Monday, December 21, 2009

Day -8 (Hospital check-in & catheter insertion)

Today the hospital called me at about 10:30am. I then walked over to the hospital together with Judy and checked in around 11:30am. We met up with the nurse and she gave us a tour and explanation of the Ackermann ward. We quickly saw the hospital room where I will be staying and met my new hospital roommate. His name is Jergen and is closer to the end of his stem cell transplant recovery, as opposed to me where I’m still at the start. I’ll send pictures of the room on a future post. The main thing regarding the hospital stay is that it’s a little like 6th grade camp. The admitted patients are expected to follow a specific schedule (daily weight check, blood tests, medication timing, eating times, etc) and also expected to bus your own food trays and change the bed linens twice-a-week. So patients here are not babied. Everyone has to pull their own weight. No exceptions (unless I might have a problem walking at some point. Then they’ll step in and help.)

So first thing after getting the tour and lay-of-the land, I sat down with Dr. McClanahan to review the treatment plan and schedule. I spoke with her regarding my receiving this stem cell transplant for MS. This will be her first time treating someone for an autoimmune disease (even though it’s exactly the same protocol as cancer), and she agreed with the basic science of the treatment (same as Dr. Raab, Dr. Thalheimer and Dr. Hundemer). It seems that the only people that disagree with the treatment for an autoimmune disease are the very people that SHOULD be supporting it. . . clinical neurologists.

It became very clear very quickly that Dr. McClanahan is an excellent and capable practitioner. Her extensive experience is the key to keeping my treatment and prognosis of recovery to plan. In the afternoon we went to a special room with ultrasound to perform the procedure to insert the jugular catheter (it's actually called a Peripherally Inserted Central Catheter, ot PICC) that snakes down close to the heart so that the chemo drugs are dispersed equally throughout the body at the same time. Dr. McClanahan, who performed the insertion procedure, is also a good surgeon. Following the catheter insertion I went down to have an x-ray to make sure it went down the superior vena cava vein near the heart, stopping about 2cm short of the pulmonary valve. I also saw the x-ray and it is exactly on-target! Dr. McClanahan made the whole procedure much easier on me than I was expecting. I now have an insertion and sample port connected to my neck. Very convenient for chemo, saline drips and blood draws. They plan to remove it following chemo so a potential source of infections is eliminated following the ablation of my immune system. And although it looks uncomfortable, it doesn’t bother me. In fact, it’s surprisingly able to move with my head & body.

The chemo will begin tomorrow (Tuesday) so that the drug delivery from the pharmacy can be properly timed for the remainder of the week. The timing of the chemo drugs is as critical as the administered dosage. So the schedule is to administer the BEAM drugs per the following:

B Carmustine (BiCNU®) - Tuesday only - once
E Etoposide - Wednesday, Thursday, Friday, Saturday - twice per day
A Cytarabine (Arabinoside) - Wednesday, Thursday, Friday, Saturday - twice per day
M Melphalan - Sunday only - once

Then Monday will be the pause day (-1) without any chemo followed by the stem cell infusion (day 0) on Tuesday of next week.

There are a lot of other details of what is going on here that I’m sure might be interesting to some of you. I’ll post some more of these details when I fall into the routine around here and really figure out everything.

Big news for me. . . Yuko will arrive tomorrow (Tuesday) evening. I haven’t seen her since I left for Germany three weeks ago. I can’t wait to see her.

And very important. . . . . continued huge “thanks” to Judy for sticking around to help me (and soon, Yuko)! This would be soooo much harder without her around. Thanks a million Judy! (Although, I bet she might be happy to have my lazy butt out of her hair!).

Last thing. . . a short video of someone I’d like to introduce to you. . . . .

See you tomorrow!

- George

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