November 30 - The transplant

Dennis celebrated a stem cell birthday today at 1:30. His stem cells were returned to him within a half-hour; what an amazing process this is. Dennis is resting and is now another step closer to being home. Until then, we are residing in Room 8217.

Stem cells  live in the bone marrow, where they divide to make new blood cells. Stem cell transplants (or bone marrow transplants) are conducted to restore the stem cells when the bone marrow has been destroyed by disease, chemotherapy or radiation.

The Karmanos staff, while describing this transplant, told us that when his cells are returned to Dennis there will be a heavy aroma of, “some people say garlic, others describe the scent as tomatoes, and still others report the smell is like creamed corn”. Well, in this case, it’s tomatoes – a very, very, strong scent of tomatoes. I’m sitting next to Dennis in a mask as he sleeps, not because he needs me to wear one, but because my stomach is queasy unless I do. We are advised this will last only about 48 hours, but as that time ticks away the odor seeps from Dennis’ pores and from his breath when he talks (or snores). He was advised to bring breath mints with him; I’m here to tell ya – ain’t gonna help. There were 3 transplants on the floor today. One activity patients must do to get well is walk - the only place to walk is the hallway. I used to enjoy tomato soup. We understand the preservative the stem cells are frozen in causes this odor.

Stem cells are living cells that would die if frozen without a preservative, which attaches itself to each individual cell. The stem cells wear their little “jacket” until it’s time to thaw and then transplant them. I’m wondering if there is more than one type of preservative. Maybe it will smell like garlic tomato soup with a side of creamed corn here in a few hours.

I have captured some pictures so you can “watch” the stem cell transplant if you want to; but, if you would rather not see it, please stop reading here. Hover over the pictures to make them larger.

The transplant team

Out of the deep freeze. Notice the "fog"? There were 5 storage tins containing Dennis' stem cells. An additional 5 tins are being kept in storage in the Karmanos lab in the event Dennis ever needs more.

Each tin of stem cells was systematically checked to be sure the cells belong to Dennis.

The stem cells were removed from the tin they were frozen in and warmed in a bath; not long enough to warm them completely, but long enough to thaw for transplant.

The stem cells were retrieved and readied for return to Dennis. The transplant team had 15 minutes from the time the stem cells were thawed to return them to Dennis or the cells would die.

In total, 10 tubes of stem cells were slowly re-introduced to Dennis through his PICC line. Dennis was asked questions consistently during the short 1/2-hour process so his mental acuity could be monitored through conversation, as well as his blood pressure and heart rate. 








Okay, stem cells - do your thing!

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November 29 - Waiting for admission

Hello everyone -

I'm not sure if it's the medication keeping the nausea away after chemo, or if I'm just a member of the "lucky 50%", but so far no nausea at all. I'm feeling "out of sorts" but not sick, really; just wiped-out and napping a lot. I'm bored with sitting around and want to get things moving forward.

The only difference I really notice is a challenge focusing while reading or following along with conversations. It feels like I'm in a fog. Questions I know the answer to take a minute or two to concentrate on and answer. I'm also having trouble hanging onto things. I drop things easily and am having a hard time picking things up. We're told this is a neuropathy affecting the nerve endings in my fingers and is a side-effect of the chemo (and will go away eventually).

Transplant day is tomorrow; we will receive a phone call in the morning to let us know what time to be at Karmanos for admission to the hospital. We'll let you know how that goes! Thank you for checking in on me.

Dennis

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November 28 - Hammer receives "The Hammer"

One word describes today.  B – o – r – i – n – g

But, all is well.  Today’s prescription is the full day of the chemotherapy referred to as  “The Hammer”, and is an infusion that will take 8 hours to complete. This chemotherapy will (gradually) completely destroy all of Dennis’ red and white blood cells. There are 3 prescriptions waiting for us to pick up in the pharmacy “just in case” of nausea, moving forward from tonight. Eating “light” has been recommended at dinner (no fast food/grease).

As to what we can expect, the staff here relates that, because the chemotherapy effect is gradual, Dennis will feel pretty good on Friday and Saturday (December 1 & 2), and then will begin to feel weak and “crappy” in general as his white blood cell count drops. Red blood cells can be replenished with a transfusion if necessary, but the white blood cells must rebuild themselves; hence, the low immunity level. We are told that by the time Friday & Saturday December 7 & 8 arrives, the white blood cell count will be at it’s lowest and Dennis will feel at his worst (and will lose his hair). After that, however, the white blood cell count begins to climb, and as it does, Dennis will begin to feel better. We are hopeful that he will be released from Karmanos in 14 days (around December 15).

With the above timetable in mind, if you would like to visit, you are certainly welcome. PLEASE don’t feel as though you need to visit, though. It is quite some distance from West Michigan.

We did learn yesterday that the doctor expects us to stay very close during the first week after release – so it looks like another hotel stay may be necessary. Because everyone recovers from a transplant at his or her own pace, everything in regard to dates and condition remains tentative. We’ll be sure to keep everyone posted.

Tomorrow, November 29, will find us here again for 5 or more hours as Dennis is monitored and receives more hydrating fluids. Friday is the long-awaited and very well-earned day of transplant.

Dennis is receiving all of his messages, thank you for sending those along. We really appreciate all of your expressions of affection and support. Thank you so much for your friendship. 

Dennis & Deb

An aside - For those of you interested in the cost of cancer (we always find it to be interesting, but mostly unbelievable):  Eight ounces of today’s chemo drug is approximately $20,000 (a nurse’s guess). Add that to that the special injections needed before the stem cell harvest – $35,000 (for 12 injections).

We're thinking we will create a tab here about the cost of this process, in case others are interested. We continue to shake our heads in amazement and completely agree that the health care system in this Country needs a MAJOR overhaul.

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November 24 - Schedule is set

We  received the the much anticipated telephone call from our transplant coordinator yesterday. Dennis and I will be leaving for Detroit on Monday afternoon, November 26 so Dennis can begin the grueling medical preparation necessary for his transplant. We will be staying close-by the Karmanos Cancer Center, at The Holiday Inn Express on Washington Blvd., during four nights this week.

• Tuesday - Meet with Dennis' doctor. Dennis will also receive his PICC line on this day. 

• Wednesday - Dennis will undergo 8-hours of chemotherapy; this is the very heavy dose of chemo that his doctor refers to as "the hammer'. 

• Thursday - IV fluid intake and monitoring all-day.

Dennis will be admitted to Karmanos, and will receive his stem cell / bone marrow transplant on Friday, November 30.

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November 21 - Relaxing at home

At home

We're home from Detroit and relaxing until we receive word from the doctor at Karmanos that Dennis has been scheduled for his transplant.

We are thankful for the opportunity to be with our family on Thursday to celebrate Thanksgiving.

We will update this page again when there is more news to report. Enjoy the holidays!

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November 20 - Stem cell harvest, Day 2

No more Cobe-spectra

A second long day was spent attached to the Cobe-spectra. Great news, enough stem cells have been harvested, meaning Dennis will not need to spend a third day on this machine.

We left Detroit and are home this evening. 

Dennis is doing well, albeit a bit weak and tired from the procedure. He does have thrombocytopenia - his blood platelet count is low, which is normal after a stem cell harvest. Special care must be taken against an open injury, so no shaving with razor blades for 5 days. . . and he can't run with scissors.


Because platelets are needed for clotting, cutting himself with a low platelet count will put Dennis into a possible '911' situation. 

The next milestone in this journey is the transplant. Stay tuned to this space and we'll let you know when.

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November 19 - Stem cell harvest, Day 1

Cobe-spectra

Tired, and very sore from laying on his back, and in one position, for 6 hours, Dennis has completed day 1 of 2 harvest days. With both arms hooked to this machine (called a Cobe-spectra), a patient absolutely CANNOT MOVE their right arm for fear of dislocating the line.

Blood is being removed through Dennis' right arm, then runs through the machine where the stem cells are being retrieved, and then his blood is returned to him through his left arm. Amazing.

We will return to Karmanos bright and early tomorrow morning for another day of harvest.


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November 18 - In Detroit

Dennis and I are in Detroit tonight, staying downtown at The Holiday Inn Express on Washington Boulevard.  We will report to Karmanos Cancer Institute at 7:15 a.m. on November 19 so the doctors can begin harvesting his stem cells. We expect to be in Detroit for 2-to-3 days, until enough cells are retrieved for freezing. Dennis will receive his own stem cells during the transplant.

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