Last Thursday was the 13th installment in my induction chemo plan. This means I have only 3 more treatments and then I prep for the stem cell transplant. :) The great news is that my total protein levels have been reduced from 18 to 2. Almost cancer free. :) Doctor was impressed and said I am technically ready for the transplant now (the goal of induction chemo is to reduce the cancer leading up to the collection of stem cells) but we may as well complete the planned course.
I will have my last chemo treatment (cytoxan, velcade and dex) on April 3rd. I will still need to go in on April 10th for my pamidronate (monthly IV to combat bone loss).
The next step is the "info session" with the doctor and transplant team on April 15th. At this meeting they go through the process in detail and we sign off on the procedures.
On April 20th I have the central line put into my chest...this will facilitate the high dose chemo, harvest of stem cells, reinfusion of stem cells, and any blood transfusions that may be necessary during my hospital stay. It goes in just below my collar bone and stays in until my white cell count is safe.
On April 25th I have high dose Cytoxan chemotherapy (the same one I am currently taking orally). This is my mobilisation chemo that preps my body to make lots of stem cells. The day after this chemo I will begin Neupogen shots every day for 10 days. This stimulates the production of blood cells and stem cells. A nurse will likely come to my home each day to administer this shot.
At the end of 10 days, on May 5th, I will go to the hospital for "collection" or "harvest". They will hook me up to a machine like a dialysis machine and re-route my blood to sift out the stem cells. That night they will call and tell me whether they got enough or if I have to come back for a second day of collection. They collect enough for 2 transplants. One for now and one to keep in the bank for later. (If you have read about Multiple Myeloma you will know that it is not yet curable, so after the transplant I will go into remission, but the MM will become active again. At that time, we will likely go through this process again - unless a new protocol has been developed.)
After collection I think I have a little break. :) I will be admitted into the hospital on May 20th for the transplant. I believe the process is for me to settle in on the first day, melphalan chemo on day 2. This is the nasty chemo that kills the cancer and destroys my bone marrow at the same time. It will make me very sick starting about 3 days later...and lasting for several weeks.
The next day I get my stem cells back. The process of engraftment then begins. This means that the stem cells make their way to my bones, and set up bone marrow production shops. It takes several days for this to start to be productive and once that happens, my white cells will start to increase. During this time, I will have no immune system and will be in the hospital in a sterile environment.
Once my white cell count is safe, I can go home. This will likely be about 2 weeks after my transplant. This is still a dangerous time...and I will be vigilant to ensure I do not get an infection or virus...so don't plan on visiting me in June. :)
I will be very fatigued and vulnerable to infection so I will be doing very little except resting over the summer. :) By early fall, I should be strong enough to start visiting and doing more. :)
That's it in a nutshell. I am anxious to get going on the next phase. This last 3 months has gone by very quickly, so I anticipate that the next will as well. I will try to keep up with my blog posts as best I can.
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