Thursday, April 2, 2009

The transplant plan...

First, thanks for the words of encouragement on the heels of my previous post, which I admit was rather moribund. But honestly, you should see that place.

We met with BB yesterday and he was quite optimistic about things. We went through my recent series of tests, confirming again that all the focal lesions are gone (although there are a lot of "hot spots" still, including many in my spine which puts to rest, I think, the issue of where the back pain is coming from) and that my IgG is down to around 5600. My marrow, which had been 70%+ plasma cells since diagnosis, is now around 50%, which is certainly a step in the right direction. BB is going to give me a couple of units of blood to help with the exhaustion.

Jill left today for a week to spend some quality time with the kids, which is overdue for all parties. My dear friend Paul is going to stay with me for a few days, followed by some friends from business school, whom I look forward to seeing. I continue to be humbled by the kindness and generosity of my friends and the difference that they make. Thank you.

The traditional transplant involves 1-2 days of very high dose Melphalan, a type of chemo that's been used for decades. Typically this dose will be 200 mg/m2, as noted previously. In the BB "lite" protocol, I will receive 50mg/m2 per day for four days -- the same total amount but fractionated to reduce toxicity: i.e. hopefully there will be no nausea of vomiting (BB seemed pretty confident of this). On the fifth day, I'll receive a bag of my previously-harvested stem cells. The Melphalan will destroy the old bone marrow and blood cells; the stem cells will rebuild it. While I have no immune system I'll be pumped full of blood, platelets and God knows what to get white counts up, and then presto: hopefully remission. Then I'll have a couple of weeks off to rinse, lather and repeat.

This will start on Sunday. In the meantime, I continue for daily labs and try to get rid of the last of my cough, which is still rattling around but is 99% gone. More news as it becomes available!


  1. Nick, thinking of you everyday. Your humor, spirit, and fight are awe-inspiring. Good luck on Sunday.


    P.S. "Blessed are the cheesemakers..."

  3. Best, best, best of luck tomorrow, Nick!
    Thinking of you all. You're in every prayer. Big huge hugs.