Transplant + 26

It has been a wonderful two days home.  Home sweet home is a great statement.  Although physically much has changed in our house in the last 6 weeks in preparation for me coming back, home is "where the herd is",   is certainly applicable.  Back in my own bed, a real chair to sit in, room to walk, recognizable food from an excellent cook.  There really is no better place to be.  I can look at our trees, see the farm from the road, wheat up, corn ready to go, colours still around but faded.  A good blessing.

What has been the hardest to get used to is the lack of intensive care.  No IV, no blood taking, no numbers, no questions to ask, or answers to question, no nurses or doctors or cleaning ladies.  It is peaceful at home.  Barb is feeling some of that pressure as she wants to ensure that all my needs are met and that I have the best food, the best nutrition overall, enough fluids, not feverish, get enough sleep and exercise.  All things for us to get used to.  We have all my medications figured out and put into the daily containers, and appointments figured out.  Our lives are quite focused on my health and health needs.

I am feeling good, sleeping pretty good, no fevers, enjoying Barb's cooking and trying to find the groove for the next while.  On Tuesday it is back to the Cancer Clinic and the Transplant Clinic for tests and go from there.  Today Barb was able to worship at church sitting on a chair at the back, slipping in and out, while I was able to listen to a service online this morning and on CD this afternoon.  A good Lord's Day.

Some people have asked what I was referring to when I speak of different phases in my treatment and that we are finished Phase 1 and going to Phase 2.

Phase 1 -  Consists of the intensive chemotherapy regimen, followed by stem cell transplant from donor on Day 0, known as transplant day.  Working through side effects of chemotherapy while waiting for the beginning of engraftment.  When engraftment has begun, and side effects controlled so that patient can go home.
            -  Phase 1 does not mean engraftment is complete.  My blood numbers are still quite low.  WBC have been raised using drugs and will have fallen now by 50% since I cannot have Neupogen shots at home. My platelets are barely stable and my hemoglobin is less than stable.
           -  Phase 1 completion does not mean my cancer is cured or in remission.

Phase 2 - The continuation of engraftment so that blood numbers go to normal range on their own and stabilize within that range.  Once that happens the doctors may call it a remission.
             - Phase 2 goes to around Day 100 post transplant while I am on anti rejection drugs.  I am at Day + 26 today.  I will be on cyclosporin which is an anti rejection drug.  This is to prevent my new stem cells, my new immune system, from rejecting my body as foreign.  The way it does this is by putting "brakes" on my new immune system so that it won't get to revved up and attack my organs.  We expect some of that to happen and this is known as Graft versus Host Disease (GVHD).  So during these next 2.5 months I will have a baby immune system with brakes on, making me vulnerable to most bugs.  I have been given a list of things to look for as engraftment takes hold and GVHD becomes a larger possibility. A little bit of GVHD is good, because it strengthens the immune system and will make it more aggressive against any surviving cancer cells.  Any GVHD prior to 100 days post transplant is called acute and can easily put me back into the hospital for treatment so a close eye on symptoms and a quick response to control is needed.

Prayer Requests

1.  Thanksgiving for being home and doing well.
2.  For strong blood tests on Tuesday that show engraftment continuing.
3.  For watching over me through GVHD.
4.  For good health for my children and grandchildren so that we can have them visit.

Psalm 31:3 ESV  "For you are my rock and my fortress;
and for your name's sake you lead me and guide me;