Saturday, March 23, 2013

Stem Cell Transplant... Six Months Out.

This morning I walked west bound on Beacon Street for about a mile and then back to my apartment, (just two miles from Fenway Park). Beacon Street is lined with old but well kept, three and four story brownstones interrupted at random intervals by contemporary, concrete gray apartment buildings. Shrubs and flower beds form a border between the buildings and the sidewalk. While walking today I noticed white and purple crocuses pushing through the dirt, rhododendron buds swollen with purpose amidst shiny green leaves and a sprouting tree here and there. Not many years ago I would jog this same route to clear my head of work stress, oblivious to spring's nascent beauty along the way.

I completed an auto stem cell transplant this past September. 'Auto' is short for autologous and, as my friends on this path know, refers to a transplant of one's own pre-harvested blood. An allogenic transplant uses a donor's blood. On day one, I reported to a procedure prep area and an hour later a port for drug delivery had been painlessly inserted, high on the right side of my chest. Next, I was delivered to a bed in the sterile enclosure of the stem cell transplant area, and placed in the care of a  bright, intense team of specialized nurses.

At each point of my three week stay the nurses prepped me for what was to come, describing in detail how a procedure would be done, why it was being done and how it would effect me.  Melphalan was administered on days two and three and on day four, my bright red stem cells were returned to my body and went to work.

Knowing that melphalan rages on myeloma cells made the discomfort, (some nausea and diarrhea), easier to put up with. I followed the advice of my nurses; by chewing ice chips during the chemo infusion and using a prescribed mouth wash as scheduled I minimized mouth sores. Just getting out of bed and walking the floor around the nurses station, strengthened me enough to win my release a day or so earlier than planned. Adhering to a few simple guidelines like hand washing, avoiding raw foods and germ laden environments like supermarkets for the first three months, I remained free of colds and flu.

Having a caregiver for the first week or two at home is important. I wanted to avoid burdening my son and daughter, (both in their early twenties), during recovery. Brushing aside my concerns they took charge, coordinating visits and preparing a sterile and functional environment at home ahead of my discharge. Once home they sent updates to family, worked out a transportation schedule for follow up appointments, shopped for groceries and cooked my meals. I think they spoiled me.

Once the decision is made to undergo an SCT it helps to be aggressively positive from the start. Focus on the results you are hoping for and rely on your nurses who have cared for hundreds of transplant patients before you. I thought of the many who had preceded me, some with more than one SCT, and I knew I'd get through OK.

My desk faces three large windows that line the wall of my apartment on the backside of the building. With my morning coffee I look out beyond the resident parking area to a sparsely wooded section that rises sharply to a neighborhood of old, wood frame, Victorian houses set on the highest elevation in the town. A huge red brick and field stone retaining wall, 50 feet high by 200 feet wide, built in the early 1900s, supports the high ground. A pair of cardinals, the male a bright red streak chases the female, camouflaged in a subdued maroon splotched with brown and grey,  collect material to build their nest. They have been a special presence during the three years I've lived here and it's good to have them back as spring arrives.