trekked off to my visit at the cancer center.

    Traffic was terrible as I expected so I quickly detoured to the secondary roads. The journey was a bit frightening as several cars darted in and out of traffic like the drivers didn’t have a clue the rest of us were there beside them. Then we finally arrived at our destination around 8:30 a.m.

    The short walk from the parking garage and down four flights of stairs got the blood pumping and I was ready to take on the challenge in front of me. In all honesty I must confess I had read a scripture from the Bible, and had prayed for strength before leaving the house.

    I also had my beautiful bride with me as a tour guide. I was ready to conquer the giants in front of me.

    After checking into the cancer center I immediately reported to the lab where a young man stuck my right arm and drained about ten tubes of blood from my body. Then, not thinking clearly, I let him pull the IV and I headed off to my next test.

    I had two chest x-rays taken right there in the same area of the hospital and headed to another floor to the Nuclear Medicine area where they performed a MUGA Scan. Had I remembered to leave the IV in they could have drawn the blood they needed to tag my red cells and put the new mixture back into my body.

    But since I failed to do that the young lady, who I might add was a student, simply poked my left arm and we were headed down the road to success. I had just a short wait before the lab finished preparing my blood for the test then it was quickly completed and I was on my way.

    The next test was an EKG and it was over in a flash.

    Finally, we made the journey through the maze of the hospital to another building and we arrived in the pulmonary department and I had a pulmonary function test run. That involved an arterial blood test and some heavy breathing into a machine. It was all over in a jiffy.

    I had finished all five tests and was back in my car driving out of the parking lot in exactly four hours.

    The stairs were a bit more of a challenge on the way up than they had been on the way down. But that’s what keeps me healthy.

    I got a call late this afternoon and my doctor already had all of the results except for a few of the blood tests. I am blessed to report the tests were all very normal.

    Since I had these same tests run back in 2001 they had my old records to compare with today’s tests. Everything was the same or better than before. So like I said I am very blessed and I am very thankful.

    Tomorrow morning I will get a routine dental exam, which is actually part of the stem cell transplant evaluation protocol. It will be done in conjunction with my regular six month cleaning. Then we are off to the races so to speak.

    When my wife talked to my transplant coordinator this afternoon she asked that my doctor evaluate any clinical trials that I may be a candidate for, and look at all my options to help us decide for sure which direction we want to go next. The next step for now is to start Neupogen shots next week in preparation for a stem cell harvest the following week.

    When that is finished I will jump right into the next treatment regimen. Right now the preliminary plan is to use a radioimmunotherapy (RIT) treatment regimen called Zevalin in an attempt to get the cancer back into complete remission.

    It is so wonderful to have the options in front of me in this era of medicine. I feel so blessed to have these opportunities and to literally have them in my backyard (so to speak).

    Another exciting fact: Now that we have adjusted to the new daylight savings time here in Kansas we love the extra daylight in the evenings. It sure seems like spring is in the air and we are getting anxious to seeing the plants come to life.

    My wife pointed out the Daffodil plant in our neighbor’s yard that has already started to bloom and it was sure beautiful. It won’t be long until we are seeing green everywhere.


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  2. March 29, 2007 — Time to Harvest My Stem Cells
    I reported to KU Medical Center’s Cancer Center on Thursday, March 22, to get started with Neupogen shots in preparation for an autologous stem cell transplant. Remember: The goal for me is to simply harvest my stem cells and hold them for future use.

    Terminology
    Perhaps this is a good time to introduce some terminology that better explains the Hematopoietic Stem Cell Transplant I’m being prepared for. The first step, with the Neupogen shots, is called mobilization. The shots contain growth factors to get my blood ready for the collection my peripheral blood stem cells.

    The second step, after the initial shots are completed is called Apheresis. This is a procedure where my peripheral blood stem cells are drawn from one of my arms and circulated through a machine that removes my stem cells. During this process the rest of my blood is returned to me in the other arm. I am my own donor thus, if it is needed, I will have an autologus bone marrow transplant.

    I used the National Marrow Donor Programs Glossary to clarify the terminology I used her so I could explain it in more detail. The glossary contains a lot of useful terminology about bone marrow / stem cell transplants.

    National Marrow Donor Program Glossary

    After the nurse gave me the first shot, she had me give myself the second one. This was to make sure I could administer them to myself over the weekend.

    While all of this was going on I had another man sitting there waiting to take me on a special field trip in the hospital. He was personally overseeing my stem cell harvest procedure and his goal, the first time I met him, was twofold. First, to take me on a field trip so I would know where to report the following Monday morning. Second, to examine my arms to see if they could accommodate the two IVs required for the procedure. (If not I would need to get a catheter inserted in my chest.) I was pretty happy when Dean told me both of my arms would handle the IV and that I didn’t have to get a catheter. We were off to a wonderful start and I really liked the new person that was getting ready to take care of me.

    After giving myself two shots a day over the weekend, I reported to the lab on Monday, March 26. I met Dean and a new man by the name of Kiah. They very quickly loaded that special chair, the place I would sit for the next four hours, with a pile of pillows that would help me get comfortable. Then they helped me get seated in just the right position with both of my arms laying out flat on top of pillows. I sat there in a fully reclined position anxiously waiting what would come next.

    They called for a nurse to come into the room and insert an IV in my left arm so it could hopefully stay there for the number of days this procedure would take. When she left the room Dean asked me if I wanted a countdown as he prepared my right arm for the last IV. (My right arm was going to be home for a fairly large needle. A regular IV wouldn’t work because it was the source for the machine that would pump the blood from my body and siphon off those precious stem cells that might one day save my life. My left arm was simply the place the machine pumped my blood back into my body after it was processed so it could be somewhat flexible.) Just as I answered Dean, “Whatever you want to do,” he quickly answered “OK – I’ll do it on three.” And wouldn’t you know it – just as soon I started a conversation with Kiah – the countdown began.

    Dean said, “one, two, (I felt the stick) three – OK – I lied” and we laughed about him jumping the gun. For anyone that hasn’t had an IV inserted in their arm take it from me the humor helps you put up with all the pokes and sticks. And by the way this man was very experienced and it didn’t hurt me at all.

    In order to keep this short I will simply say that I didn’t have any problems at all. The process took a full four hours to the minute on Monday. Then, nearly the full four hours again on Tuesday (they gave me a 20 minute reprieve) and I was done. They had warned me to plan on three or four days so I must had done very well.

    There was no pain except for the bone pain which is merely like the aches and pains from having the flu caused by the Neupogen shots. That’s because the shots were given to activate my bone marrow and get those stem cells out into my blood stream for harvesting. It actually felt pretty good to have the process going.

    As the stem cells were collected from my body the pressure seemed to subside. I was a little apprehensive about getting the needle poked back into my arm after the first day, but I only had to do that on Tuesday. The same old spot worked great.

    Again, there wasn’t any pain as Kiah hooked me up. Finally, late Tuesday afternoon, I got the call to tell me I was finished and I could take out the IV and stop the shots. What a wonderful experience. It was finally finished and I had a stash of life saving stem cells sitting there in case I ever need them.

    I struggled with a little nausea caused by the shots, but that is pretty much gone today. I also went to work on Tuesday afternoon and worked the rest of the day without any problems.

    One more thing: People have asked me how new the stem cell transplant procedure is. As it turns out The University of Kansas Medical Center has been doing this for a long time. The following information tells the story.


    THE UNIVERSITY OF KANSAS HOSPITAL
    UNIVERSITY OF KANSAS MEDICAL CENTER
    December 28, 2006 – January 03, 2007 CENTER eXpress:

    Transplant Program Marks 30th

    As 2006 draws to a close, so does the 30th anniversary of The University of Kansas Hospital Blood and Marrow Transplant Program.   The program has existed nearly as long as bone marrow stem cells have been used to treat cancer patients. Stem cells in bone marrow are mature, or adult stem cells, and are the most common type of stem cell used to treat disease.

    According to Barry Skikne, MD, professor of hematology and oncology and director of bone marrow transplantation at the hospital, stem cell transplant procedures continue to improve each year, with greater success and suitability for more patients. More than 9,000 people in the U.S. undergo stem cell transplantation annually for leukemia, lymphoma or myeloma.

    In October, 49 of the hospital’s former transplant patients gathered for the fifth Celebration of Life Banquet, which included the transplant program’s physicians, nurses, technicians and patients’ families. The largest such event to date, the banquet honors bone marrow and peripheral stem cell transplant patients who have received treatment at the hospital.

    Speakers included former transplant patients Rose Marie LaCapra, North Kansas City, Mo., and Stuart Lindell, Shawnee, Kan., who shared their experiences in the fight against cancer.

    “The celebration is a really good opportunity for the hospital staff to see our transplant patients again and recognize the impact their care has had on so many,” said Dean Merkel, the hospital’s stem cell lab manager.

    Just in case anyone is interested Dr. Barry Skikne is my doctor. I am very blessed to have the best of the best in this field personally taking care of me.

    Finally, I have a tentative date of April 9 or 10 for starting the Zevalin treatment regimen. I am very excited to finally be at the point where something is being done to kill off those dreaded cancer cells that are working inside my body.

    I am on final approach and I can see the runway clearly. The gear is down and locked, and everything is a go for landing. I am anxiously awaiting my arrival at the gate and to hear Dr. Skikne tell me the Non-Hodgkin’s lymphoma is in complete remission again.


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