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The plan

I did not get to sleep until 3:30 AM or so. The steroids (helps lessen the chemo side effects) get you a bit wired plus I am sure my nerves are simmering. Bit of a surreal experience getting this crap injected into you. They game me the steroids and nausea medicine first. Then the 3 chemo drugs: Vincristine, Daunorubicin, Cytoxan The three amigos. Standard issue treatment for this so I guess it leaves little to guess. The big deal is getting the amounts correct given height and weight. Given the attention to process at RDA, I am driving the nurses at GBMC nuts. Every nurse does things differently. Some minor some major. I am every vigilant while I can to make sure the right stuff is happening (given what I have learned from my two favorite head nurses).
The chemo was generally anti climatic. Did not feel it going on except for a strange odor that my brain manufactured (happens when they flush my hickman--almond smell...weird). Watched a movie, shot the shit with a friend who could stay and finally got a quality 2 hours in before they came in at 5. It was a quick visit and I was back out till 9. Marcy and the Kids are do over 9:30/10:00 so I was up and about, ate breakfast and the brood appeared.

It was great seeing the kids. Libby is so pleasant now (finally ! ) Patrick picked right up with playing with Da-Da. He loved the up and down buttons on the bed. Gran had bought him a little people toy set which we had set up earlier. He played with for a while. We went for a bunch of walks down the hallways. I convinced the nurses to unhook the IV since I was only getting fluids for the moment. I have my Xbox here which plays DVDs so we had one in for Patrick. We all had lunch and played some more.

It was a shot in the arm to have my whole family here. The room supports it (palatial estate at GBMC) so there is no reason to have them over except if anyone is sick.

I had a chance to recap some things with Dr. Cohen in the morning. Of course, the PM is coming out of me so I needed the timeline, milestones, risks and such. I am sure I will be driving him nuts in a few more days . Here is the gist of my treatment plan:

Next three weeks: Marrow Chemotherapy
Goal: kill the marrow including the leukocytes cells. Start my own stem cells to fire back up and produce normal cells.
Risk: Infection. When the marrow is gone, I am in a dangerous period with no self defense--the Nader.
Mitigation: Antibiotics, Antivirals, Antifungals. Temperature control

Bone Marrow Biopsy:
Desired results: Remission (no abnormal leucocytes , improving blood counts)

10 to 12 weeks: Marrow and intrathecal (spinal column)
Goal: Kill any stragglers in the marrow. Kill any leucocytes that may be in the spinal cavity or brain. Intrathecal is a preemptive strike.
Risks: Same as above. Minor surgical procedure with the lumbar punctures. Headaches.
Mitigation: Same as above.

3 to 6 months from today, Bone Marrow Transplant
Goal: Intensive 2nd wave to eradicate any rogue abnormal cells. Reintroduce healthy marrow stem cells.
Risks: 10 time more extensive than normal chemo. Aplastic Anemia
Mitigation: Stem cell donor (myself, cord blood, anonymous, sister)

So, this is the drill that is a head. If things progress smoothly, and I get the transplant, I should be cured. Odds in my favor.

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Posted by: Gary on Jan 29, 03 | 7:00 am | Profile

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