Here’s my latest update, along with details about the reality I’ll be facing (as far as I know without having actually experienced it) for the next six weeks or so.

I met with the Bone Marrow Transplant team to go over everything before all the transplant prep starts. My blood tests show that I’m in Complete Remission!!! Remission in this case means that my cancer numbers are near zero. That is really good, because the fewer cancer cells I have, the longer remission can last. All those treatments for four months worked!

You may ask why I need to do a bone marrow/stem cell transplant if I’m already in remission. It’s because they need to kill every cancer cell in order for remission to last longer than a few months. Without it, the few cancer cells left in my blood would begin to multiply and I’d be back where I was in November, with cancer raging and tumors forming all over in my bones. In addition, the treatments they can give me in the future won’t work as well as the ones they used first time.

You may also ask if the transplant will cure my cancer. The answer to that is unfortunately “no”. There currently is no cure for Multiple Myeloma, but there are things that can be done to increase the quality of life and my time in remission. Everyone has cancer cells that pop up in their bodies, but most people have other cells that detect them and kill them before they can multiply. My body has a genetic mutation which doesn’t fight these cancer cells, so they pop up again, I won’t be able to fight them off, and the cells will begin again to multiply. Thankfully, I have modern medicine to help me fight them.

The BMT doctor described the transplant this way: Imagine that your lawn is so filled with weeds and garbage grass that you need to completely start over and re-seed it. You get some new good grass seeds to plant, then you spray the whole lawn with an herbicide, which kills all the weeds and garbage grass, but also any good grass that’s still there. You clean all the dead stuff off, leaving bare dirt, into which you plant all new seeds. Finally, you water and watch and wait until you have new, beautiful grass. Here’s that process as it will work with me:

Stem Cell Collection (Get some new good seeds): I started the pre-transplant shots on Friday. The shots are a compound that tells my bone marrow to send stem cells (seeds of blood cells) into the bloodstream. I get these every day for four days. These give me a constant headache, plus bone pain, which I feel mostly in the bigger bones. The first day I had body aches like the flu. Three days later it’s more like the back pain of childbirth. Fun, fun, fun.

After four days of this, the blood is now full of stem cells, so I get hooked up to a machine (kind of like a plasma or dialysis machine) that takes the stem cells out of my blood and clean them up so there is a higher concentration of healthy cells. Then they put the blood back into my veins and store the stem cells in a freezer. I’ll sit, hooked up to a machine for 5-6 hours a day for 2-3 days. I’m told that this will make me really tired for several days.

High Dose Chemotherapy (Round-up): I get a few days of rest, then I get a super dose of chemotherapy. They call that “pre-transplant conditioning”. Sounds nice, right? It’s actually pretty nasty. It destroys the cancer cells, along with existing bone marrow (creating space for new stem cells to grow),and suppresses the immune system (so new stem cells won’t get attacked). This is where I’ll get really nauseous, my hair will all fall out, and I’ll feel really awful for about a week. Having also eliminated all infection fighting cells, I’ll be very weak and vulnerable to every kind of infection.

Re-Infusion (Planting new good seeds): Having cleared the bone marrow, they finally put the purified stem cells back in my body and wait for the new blood cells to grow (called engraftment). Because my white blood cells are gone, and I won’t even have enough red blood cells to carry oxygen around to my body, I’ll be really weak until the blood cells multiply to healthy levels.

All this takes about 6 weeks with daily trips to the hospital or the BMT Clinic so they can do all these procedures and watch me like a hawk. We keep that up until my cleaned-up stem cells are producing an acceptable level of healthy, cancer free blood cells. The transplant will then be complete, then it’s just being patient for several months while I regain strength and energy. It will be a while before I’m back to any level of normalcy. Hopefully all this will give me several good years where I am healthy and strong.

I had a really good, strong several days last week where I was able to experience my normal energy and enthusiasm to tackle the world. That was a blessing for several reasons. I’ll write about the most important one in another post. It was great to feel like myself again, even if it was pretty short lived. All in all, I’m feeling good about the past, and pretty nervous about the future!