2008-January

January Updates

The month of January, as you will see from the list of dates and events, was very busy. It started with the approval process and then me entering into the hospital to move forward. Each day listed is very significant. This is a good time to explain that the first 100 days after a Bone Marrow Transplant are critical. And the recovery process goes well beyond that.

While reading my story please remember that not everyone’s experience is the same as mine. People can have various complications and much harsher circumstances that I did. Sometimes people don’t survive.

I have been very blessed over many years and get the honor of being a long-term cancer survivor. My goal here is to provide you a basic understanding about this medical procedure.

List of events

  1. January 4, 2008 — Approved for the BMT
  2. January 8, 2008 — BMT Day Minus 7
  3. January 9, 2008 — BMT Day Minus 6
  4. January 10, 2008 — BMT Day Minus 5
  5. January 11, 2008 — BMT Day Minus 4
  6. January 12, 2008 — BMT Day Minus 3
  7. January 13, 2008 — BMT Day Minus 2
  8. January 14, 2008 — BMT Day Minus 1
  9. January 15, 2008 — BMT Day “0” (zero)
  10. January 16, 2008 — BMT Day Plus 1
  11. January 17, 2008 — BMT Day Plus 2
  12. January 18, 2008 — BMT Day Plus 3
  13. January 19, 2008 — BMT Day Plus 4
  14. January 20, 2008 — BMT Day Plus 5
  15. January 21, 2008 — BMT Day Plus 6
  16. January 22, 2008 — BMT Day Plus 7
  17. January 23, 2008 — BMT Day Plus 8
  18. January 24, 2008 — BMT Day Plus 9
  19. January 25, 2008 — BMT Day Plus 10
  20. January 26, 2008 — BMT Day Plus 11
  21. January 27, 2008 — BMT Day Plus 12
  22. January 30, 2008 — BMT Day Plus 15
  23. January 31, 2008 — BMT Day Plus 16
  1. January 4, 2008 — Approved for the BMT

    2. I am excited to have good news to share with you today. Our prayers have been answered and my follicular non-Hodgkin’s lymphoma responded to the salvage RICE chemotherapy regimen I just completed. This is a day to praise God for his blessings.

    During my visit with Dr. McGuirk he also had some additional news to share with me. He has made a change in my treatment plans and honestly I still haven’t gotten over it, but I want everyone to know.

    My pretests have all been completed, and my healthcare insurance company case manager just called to confirm that I am cleared to go in the hospital next week for the Bone Marrow Transplant (peripheral blood stem cell transplant). I have a consultation meeting with the doctor on Monday to go over all the details and sign my consent form. Then, the change is, that I will check-in to the hospital on Tuesday morning to get started (our original plans were to do my transplant outpatient). You can see why I said I still haven’t gotten over it. This means I will be hospitalized for three to four weeks.

    Now let me clarify that I am not going to give you any technical information here. That’s for your doctor to do. My goal here is to share how my medical case has been handled as an educational tool and to encourage people that face the same type of situation.

    The next phase of this process is for me is to be given high dose chemotherapy that my medical team calls RBEAM. The “R” stands for Rituxan and then “BEAM” identifies carmustine, etoposide, cytarabine, and melphalan chemotherapy agents. It will be administered over a period of approximately six days. After that I will have a one day rest period before continuing with the process.

    The next day is called day “0” (zero) when they actually thaw out my stem cells and inject them into my catheter. My transplant coordinator (Janet) explained they go right into my heart and then are pumped out into my body where they actually find their way into my bone marrow. Once there, they will engraft and get to work rebuilding my immune system. That will take ten to fourteen days. And it takes months for things to get back to somewhat normal again. But remember the goal is to give me long-term remission and quality of life so the risk is worth it.

    I think it is important to tell you that I have talked this over with the doctor that kept me alive for the past 12 plus years and he is very encouraging. He always reminds me that I have never had a bone marrow biopsy come back positive and that is a good thing. And he always tells me I am going to do very well with this procedure. After all, he sent me to KUMED to get this done. It is very encouraging for me to have his support going into this (thank you Doc!).

    Let me close by saying my plans are to take my portable computer with me and keep everyone up-to-date as best I can. There may be some lapses in my communications, but I will do the best I can to let you know how things are going. I appreciate your prayers for Deborah and me as we face this leg of our journey together.

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  2. January 8, 2008 — BMT Day Minus 7

    3. I have just unpacked my suitcase and gotten somewhat settled into my hospital room here at KUMED. It is really neat that the Nurse Practitioner today is Julie because she has taken care of me a lot over the past couple of months. That gives me a comfort level as I start down this new path in my life’s journey. Now that I have an Internet connection I have the ability to stay in touch with people outside of my little room.

    My nurse’s name is also Julie so I may even be able to remember a few people’s names for a while. Just as I started writing this paragraph my Nurse’s Aide (Sam) walked in to weigh me, take and record my vital signs, and run a test called Vancomycin-Resistant Enterococci (VRE). You can search http://www.webmd.com to learn more about it if you wish. The VRE test consists of a special swab being run across the most private part of your rear end. It is painless and almost doesn’t seem like it could do anything. The data gathering has started. It was interesting when I met my nurse this morning. She asked me what I am doing here because I look so healthy. I responded that I was trying to figure that out myself.

    Yesterday afternoon during my meeting with Dr. McGuirk he explained the stem cell transplant process in so much detail that I wished I had a tape recorder to capture everything he said. One of the huge things I walked away from that meeting with that was so interesting, and Deborah even reminded me about it on the drive here this morning, is the fact that using peripheral stem cells gives the patient’s body so many more cells to get started with in the rebuilding process. He explained that in the old days when they actually used a surgical procedure to harvest bone marrow the end result didn’t give them the quantity of stem cells they get today with the newer procedures.

    What the new peripheral stem cell collection process does for a person like me is twofold. It makes things so much more comfortable. And, if I understand everything I heard, it gives us a big boost as our bodies start to heal. In the end, everything goes so much faster than in the old days.

    I’ll try to keep everyone up-to-date when I can. Let me close by saying this for my benefit, and maybe it will help someone else too. God has a master plan for my life and he is controlling everything that goes on concerning me. Just to prove it let me share the fact that Dr. McGuirk told me yesterday that all my tests show that I am in pretty good shape. That’s after a lot of different chemotherapy treatment regimens. Praise God for everything he has done.

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  3. January 9, 2008 — BMT Day Minus 6

    4. I wanted to update you on my last couple of days. In the BMT business they call yesterday (1/8/08), the day I started my chemo, Day Minus 7. My day consisted of taking the routine tests, seeing a Respiratory Therapist to get a little Incentive Spirometer (IS) breathing machine to help me practice taking deep breaths (I thought to myself – come on I am a lap swimmer), hooking up the IV pump with various premedication regimens, running my dose of Rituxan, and then running my dose of BCNU (another name for Carmustine) chemotherapy agent. Since I have had Rituxan many times without any issues it was the BCNU that was potentially dangerous for me. I have been told some people have a lot of trouble with it. However, I was blessed to only get a major headache.

    The headache the BCNU chemo caused is primarily because it is in alcohol. They tell me I had a big time hangover headache, something I know nothing about because I am not a drinker. Since it was the last thing I did for the day (we started it at 9:50 p.m.) I went to bed as soon as the approximately two hour run time finished and I managed to get to sleep sometime after 1:00 a.m. this morning. I managed to get a little sleep before the 04:00 a.m. nurses visit for vitals and routine blood tests to be drawn.

    I spent most of my spare time yesterday on the computer setting things up and solving problems with my e-mail configuration between all of the action going on in my room. During the afternoon Deborah came up to hang out with me, and just before she left I rode the recumbent bike for thirty minutes and got in six miles. Then after she left and I made a few telephone calls and relaxed for a while. I also did some journaling about my thoughts for the day.

    Oh, yea, you might be interested to know that after that late night my nurse showed up with my medication for today at 07:00 a.m. Then my breakfast showed up at 07:40 a.m. so I was forced to lie around and relax for a while. Then I jumped up to start my day at the office.

    I have already place photographs of my office and what I saw looking at my door. That gave you a glance at my living quarters for the next three to four weeks. It’s all freshly remodeled and looks pretty neat. And I have a fairly good view out the window on the West side of the building so I get the sunshine when it’s out.

    You read how my night went then carried over into this morning. After I got up, the routine I mentioned earlier, where the people come and go so much was a little slower. That is because they didn’t have to monitor me as much today with the chemo agent I got. The new chemo agents I am doing today through Saturday are called Etoposide and Cytarabine. I get those infusions two times a day at approximately 9:00 a.m. and 9:00 p.m. It went very well this morning so I don’t expect any problems with them. My doctor feels like we have reached smooth sailing and the rest of the week will be easy. I pray that is true because quite honestly after having the grand mal seizure four weeks ago tonight I got a little scared of this stuff.

    Since I had more time on my hands today I finished dealing with the support issues on my email and got it fixed. I also worked on a document for our new BMT Support Group for one of the nurses. Somehow I managed to find three meals that I could get down without any problem. And my beautiful bride came up to hang out with me again and I rode the bicycle thirty minutes again tonight. It was a very good day!

    My new nurse for the night just came in to visit me and I am going to start my evening dose of chemo between 09:00 and 09:30 p.m. so I had better wrap this up. Let me tell you the most important thing regarding my day today before I close. I read about God’s power in my life in Ephesians 3:14-21. I can honestly say I am not doing this alone. The prayers people are offering up on my behalf, and my prayers too, are making all the difference here in room 4111.

    P.S. Day “0” (zero) is significant

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  4. January 10, 2008 — BMT Day Minus 5

    5. I wanted to report that things are going quite well for this regimen to date. When Dr. Ganaguly and his team left my room early this afternoon he said he anticipates, with my current response to treatments, that I will continue to do well. He mentioned I may have a few tough days, but overall I seem to be tolerating the chemo well.

    Right now I am in day -5 which includes the same chemo regimen that is used for day -6, day -5, day -4, and day -3 so I thought it would be a good time to tell you why I am seemingly stuck in this mode. I think I already mentioned I get the regimen of Cytarabine (ARA-C) and Etoposide (VP-16) two times a day during this timeframe at approximately 09:00 a.m. and 09:00 p.m. That is because they are literally saturating my body with these chemicals to kill off the cells in their entirety.

    If you do some research on the Internet you will find this period of the peripheral stem cell transplant called the conditioning phase where high-dose chemotherapy is used to wipe out or condition the immune system and bone marrow in preparation to receive the stem cells that in my case were taken from my own body. You can read the detailed information at:

    After this there is one additional chemotherapy agent that will be infused on day -2 called Melphalan. I understand it is a quick infusion time like the ARA-C. Then day -1 is a rest day where I will not get any treatments at all. Hey, after six days in a row of this you need a break! That leads up to the all important day I have mentioned very briefly before or “day 0.” But first, let me explain more about the big picture. The countdown I have described from day -7, down to day -2, is where I get all my treatments to condition my immune system and bone marrow in preparation for the new peripheral stem cells to be inserted into my body and go to work. Following that, day -1 is a rest day in preparation for the big day they call day 0 (I suspect the day actually allows the chemotherapy agents to purge out of a person’s body.) Day 0 is significant because the peripheral stem cells are injected back into my body. Some people actually call this their new birthday.

    The timing of day 0 is critical because without those precious stem cells being injected into my body at just the right time my bone marrow would possibly never rebuild them in time on its own. Without the stem cells the other critical white, red, and platelet cells would not be available to do their jobs to keep me alive. There is a term to describe the period in time when everything is not working as it was created to work, it is called nadir. For detailed information on that you can visit:

    http://www.chemocare.com/whatis/what_is_nadir.asp

    In my case the high-dose chemotherapy regimen I am using is called R-BEAM. On the chart one of my nurses drew for me you would see the blood counts are still heading downward on the graph after the chemo is finished, and they also proceed to drop to nadir for several days past day 0. Then, after things hit bottom, and the stem cells get busy rebuilding my system, they tell me one day it will be like someone turned on a switch and I will suddenly start feeling better.

    On day 0 my peripheral stem cells will actually be injected into my catheter, which is placed so that it empties directly into my heart so the stem cells are immediately pumped out into my entire body. That means the stem cells start their journey into my blood stream and find their way back home into my bone marrow where they will engraft (This is actually the doctor’s way of salvaging my bone marrow quickly enough to save my life.). The stem cells will start doing their work to rebuild my system, or as the literature says “to reconstitute the immune system.” Then it will take time for me to fully recover. (Remember to look at the pictures.)

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  5. January 11, 2008 — BMT Day Minus 4

    6. No update provided.

  6. January 12, 2008 — BMT Day Minus 3

    7. I guess I missed a day posting. I’m not sure if it was because I was so busy all day or the fact that I got tired last night and just went to bed. But either way I want to let everyone know how things are going.

    Today is my fifth day in the hospital and I can tell the chemo and the grind of the routine is wearing on me. I am trying to be very positive and keep focused upon God being here with me during this time. My nurses are all very encouraging, and they help remind me of my motto that I need to maintain a “balance” and today is a day my inner body needs the energy. My nurse today helped me by talking to me about my goals for the day to help me focus. It is to rest more and relax.

    One of the things a chemo patient has to be aware of is constipation and controlling it. Perhaps the opposite side of that coin should be mentioned too as time goes by because it is easy for our bodies to go back and forth. They tell me that this especially true on the high-dose chemo regimen I am on. Yesterday I took some medicine to help me overcome the first issue, but we are being cautious today and trying to handle that with liquid and the right mix of diet (fruit, fiber, etc.). The hospital food has been difficult for me.

    There is another issue that is new to me. I am retaining water and we had to use Lasix yesterday to get some of it out of my body. The nurse gave me the IV type and I started traveling to the bathroom on a regular basis for a while. I’m not sure what we’ll have to do today, but the doctor will be in soon and he will make the decision.

    Now that I have bored you with all that stuff I should probably tell you that my concentration seems to be slow today as well. I started my day off waking up at about my normal time, but just not really caring if I got out of bed. Then, when my breakfast was delivered, I jumped up, put on my clothes, made my bed, and moved over to the sitting area to eat. Realizing I just don’t have the focus I want for today I decided to go stir up some endorphins in my brain by riding the bicycle. I managed to ride 30 minutes but was off my normal pace of six mile in that time-frame by a bit. I gave it a try, but I think today is a down day and I am going to have to accept that.

    I have really been enjoying the nurses and the other staff here that takes care of us here in the BMT unit. Today is rotation for the doctor’s so I will meet a new doctor here in a little while.

    That should be exciting. And Deborah is coming up this afternoon to hang out with me too. I always love seeing her.

    Let me close by saying things are really going well. Tomorrow is my last does of chemo and I can’t wait to get it over. I am still on the downward glide scope towards nadir where my counts will all be bottomed out. That will last for a while and then we can turn the corner and start rebuilding my immune system. Right now I am getting excited about day 0 (next Tuesday) because that is the key to bringing me out of this slump. As my transplant coordinator mentioned, and some other people I have talked to that have experienced this whole phenomenon, there is a lot that goes on to get a patient to that special day. I want it to be a day to remember because it is critical to my survival. (God’s creation is going to work as it was intended to work one little cell at a time.)

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  7. January 13, 2008 — BMT Day Minus 2

    8. I am ecstatic that I have finally completed my entire R-BEAM chemotherapy regimen. That’s right, just before lunch early this afternoon, my nurse disconnected that last bag from my IV pump and I am done. Today’s dose was fast and only took approximately 30 minutes to administer. Then I topped it off with a soft taco and refried beans.

    There is a neat side story to the administration of Melphalan that may interest you. The nurses all primed me early on that I would be iced down as we started the regimen, during it, and even for a while after it was completed. OK, I know that didn’t make sense so let me tell you how we did that. I had a line of cups with ice chips lined up on the table beside my chair. And I had a couple of Orange Popsicles along with them. The goal was to keep my mouth cold and the downstream parts of my body chilled during the administration of this chemo agent. It is supposed to keep the membranes sealed up and help prevent mouth sores and the like.

    On top of that little process, which to be honest was a bit tough because it took a lot of effort to shove all that onto my tummy, I had to start some new medications. We are at the point where my body’s natural immunities are getting ready to crash so my system is being supplemented with drugs to do the job during this time. I started Acyelovar which is an antiviral; Diflucan, which is an antifungal; and Levofloxacin, which is an antibiotic to handle the other issues that need to be addressed during this time. And, I understand they monitor everything during this next phase and will add medications to keep my system safe until my immune system gets back on its feet.

    In the area of energy, I had to confess yesterday was a bit of a downer, so I want to let you know today seems to be doing much better. After breakfast I hit the bicycle for 30 minutes and made my distance of miles OK. Then after we finished my treatment and I got lunch down I was energized so I went out around noon and did 30 minutes on the treadmill. Now I’m not as aggressive on that piece of equipment so I only logged 1.5 miles. After that it was time for a short knap while Deborah sat in the room with me and finished her Newspaper. But now I am up and at it and feeling good.

    During my doctor’s visit this morning Dr. Abhyankar examined me thoroughly and discussed one of the blood tests he his monitoring for me. He is seeing a bit of a change in my total Bilirubin for my liver and just wanted me to know that. It is my understanding that all the chemo I have had causes some of these changes so they simply monitor things like this. This is what causes jaundice in patients when it gets too far out of line. So far we are just watching it. No problems to report.

    Earlier today it was cloudy, but now the sun is shining in my window very brightly. I love to feel the rays of the sun hitting my body and warming me. It makes me remember God in a special way. I often tell people that in my opinion the closest thing to God a human being will ever know on earth is the Sun. That is because we can’t look directly into it without being blinded, God is perfect so mankind cannot look at him. The warmth that we feel is representative of his love for all mankind, irrespective of the fact that a person accepts his love, it is still there and available to anyone that will choose to accept it.

    Well Deborah just came in from eating lunch at one of our favorite restaurants. A lot of our friends there sent me words of encouragement and even a note. So I had best close and spend time with her now. Thank you for taking time to follow my story. Tomorrow is a rest day here in the BMT unit for me. Then Tuesday is my day 0. I am excited to have this opportunity for long-term survival.

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  8. January 14, 2008 — BMT Day Minus 1

    9. My schedule for today says day -1 “Rest Day” here in the KUMED BMT unit. So I thought I would take this opportunity to share more of the details from my exciting week. Yes, tomorrow it will be a full week I have been in this regimen, and I am feeling very good at this point in time.

    Anyone that knows me is aware of how much people mean to me. I just have to share with you that I got a double blessing this morning. First, the Nurse Practitioner that started me on my RICE regimen back the week of Thanksgiving took care of me today. It was nice to see Jan and to have her go over me ever so thoroughly. Then just a few minutes later one of the gentlemen that harvested my stem cells came through and I got to say hello to him. His name is Khai and tomorrow he will be here in the BMT unit for me, delivering my cells. The day I have already explained they call day 0.

    Since it is a rest day I lounged in a bit this morning. After eating breakfast I listened to my radio and took in some spiritual nourishment from Dr. Swindoll, Dr. Evans and a couple of other men. Then I pursued my day by eating lunch and heading out to the bicycle. The whole team was traveling with Dr. Abhyankar today, and I asked him if I had time to get in my thirty minute ride before my number came up. He just had me keep going then came to get me when they were ready at my room. I thought that was real nice. (I was two minutes short of my time so I went back and made it up. And for anyone interested I boosted my distance to 7 miles today.)

    The only news on the medical front to report in my case today is that Doc saw a bit of a change again in my total Bilirubin for my liver. He is going to have some additional blood tests run to double-check this. Other than that he called me a model patient in front of his group today. I am doing my best with God’s help.

    My medications: Let me summarize where I am right now. First, starting day one they started me on Prevacid tablets in the morning (every day). Next, with the chemo I have been getting regular IV doses of Zofran and Decadron. And all along I have been on Benadryl and Ativan by IV with a button to push if I get sick (I haven’t needed it at all). Finally, as I mentioned yesterday, I started on Acyelovar which is an antiviral; Diflucan, which is an antifungal; and Levofloxacin, which is an antibiotic. A whole pile of pills to take in the morning, and less in the evening; no big deal! (I did have one dose of Lactulose for constipation one day, and Potassium tablets along with Lasix when I retained water. That is all under control the past couple of days.) So you can see how they introduce what I need, when I need it, and then take it away when it is no longer required.

    In addition to the medications they started me on they also did another VRE test like they did when I was admitted last Tuesday (the swab test). It was negative so that was a good thing. However, it is a regular test they run on a weekly basis to keep a head of things. I am also told that if a patient comes up with anything else like a cough or runny nose or whatever, they immediately test for the culprit and get on track to fix it. The benefit of being in an inpatient setting with professional nurses taking care of you during a BMT.

    I read in my Bible this morning and was reminded how God has the very hairs on my head numbered (that’s how much he loves me). Even though right now they are pretty slim picking it means a lot to know he cares that much.

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  9. January 15, 2008 — BMT Day “0” (zero)

    10. Today is day 0 for my BMT. That is exciting for me because today I reached the culmination of a long journey. While I was supposed to have a BMT back in 2001, as the standard of care for a recurrent non-Hodgkin’s lymphoma survivor, my doctor (Dr. Barry Skikne) gave me an opportunity to go without it. And that resulted in me having a wonderful six years of life. The most recent journey, which has lasted over one-year, now, is also behind me.

    The thing I want to concentrate on tonight is the wonderful opportunity I had today. There were a lot of tests run, there were a lot of people involved, and there were a lot of treatments given me to reach this point in time. Today, I was blessed to see the end result when at approximately 1:30 p.m. they started injecting my peripheral stem cells back into my body. I asked for the number and it was 343 million stem cells. They are inside my body, headed where God programmed them to go, and they know full well what they are supposed to do. Now it is a matter of time.

    According to the blood tests, my counts have been headed down slowly without any worry or problem. It will probably be a few more days before they reach the low and I hit the period in time called nadir. The important thing is the stem cells are out there doing their job now getting ready to rebuild my system just in time. As my counts hit bottom and hang out down there for a while, my system will be supported in various ways. I have already described the antibiotics, and they say it’s not unusual to get transfusions along the way. But that is all under control so there is no need to worry.

    I was excited when the schedule worked out so Deborah could be here with me this afternoon. My nurse pre-medicated me with Tylenol and Benadryl then we sat together in my BMT room as things were carefully explained yet again. The transplant coordinator then pulled out the huge hypodermic tube that contained my stem cells and connected it to my Groshong catheter. She reminded me it would be very cold as she injected them into my body. In all I had four bags of stem cells on deposit that were broken into two injections each. And within less than one-hour the procedure was completed and all eight tubes of cells were on board and headed off to work. I had some Jolly Rancher candy in my mouth to prevent any uncomfortable taste. And I didn’t have any problems at all so it went full steam ahead. The process was finished before I knew it.

    Now there are some of you wondering what the little stem cells looked like. They really looked just like a strawberry Popsicle that is a little slushy sitting in a plastic bowl melting. And it felt really cold as they passed through my catheter into my chest and into my heart so they could be pumped out into my entire body. I was really excited when the process was over and I hadn’t had any complications or reactions.

    After we finished the process I went for a little walk inside the halls of the BMT unit, and sat in the sunshine to feel the warm sun’s rays beating on my body. It was so good to see that big bright Sun out there in the afternoon sky, and to feel the heat as it shined in through the window and onto my body. I came back to my room and called Dr. Kashyap to tell him we were finished, and he reaffirmed once again that I would do well.

    Let me close by saying thank you for your thoughts and prayers again. They told me to plan on being here for three to four weeks. Today is the start of week two. So we have a bit of work to do yet. God has blessed me thus far and I am excited about the future. Please continue to support Deborah and me during this time. God Bless!

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  10. January 16, 2008 — BMT Day Plus 1

    11. I am trying to post something every day so you can keep up with my situation. Today started out a little rocky, but turned out to be alright. My tummy wasn’t sure what was going on and I worried I would go from bad to worse as the day wore on. But things settled down and I did ok. The real highlights of my days have been visitors here in the BMT unit. Now don’t get upset because you cannot come see me. The visitors I am talking about are nurses. Over the past couple of days I have met some wonderful people that have reached out to me in special ways. I don’t believe anyone would get upset with me if I say the most important ones, are people that have been on the side of the fence I am sitting today. That’s right; they have been chemo patients.

    I can only tell you our conversations have been very special. Life is so precious to us and we have a lot in common. I noticed we are all keenly aware of the stress that our illness, and the treatment regimens we must endure, causes for both our family members and our friends. And we talked about how we each have to deal with those lingering days that seem to go on and on as we wait on test results. Yes, I was very encouraged by my visitors over the past couple of days! The scary part is they were young people who have already been through a lot in their lives. I can tell you I am very thankful for them.

    Perhaps one fact about my situation that I haven’t mentioned before is the odor of the preservative used to freeze the stem cells. I am told I have a unique aroma right now that will subside in a few days. My beautiful bride Deborah told me it’s not bad, but she can smell it when she comes to see me. I am so blessed she is able to be here in the afternoons for a while every day. The good thing is it will be gone in just a couple of days.

    My blood counts are still running along the line they are supposed to be trending downward. My energy levels are lower today, and being cooped up in a building is difficult to deal with. But all in all I am doing very well and life is good.

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  11. January 17, 2008 — BMT Day Plus 2

    12. Today is day 2 post transplant and all is going very well. Last night I was awakened by something similar to night sweats and a bit of a sick tummy. My nurse changed out some bedding for me so I could relax and go back to sleep, and I used my Benadryl Ativan pump for the first time to relieve some nausea. I did get back to sleep and rested quite well.

    When I got up this morning and ate my breakfast I continued to have that feeling in my stomach. It seemed to hang on and I couldn’t tell if it was nausea or trying to break free into diarrhea. Ultimately, using the BA Pump again didn’t help much so I found myself in the bathroom. Let me just say they ran a new test, and I have been carefully negotiating my trips to the bathroom today.

    This is pushing my previous limit on the number of days I have been confined in a hospital before. The last time I wasn’t stuck on a unit in isolation so I could move about with a little more freedom. I am doing well with the surroundings and being here in our BMT Unit, but I can tell you I am getting excited to walk through the doors out of this place with my beautiful wife. My radio is very useful. I listen to my favorite preachers on a regular basis. And I am finding my computer to be invaluable as I keep in touch with a few people via e-mail. I also find the challenge of updating my journal on a regular basis to be rewarding. Then, occasionally, I will watch that television if I just have to. I have found keeping somewhat of a routine the best thing to keep my mind busy. Even now that I am reducing my exercise routine a little (because the tummy says no) I am coping very well.

    The highlight of my day today was getting to participate in our new BMT Support Group via the telephone. Our Nurse sponsor Amy called my room when they got started so I could join in. Today’s topic was nutrition for a BMT patient. We covered a lot of good material and I think people learned a lot about their particular situations. I have learned the chemo nurses see their patient’s predicament as quite unique, and they just want to get some nutrition into that person’s body. In my case I have learned to eat healthy and to live a very balanced life-style that includes making healthy choices when I eat (even when I am facing problems on chemo). Then our professional subject-matter experts have their goals to meet as well. From where I sit today I think I will vote that we need to find a balance in all these areas that will help chemo patients eat healthy as much as possible. Food is a challenge right now especially in the Neurtropenic situation a patient like me is in with our BMT in progress. I was excited to hear there is ongoing work being done in this area and hope to give input into that some day.

    How long has it been since you have had time on your hands? Come on, be realistic, when was the last time you needed to fill up a block of time and wanted to do something useful. Tonight I had that problem so I took out my Bible and read Genesis 1 & 2. Actually, to be totally honest, I read a few of the study notes in my NIV version before reading the text I mentioned. I focused upon God and creation tonight. The six days of creation and the seventh day of rest really meant a lot to me this evening. I couldn’t help but wonder what it must have been like when Adam was created and God breathed the breath of life into his nostrils. Reading the story helped me focus on the one in my life that has total control right now. It made me feel closer to the Lord God of Heaven, and it comforted me.

    P.S. The photo of the swimming pool is up front to honor my friends at the Y for swimming for me. Thank you Dana!

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  12. January 18, 2008 — BMT Day Plus 3

    13. Today is day 3 post transplant and everything is going very well. My tummy is still not sure what to think, but it is manageable. I rested most of the day by knapping in my chair. My counts are down now with a bit more to fall before they hit bottom. Then they will hang out there for while. Right now those stem cells are working full-time to engraft in my bone marrow getting ready to launch the attack that will save my life. But in the meantime I will continue on medications to keep all my systems functioning. The human body is such an amazing thing to me!

    Food has been a challenge all along. I have resorted to trying bland items from the menu. Chicken noodle soup seems to help a bit. I have also started eating snacks to add some fuel to the fire as my body fights this war inside. My mouth has a few little sores and I am using rinses to manage that. It is just a process several days now.

    The highlight of my day was when Deborah came to see me. Then, after she left, I pretty much went back into rest mode. It was also real nice to see a couple of people get to go home today. I pray they do well. I did ride the bicycle for 25 minutes and walked the halls a couple of times. So that’s the story for today. God has blessed me tremendously and I am thankful for it.

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  13. January 19, 2008 — BMT Day Plus 4

    14. Today is day 4 of my BMT process. Since day 0 we have simply been monitoring my system and using whatever medications I need to keep me stabilized. That includes the three antibiotics: Acyelovar which is an antiviral; Diflucan, which is an antifungal; and Levofloxacin, which is an antibiotic. In addition to those three antibiotics I have required IV Potassium the past two days. As my nurse said this morning that’s not a lot so far and I am doing very well.

    My goal for writing this is to help people learn about the life of a patient like me. It is exciting to have the opportunity to have a BMT which promises to be a tool to give me long-lasting life. It does take a little work along the way and I think some explanation is in order for where I am at this point in time. For example I have mentioned the ups and downs of a sick stomach over the past several days and the touch of diarrhea I had to deal with. Today I can report I had a somewhat normal morning constitutional, which is huge progress. But there is a bit more to the story.

    Whenever the GI track is hit with chemo things get crazy. I have been blessed not to have too difficult of time with this phenomenon (prayers do work). For example the lining of my mouth started getting fuzzy feeling and the only way I can explain it is the feeling you get when you eat something too hot and it flash burns the surface. Now the burn is too harsh a description, but the feeling after it starts to heal would be more accurate. And to go along with that there are just a few sores here and there. This leads down the back of your throat into the rest of your body.

    For anyone that has experienced bad heartburn you have some idea how this feels from the mouth down to the lower extremities. It’s like you burn through and through. I rated my burning sensation for my doctor a few minutes ago on a scale of 1 to 10. I ranked mine today as a 2 or 3. It is uncomfortable, but tolerable. This requires a patient like me to keep eating something to keep all the parts functioning. They tell us use it or lose it and keeping it going is much easier than not. The recommendations are bland foods.

    The past couple of days my breakfast consists of scrambled eggs, biscuits and a touch of gravy, turkey sausage links, chilled peaches or applesauce. Then for lunch I am eating a plain old hamburger patty, chicken noodle soup, chilled peaches, and diet pop. And mid afternoon I have an instant breakfast. For supper I have been eating chicken tenders and another cup of chicken noodle soup. You can see that I am trying to keep solid food going and other foods that will comfort the old tummy. And, for anyone that hasn’t heard, for a chemo patient everything is subject to change!

    I want to take one more minute to tell you the phenomenon I just described, at least in my opinion, is one of the reasons some of us end up eating to feel good during this phase of our treatments. Back in my early years I resorted to grazing the wrong foods and keeping my stomach full to keep the burning sensation under control. And if I remember correctly Doc gave me an antacid to help with it. But with experience now, and learning there are healthy food choices to make during this time, I am convinced this can be managed in a healthier manner. Tonight I am going to try baked fish for something different. I do want some variety in my meals it’s my stomach that doesn’t care if it even sees a meal for a while.

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  14. January 20, 2008 — BMT Day Plus 5

    15. Today is day 5 of my BMT process. In my note yesterday I attempted to explain the problems encountered in the GI track. My routine today got more complicated as things moved down into the lower portion of my body. We added Imodium to the mix and I had a difficult day. I woke up feeling fairly good, ate breakfast and about one-hour later got to trot off to the restroom for a while. Then after adding the Imodium I pretty much repeated the same scenario the rest of the day. The mode I am in now is giving my insides time to heal and repair themselves. And as I explained yesterday it is better to keep things going in during this process. It is miserable, but my wonderful nurses tell me I am doing great and this too shall pass (no guarantee when).

    One other big change came today. This morning I started Neupogen shots which are used to boost my stem cell creation. It is my understanding they will continue the shots until a specific blood test responds with a certain count for a couple of days. There is a possibility I will have some pain from the shots working typically in the large bone areas like the breast bone. I am excited that we are turning this corner because it’s just a matter of time until my immune system takes hold and takes over so we can stop the prophylactic drugs to keep my body safe. Now I think it is important for me to share one thought with everyone tonight. My doctor’s have always told me not to get frustrated. When that happens everything seems to go downhill. I must be honest and admit that this morning I had to focus on God and confess that I was getting frustrated with things. The physiological situation I am in right now is difficult, and emotionally I am frail as things seem to be out of whack. But I cannot fail to see how blessed I am in the situation I am in. I have hope and I have all kinds of support as I walk through this phase of my treatment. So I made a decision this morning, and several other times today, to have a positive attitude and to be happy. I am just going to do my best to take things one day at a time like I have always done.

    Let me close by saying thank you for your prayers. I can tell you they are making all the difference in the world for Deborah and me. In case you have forgotten to tell someone today that you love them, and to thank them for taking care of you, you might want to do that before it’s too late. Thank you Deborah for loving me and taking care of me!

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  15. January 21, 2008 — BMT Day Plus 6

    16. Today is day 6 of my BMT process. I think you could probably tell the weekend was a little difficult for me. The day ended with me getting dizzy in the shower and feeling like I was going to pass out. But I used the techniques my nurses had taught me and slowed my movements, got the warm water off me, and took some deep breaths. Then I quickly dried off and made my way to my bed and called my nurse. I made it, but I sure wasn’t sure I was going to for a few minutes.

    There is nothing like feeling helpless. The shower episode simply reminded me how quickly things can happen. It also reminded me why I need to trust in God for everything in my life (even wisdom about getting out of the shower when I feel week). I slept really well and took my time getting around this morning just in case. Then when my day nurse came in to see me she told me my counts are bottomed out and I will be week for a while. This, after all, was the goal of my BMT. The really cool thing here is my body is rebuilding using those stem cells that I got a week ago tomorrow. I am so excited to see this part of my story coming to fruition.

    Now that I have given you some of the details from my bad experience last night I want t to turn a corner and tell you some really exciting news. First, after taking my time to get out of bed this morning, I had some fairly good energy today. I walked the hallways several time and then rode the bicycle two different times; the first time for seven minutes, and this afternoon again for twelve minutes. No record setting I know, but yesterday I couldn’t do it at all. Second, my energy today seems to be a sign that my body is starting to recover. We’ll have to see how the counts come back in the morning, but Doc told me we might see the first signs that soon.

    Since I was feeling so good this morning I made a few telephone calls to my family and enjoyed talking to them. Deborah came up and spent the afternoon with me and we really enjoyed each other’s company. And I ended up resting in my recliner chair for most of the afternoon. But I am excited that I had a really wonderful day. God is good and he truly blessed me today. I have found my radio to be very useful. As in the past I can listen to the radio ministers I love to hear and keep positive information flowing into my mind, heart, and soul. It also makes me feel like the time is not being wasted while I recover. I love learning about God and praising him as he walks with me every day. I don’t ever feel alone, I always have him here with me.

    Tomorrow is still ahead of me. But it has two milestones that I am pleased with. First, I have been here two weeks. Second, I am one week post transplant. That may not seem like a big deal to some people, but it is to me and I’m sure others who have dealt with chemo will understand.

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  16. January 22, 2008 — BMT Day Plus 7

    17. Today is day 7 of my BMT process. This morning’s blood tests showed I needed blood platelets, and I also needed Potassium. That started my day off very early because my nurse got me started on the IV products very quickly. If I remember correctly I didn’t really go back to sleep after about 03:00 a.m.

    The pre-medications they gave me for the blood platelets included Tylenol and Benadryl so after they were administered I was pretty much a goner for the rest of the day. I guess being sleep deprived and medicated took its toll and the recliner got a workout today. I could barely move enough to keep my nurse happy and to do the things I am required to do like measuring all the liquid that comes from my body. (I cannot wait until I can stop that hassle!)

    I am very excited that my white blood count showed a minimal increase today. Now my nurse assured me I will have to see a steady marked increase before I get too excited, but I’ll take all the good news I can get.

    Days like today keep me focused upon God having total control of everything all the time. It’s difficult when you can’t hold your head up and just feel like sleeping all the time. When Doc talked with me today we discussed the pre-medication and I may be able to avoid that in the future.

    That’s about all I can think of to say tonight. Thank you for all of your encouragement and prayers. As my friend Dave always says “God is good!”

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  17. January 23, 2008 — BMT Day Plus 8

    18. Today is day 8 of my BMT process. I was carefully watched last night for my temperature going out of the safety range. This afternoon around 4:00 p.m. it finally happened so my nurse had to draw several blood culture tests, put me on Tylenol to control the fever, and start me on a new IV antibiotic. Tonight I am feeling chilled and my nurse told me a while ago I may need some additional Tylenol here in a little while.

    I also talked to Doc about scaling back my Benadryl Ativan pump since I don’t seem to need it. He agreed to back it off this afternoon and see how it goes. If I don’t need it I may get one of the two tubes hanging off that IV pump taken away. I just hope my body can still tolerate the healing process without that medication so I can see that bit of progress.

    My counts were pretty stable today. I had to get IV potassium again this morning, and I was also started on an oral version around lunch. My white counts stayed the same which is a good thing. Tomorrow’s blood tests will be the indicators for the next 24 hours and I hope things stabilize without requiring any additional transfusions, but my nurse primed me that I may need something (especially if I spike a temperature).

    While I don’t want to gross people out I was also blessed to have a normal bowel movement today. That is major progress after fighting a sick stomach all weekend. To see things starting to work as normal again is very encouraging at this stage in the process. That means all that burned up flesh inside my body is finally healing so it can function normally.

    I think it is also a major milestone to mention I was able to be somewhat active today. In fact I rode the bicycle for 10 minutes. I know it may not make sense to some of you, but after the chemo regimen I have just finished, that felt real good. It will take me time to build up my endurance again and with my tummy on board and not getting sick I may be able to work a little harder at getting up to 30 minutes again. At this point I just take it one day (or one ride) at a time.

    One of the difficult things I deal with is my mind. It is so easy to wake up tired and fatigued and to feel overall discouraged. I have shared before that I have to say a lot of prayers to get on top of things. Right now I am in that critical time-frame where my stem cells are engrafting and I am getting Neupogen shots to encourage them to get busy. It kind of reminds me of one of the kids movies from years ago where the little engine ran along saying I think I can, I think I can, I think I can. And my goal is to rest while my body goes through this mode and the day finally comes when my body is that strong locomotive God created it to be, and I can run down the railroad tracks with a fully loaded train behind me. I give God all the glory for everything he is doing for me during this time. And I want to say thank you to everyone who prays for me on a regular basis.

    Please remember that I am not the only person going through this. And I am one of the blessed people that have an easy road when compared to other BMT patients. I would ask that you remember all of the BMT patients as they take on the task of this procedure. I always pray that God will give people everything they need to make it through their day and something very special to them so they know he is in control. It makes a difference you know!

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  18. January 24, 2008 — BMT Day Plus 9

    19. Today is day 9 of my BMT process. It seems to be filled with good news and I cannot wait to share it.

    The fever that caught up with me yesterday afternoon seems to be the result of the engraftment process. Early cultures have come back negative, but the protocol for a patient in my situation is to keep us on antibiotics. My Nurse Practitioner (Julie) explained they simply cannot risk letting something get ahead of us in the situation my immune system is in right now. She also qualified that with the fact that my white counts took a slight jump which is a good thing. It looks like my body is firing up and that new immune system we are doing all this for is getting ready to go. It’s pretty awesome!

    Everyone that knows me knows how much I love people. Many of you also know how much I love the doctors and nurses that take care of me. Another tidbit of good news is the fact that one of my nurses from way back in my early cancer fighting days moved to KUMED. She told Debbie and I Thanksgiving weekend that God must have known it would help us get through this BMT. Well, today, she is my nurse here on the BMT unit, and it is so neat that she is here helping me understand the things that are going on inside my body right now. Jacque is a very special person and her professional care is one of the reasons I am here today. It’s kind of neat that she would be my nurse as I navigate this new territory.

    I said today is filled with good news so here is one more item. However, I must confess, it’s a bit scary to me. We are actually backing me off IV fluids today and turning off my Benadryl Ativan pump since I don’t seem to need it. This means it’s up to me to get in the fluids my body needs now. If I can do that we will actually have me headed out the door of the BMT unit. I am actually tearing up as I write these words because it has been a real challenge to get to this point. And I must admit I begged Julie this morning, not to send me home too early. But the facts are I am doing well and in just a few days now I might actually get to put on my street clothes and my cowboy boots and walk out of this place. That is a real answer to prayers. I still have a lot of recuperation to do, but it will be at home and making regular runs to the Cancer Center for testing and monitoring. It will be so wonderful to be home and I think I am getting excited!

    With that update I guess the only thing that people might be interested in is the fact that yesterday my vision seemed to be a bit blurry. I’m not sure why I could just tell things were weird all day. Today seems to be better (I guess missing sleep could cause that and who knows what these drugs do to a guy!). My night last night was a bit challenging. I was chilled so I found it difficult to take my shower and go to bed. I actually got some additional Tylenol and stayed up until I felt like the chill was gone. Then I hurried through the shower and into bed. I went to sleep very quickly, but when the nurse came in a little over one-hour later to take my vital signs she had to rescue me from a sinking bed. The night sweats had hit and I guess my fever broke because the bed was literally soaked. After changing my bedding and wiping me down I was able to get back into bed and sleep fairly good. I bounced up early this morning and things are going real well today.

    I want to close by saying today is a good day. I am getting the privilege to enjoy it because people like you care and pray for me. Don’t ever forget the power of you and your prayers.

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  19. January 25, 2008 — BMT Day Plus 10

    20. Today is day 10 of my BMT process. I already shared how well things were going yesterday. Tonight, I have miraculous news to share, and I give God Almighty all the praise for the blessings he has given me over the past several weeks.

    Before I share the details I think it is important for me to share something else. I have learned, or perhaps I should correct that and say I have relearned some lessons from my lifetime as a cancer patient during this time. Some people don’t get good news like I have been getting. This evening I have talked to two different people who have told me about outcomes that are endings to people’s life stories. That is humbling to me. May I please ask you to pause right now and say a prayer for all the family members that lose a person to disease? Now, with that taken care of, I am very blessed to have the following words to share with you.

    At approximately noon today, my doctor and the medical team that works with him came into my room to check me over thoroughly. Then, based upon his examination and plans for me tomorrow, Doc ordered a nasal test (because I have a tiny dripping nose I think is from the dry air in my room and the change when I go for walks in the hallway), and a chest X-Ray to double-check my lungs. The most important thing he told me was tomorrow is my very special day unless something changes overnight. Yes, I am scheduled to go home tomorrow.

    The tests consisted of my nurse having me use a syringe with a measured amount of saline and inject it into each side of my nose while she caught the drippings in a container that was sent to the lab. A portable X-RAY machine was brought into my room and they pointed it at me sitting in my chair, with some sort of media behind me sitting on a pillow, aligned it with a cross-hair light, and then zapped the image.

    My fever issue, a few days ago, triggered several tests. They immediately started me on a special IV antibiotic called Cefepime as a precaution until the culture results came back. I was on that medication every eight hours until noon today when Doc stopped it. The culture test results, which are run several days in a row, consistently came back negative so I was able to stop this regimen. I am still on the three other antibiotics I have listed before, and Doc also told me I will go on a new drug next week that will be part of my daily routine for approximately six months. There will be changes as needed based upon my regular blood test results.

    I was also told yesterday that my fluid intake was critical to getting me out of the BMT unit. Today I was successful at getting the approximately 64 ounces of liquid down orally by drinking water and diet Shasta. My nurse this evening is going to talk to Doc when he calls in for his evening consultation with the nurses, to report my success. And she said he very well may let her turn off my IV tonight when I go to bed. The way I accomplished this goal isn’t that big of deal, but in case anyone is interested I will share the details. My beautiful wife had brought in flavored water for me, and I used a couple of them to help with the taste. I also used one diet drink with a meal. And I drank plain old bottled water (because it tastes better than faucet water) for the balance. Ice, to chill it all, helped me be successful as I chipped away at the goal eight ounces at a time.

    I also maintained my routine bowel movement today, and didn’t have any problems with nausea. With all of that adding up, Doc, and the entire medical team that has been taking care of me the past several weeks agreed, tomorrow I can safely go home.

    Let me close by asking you to praise God with me, and please say a special prayer of thanks for this wonderful outcome. Again, I give him all the glory for this accomplishment, and the wonderful days that are ahead of me. Thank you for caring and helping me during this time!

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  20. January 26, 2008 — BMT Day Plus 11

    21. Today is day 11 of my BMT process. It is official Dr. McGuirk just examined me and told me the rules for my discharge from the BMT unit. I am going home today. Praise God!

    All the additional tests I had run yesterday came back negative. My blood tests have shot up like expected and are anticipated to keep going in the right direction. For example, over the last few consecutive days, my white blood count did this: 0.10, 0.20, 0.20, 0.40, 1.60, and today it is 5.80. One of the great results of this is the fact that I have been able to stop the Neupogen shots. Yesterday was the last one.

    Now, as you might expect, I am very excited. I must also tell you it is a bit scary to leave the hospital and take on things at home, but I have been praying for wisdom and strength and God has helped me focus on the next phase of this treatment regimen. I must move forward and continue to recuperate from the chemotherapy. It will be tough for a little while and I have all kinds of restrictions for the next several months. I know there are challenges ahead of me but it is wonderful to head down the path to complete recovery again.

    I plan to keep journaling my days for everyone that is following my medical case. It will be wonderful to be at home so Deborah and I can be together without the journey back and forth for her. And I hope to rest and do better at home with my beautiful bride taking care of me. I am so thankful that things are going so well. I am thankful to every one of you that have been offering words of encouragement and especially prayers for me. Please continue to do so.

    Now it’s time to close up the office here at the KUMED BMT Unit. The sun is shining outside and the weather has warmed up. I understand the next couple of days are supposed to be warmer and I can’t wait to be at home and enjoy them with Deborah. I hope everyone has a great weekend with their families and friends as well.

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  21. January 27, 2008 — BMT Day Plus 12

    22. Today is day 12 of my BMT process. I am home for the first time in 19 days and loving every moment of it. When you hear that people rest, eat, and even sleep better at home than in the hospital, you should believe it. Being home just 24 hours proves that to me.

    This morning I watched Dr. Charles Stanley on television since I am restricted from going out at all right now. It was wonderful to hear him teach on the Holy Spirit. I learned a lot, and was refreshed by his sermon.

    At 11:30 a.m. I had to be at the cancer center where I had a routine blood test run. My doctor told me to just pop in, let them draw the blood and leave; there was no need for me to stay since he merely needed the documentation for my medical case. And of course my nurse had a different idea (he told me if they tried to keep me around to just walk out, but I was a nice guy – especially since it was the nurse that took care of me the first day I started RICE and I really like her). Since I stuck around I can tell you my counts are coming up.

    This afternoon I have been getting myself reestablished in my home office. And I have some new pictures to share with you today (my first day home picture). You will notice the photo shows me standing beside the balloons my office sent me at the hospital. By the way I am at 180 pounds in this picture, my lowest weight since I started chemo the week of Thanksgiving. Can you believe I used to be over 300 pounds?

    All this chemo (R-BEAM) and the entire Bone Marrow Transplant procedure was done for one purpose. It was one of the few choices I had to attempt to completely eradicate all of the cancer cells from my body. The high-dose chemotherapy was used to kill off the rogue non-Hodgkin’s lymphoma cancer cells that keep hanging out inside my body somewhere. And, along with that, I get a completely new immune system. I am told I have a real good chance to be cancer free from this procedure. The BMT actually leaves me at least one option as a backup since there are no guarantees with follicular NHL. There are also supposed to be new treatment regimens coming out in the near future.) By faith I want to say I am confident in this procedure working completely.

    Now that I am home I face approximately 100 additional days in isolation. There are also a lot of restrictions on me for six months to one full year. For example I am not allowed to have visitors inside my home or go outside the house without my mask on. No visits to Lowes or Home Depot for a while. They don’t even want me going into my basement or garage without the mask to protect me. Another big thing is I have to use my own separate bathroom (remember me hurrying and scurrying to get them both done before I started this process?) I got to come home to my brand new bathroom and it is wonderful.

    Over the next few days I will try to introduce you to the rules for an Autologous Bone Marrow / Stem Cell Transplant patient so you have an idea what I am doing. And remember this is the easy one. Some of my friends, which I have met on CarePages, have had the more difficult transplants and they have a much more difficult time. Please remember these people in your prayers because I’m not kidding they have to battle things every day.

    I cannot believe that here in just a few minutes I have been home 24 hours. It is a huge blessing to be home. I had a good supper last night, slept very well, and breakfast and lunch today were great! I have also been able to snuggle close to my wife and just relax. God is good!

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  22. January 30, 2008 — BMT Day Plus 15

    23. Today is day 15 of my BMT process. I need to provide an update for the past couple of days. But I am sure no one will mind that I took a couple of days off to relax. Let me start with day 13, day 14, and finish up with today.

    On day 13 I was home for my second day. During the morning and mid-afternoon, I dealt with anxiety. My goal is to overcome this with sheer determination and God’s power so I fought the battle in my mind. Then, as I transitioned form my evening to time to go to bed, I got up against an obstacle I realized from the past.

    The obstacle I faced was a panic attack and it required me to take action. I say I had been there before because I had a medical procedure done one time and I lost it towards the end. My nurse during that procedure realized what was happening and walked me through it until Doc finished a bone marrow aspiration. Then she taught me some things to use in the future so I wouldn’t have that difficult of time dealing with it. (The key is to take charge of things before your mind gets overwhelmed).

    With that background, day 13 ended with me fighting tremors in my right arm. It almost turned into a panic attack, but then I gave in and asked Deborah for my Ativan pill. Just as soon as it hit my mouth things calmed down and I was able to regain control and get to bed. I spent the day very anxious without needing to. You have to understand, that I know and understand very well, that my body is torn down right now and even my brain chemistry is all out of whack. I need the medications to help me manage these things.

    I also want to say I mentioned I was depending upon God’s help during this time. I was attempting to be strong and determined to overcome this problem by myself. The wisest thing I could have done would have been to make the decision I needed the help of that medication early in the day and not get myself so stressed out. They sent me home with that medication and instructions for a reason. I believe God helped me manage that difficult day and he helped me wake up to the fact that he had that medication there for a reason. (Sometimes I try to be too tough.)

    Day 14 was much better because I got myself on a baseline of the medication Ativan to control anxiety. Then, after a day off at home, I had an early afternoon appointment at the cancer center. Perhaps the thing I got most form that visit was my nurse (Carrie) talking extensively with me about my anxiety and how I let it go too far. But she also reassured me that it is good for me to know and understand my body and try to control things myself. It’s just too early for me to take on those battles without the help they have given me.

    When I walked out of the cancer canter I had blood test results that are right on target. Things are going very well and they have even ordered the removal of my Groshong catheter (that is a safety net for a cancer patient because we get nearly all our blood tests drawn from this little device so hearing that was a bit challenging. And I questioned my nurse practitioner (Julie) only to be told it is safer for me to get it out to protect my body from infection). We also have some medication changes to make this week which I will describe next time. And I am off of the Nutropenic diet so I can eat things like salad again.

    Today is day 15 and I am doing well. I started my morning out by picking myself up off the floor after falling. I was attempting to navigate my way from the bed to the bathroom and something went wrong. I don’t see any damage on the walls or floor, but I think I scared Deborah to death. It made me nervous too, but I think I got dizzy and crashed and burned before I realized what was going on in the dark.

    Finally, one of my doctors told me last week that I was an overachiever and that I would be going home from the BMT unit early. He reminded me about that yesterday. In Reality God answered everyone’s prayers. Thank you!

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  23. January 31, 2008 — BMT Day Plus 16

    24. Today is day 16 of my BMT process. Let me just take a minute to tell you everything is going very well. I had additional blood tests run today and saw the nurse practitioner. I don’t have to go back until next week.

    I started my second antibiotic called Bactrim this morning and will take it two times a day two days a week for the next six months. That goes along with the Acyclovar, which I will also take for the next six months. I am still using Ativan in a minimal dose.

    The difficult thing to deal with is being more or less in isolation for the first thirty days post transplant. I am getting close to being able to start doing a few things real soon. Thank you for your continued prayers and support.

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