I spoke to Clyde this morning. It always makes me feel better when I do. Her strength and ability to appreciate the "here and now" are reassuring. I hope that someday, I too will have that quality of spirit. After we discussed her recent Rituxin treatment, we laughed hard about life. The strength provided by the knowledge that we're fighting this together is profound. I feel like we share a remarkable bond.
I made my flight arrangements for my next voyage back to Madison. This trip, I will provide lymphocytes that will be transfused into Clyde. The medical team will use the same blood separating process that was employed the first go-around. The procedure, called apheresis, will take blood out of one arm, separate the needed cells and then replace the blood in my other arm. It takes about three and a half hours but is not painful. The harvested blood cells are supposed to "jump-start" the anti-cancer effects of Clyde's new immune system. When I spoke to Jan, the transplant coordinator, yesterday she confirmed that around 50% of t-cell transplant patients get this form of booster shot. To use her language, it will help us "get out in front" of the disease again.
I think I finally realized the angst I was feeling about Clyde's current condition was more about me than it was her health. I'm aware of how selfish that sounds but it's completely honest. The reality is that I was ready to be the hero. I wanted to be the person that cured Clyde's cancer. Yeah, that sounds a bit sick but it's the truth. It is unbelievably gratifying to think that you've been able to do that for another human being. The fact that we're having to go back and do remedial work felt like a defeat.
I asked Jan point blank if we should consider the transplant process a failure and she insisted that it wasn't. Remember her language, "we just need to get out in front" of the disease. Fifty percent of patients get additional cells and that lasting remission is a real possibility. Right now the lymphoma has gained some ground but the fight is not over. We are going to win.
When my kids are going to an audition or competition, I remind them that they cannot make the judges pick them as the winner. All they can do is their best. What happens after that is in someone else's hands. I need to remind myself of that as well. All I can do, all the medical team can do, is our best. Nature, chemistry and biology will take it from there. Fortunately, the medical technology and expertise are on our side. Add that to Clyde's positive outlook and I feel good about our chances.
I'm looking forward to going back and contributing again to Clyde's return to good health. I'm confident that this next step will help us get to the tipping point. With my cells and Clyde's strength I don't see how we can be denied.
Thank you again for your support and good wishes. The energy created will help Clyde get to the state of good health she deserves.
Be well.
Friday, March 19, 2010
Tuesday, March 16, 2010
So, You Thought It Was Over
It would seem a logical conclusion that all is well since there haven't been any new posts in over a month. Unfortunately, that isn't exactly the case. Clyde is doing well to be sure but complications are still lurking about.
A short while ago Clyde had a full-body CAT scan that showed no traces of cancer. As you'll recall, that left us all dizzy with excitement. In the weeks that followed, however, Clyde began to feel lymph nodes that were growing as lymphoma cells collected in them. While typical for someone in Clyde's stage of a t-cell transplant, we were all taken by surprise. This was the first negative news of the entire procedure.
Clyde's doctor was not at all alarmed by the emergence of the lymph nodes. He had mentioned to Clyde and Tom that some cancer cells likely remained. His response was to, as he put it, "unleash the beast." "The beast", in this case, are the new immune cells that Clyde's body is making since having grown bone marrow genetically identical to mine.
To this point she had been taking a drug call Tacrolimus. This medication prevented her new immune system from "rejecting" her body in a condition called Graft versus Host Disease. By preventing GvHD, the Tacrolimus also slowed her new immunity from attacking remaining cancer cells. In the presence of lymphoma symptoms, the newly acquired immune system has to be put into action, GvHD be damned.
The Tacrolimus was put on the shelf with the thought that Clyde would then kill the cancer cells on her own. Follow-up doctor visits showed some progress against the swollen lymph nodes but it was decided that another full-body CAT scan was in order. In the meantime, Clyde was given several transfusions of red blood cells as those counts fluctuated wildly, a by-product of the new immune system working.
The CAT scan was today. Some of her lymph nodes appear to be slightly enlarged but there weren't any that were alarming. The one symptom of note is that Clyde's spleen is considerably larger than it should be. Her doctor, while not panicked, is treating this as something that requires attention soon.
Tomorrow, Clyde is having another transfusion of red blood cells as well as a dose of Rituxin, a monoclonal antibody that attacks cancer cells without harming normal cells. Additionally, I will be flying to Madison sometime in the next ten days or so to provide some supplemental blood cells. Those will be transfused into Clyde to "jump start" her own anti-cancer immune response. Dr. Longo assures Clyde that 50% of t-cell transplant patients receive additional cells at some point. This step could be considered routine.
Clyde describes this new turn of events as a "kick in the gut" but remains positive about the outcome. "This is how it is" she reminds me. With that, we're both able to resolve ourselves to the task of kicking some cancer butt. With help from all of you in the form of positive vibes, thoughts and prayers, Clyde will be back on the trail of good news and improving health soon.
I promise to keep everyone posted on how this new chapter plays out. In the meantime, keep a positive thought.
Be well.
A short while ago Clyde had a full-body CAT scan that showed no traces of cancer. As you'll recall, that left us all dizzy with excitement. In the weeks that followed, however, Clyde began to feel lymph nodes that were growing as lymphoma cells collected in them. While typical for someone in Clyde's stage of a t-cell transplant, we were all taken by surprise. This was the first negative news of the entire procedure.
Clyde's doctor was not at all alarmed by the emergence of the lymph nodes. He had mentioned to Clyde and Tom that some cancer cells likely remained. His response was to, as he put it, "unleash the beast." "The beast", in this case, are the new immune cells that Clyde's body is making since having grown bone marrow genetically identical to mine.
To this point she had been taking a drug call Tacrolimus. This medication prevented her new immune system from "rejecting" her body in a condition called Graft versus Host Disease. By preventing GvHD, the Tacrolimus also slowed her new immunity from attacking remaining cancer cells. In the presence of lymphoma symptoms, the newly acquired immune system has to be put into action, GvHD be damned.
The Tacrolimus was put on the shelf with the thought that Clyde would then kill the cancer cells on her own. Follow-up doctor visits showed some progress against the swollen lymph nodes but it was decided that another full-body CAT scan was in order. In the meantime, Clyde was given several transfusions of red blood cells as those counts fluctuated wildly, a by-product of the new immune system working.
The CAT scan was today. Some of her lymph nodes appear to be slightly enlarged but there weren't any that were alarming. The one symptom of note is that Clyde's spleen is considerably larger than it should be. Her doctor, while not panicked, is treating this as something that requires attention soon.
Tomorrow, Clyde is having another transfusion of red blood cells as well as a dose of Rituxin, a monoclonal antibody that attacks cancer cells without harming normal cells. Additionally, I will be flying to Madison sometime in the next ten days or so to provide some supplemental blood cells. Those will be transfused into Clyde to "jump start" her own anti-cancer immune response. Dr. Longo assures Clyde that 50% of t-cell transplant patients receive additional cells at some point. This step could be considered routine.
Clyde describes this new turn of events as a "kick in the gut" but remains positive about the outcome. "This is how it is" she reminds me. With that, we're both able to resolve ourselves to the task of kicking some cancer butt. With help from all of you in the form of positive vibes, thoughts and prayers, Clyde will be back on the trail of good news and improving health soon.
I promise to keep everyone posted on how this new chapter plays out. In the meantime, keep a positive thought.
Be well.
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