10-6-10 Wednesday

Status: 9.25/10.  Feeling good.  Of course, I’ve been getting 8-10 hrs of sleep a night, something I don’t expect to achieve in the hospital.  What is it about sleep that is so healing?  Your brain turns itself off and goes into hibernation mode, dismissing all but the most intrusive sensory input.  Much like your TV when you turn it off, there’s still a little current keeping things warmed up so when you push a button it’s instantly back on.  And while it’s off, it’s fixing an amazing variety of things.  Amazing stuff.    

Events:  We may have to go up to Hopkins a day early to sign consent forms, etc.  But admission is still planned for next Wednesday.

Comments:  So it sounds easy, right?  Just get rid of the old marrow, put in a new quart, and ta-da it’s done.

  Well, it appears the road isn’t quite so smooth.  The first obstacle is a prolonged period without an immune system (having been destroyed by the chemotherapy) and what’s seems like a scenario one or more serious infections until my new white cells develop. 

 First, they’ll try to minimize the chance of infection from outside – I’ll be in a single room whose air supply comes through a HEPA filter, and the room itself is under positive pressure.  What that means is that air only flows out of the room, not in.  They’ll have me on prophylactic antibiotics to reduce the bacteria in my gastro-intestinal tract.  The conditioning chemotherapy also plays havoc with other fast dividing cells (hair follicles and the GI tract), and the injured mucous membranes of the GI tract are an entry point for bacteria into the bloodstream.  I’ve already suffered one episode of bacterial sepsis after my last chemotherapy.  And transplant patients get other weird infections, called “opportunistic” infections just as people do who are also immuno-compromised, such as AIDS patients.  Those bugs are usually innocuous (your immune system takes care them without you even knowing about them), but without an immune system you are susceptible to even the weakest germs.

  So the hope is to get by with as few and as benign infections as possible during that first 30 days.  The next and more difficult hurdle comes from the new marrow itself.  More on that tomorrow.

Love,

-Bruce

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6 Responses to “”

  1. Hansan Family Says:

    Bruce,
    I’ve been in the health field for decades and are certain you are among a select few that can communicate complex issues so simply that even a lay person understands. Thanks for the lessons as well as for the ongoing strength you demonstrate. Hang in there. Mark

  2. wendy Says:

    no new infections. that’s my mantra.. NO NEW INFECTIONS. Think this is where all your beliefs create good energy in your cells even if you don’t have an immune system.
    prayers and lots of love wendy

  3. Debbie Blum Says:

    Bruce,

    So wonderful to hear that you are feeling well and everything is falling into place for the transplant. Maybe check with your docs about using Kepivance (palifermin) to prevent severe mucositis. It worked for me, but I don’t know the current thinking on its use.

    I continue to be amazed by your blog and the constant support of your family and friends. Keep strong and visualize all this behind you.

    Best,

    Debbie

  4. Margot Mahoney Says:

    May you be infection free.
    May you be infection free.
    A mantra for all of us to recite and send through the power of positive thinking. xxo, Margot

  5. joel steinberg Says:

    No infection! No graft vs. host! No nuthin’. You have all our best wishes and our hopes for a successful outcome. Joel and Margaret S.

  6. Judi Golding-Baker Says:

    My Dear Bruce

    Keep getting that good healing rest…my thoughts and love are with you and Lisa. Stay strong.

    Love you
    Judi

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