Marc and I often joke that if there is a small percentage of something happening, then it will happen to me. I've said before how it was rare for me to have heart damage, infected gall bladder, kidney failure, and lung damage. The doctors were very stumped by me, and still are for that matter! I get the strangest reactions to medicine that doctors have either never heard of, or is rare. Some strange reactions I've had recently are rigors, chills, severe headache, extreme sensitivity to touch, a terrible bumpy rash, and a burning itchy rash that randomly moves around my body during the day. Here are some other odds:
Me getting AML Leukemia- .001%
Rejecting the transplant- 1% (My doctors here have never seen someone with a perfect match reject)
Well, my luck with terrible odds finally paid off today. Last week Marc took the kids to a relay for life and entered into a raffle for a free cruise. We got a call today that we won the cruise!!! I think it will be the perfect way to celebrate my one year graduation from transplant next year!
I have been told that alot of people don't know what a bone marrow transplant is, or how it works. I have been asked to try to explain the basics, so here I go!
Leukemia is cancer of the blood. It begins in the bone marrow where blood is made. Blood starts out as immature blasts. When those blasts mature they become either red blood cells, white blood cells or platelets. Then they are released into the blood stream where they live for a few weeks giving the body what it needs. Someone with leukemia creates immature blasts, but releases them into the blood before they mature. They then become useless space takers in the blood. As time goes on there is less and less room in the blood for white blood cells, red blood cells and platelets. Eventually the blasts take over and the individual dies from lack of useful blood.
Treatment begins with large amounts of chemo to kill off the damaged cells that create these immature blasts. Once the cancer cells become undetectable you are considered in remission, but just because they are undetectable does not mean that they are gone. Science has not come far enough to look closely enough to find every last cancer cell. The hope is that after 3 or 4 rounds of chemo, all the cancer has been killed and the bone marrow is clean. However, they have found that in about 70% of patients the cancer survived the chemo and over time grows to the level where it is again detectable. You could argue that 7 or 8 rounds of chemo would be more effective, but the fact is that most patients cannot survive more than 3 or 4. So in order to be sure that the cancer doesn't come back, the healthiest of patients are then advised to continue onto transplant. The idea of transplant is to completely obliterate my defective bone marrow with chemo and possibly radiation. I then recieve donor bone marrow that is put into my body through my central line. The donor cells find their way to the bone marrow and hopefully make themselves at home and begin their job of producing blood. In order for a person to be a donor the doctors look at the donor and recipiants blood. The match goes much deeper than blood type (infact, blood type DOESN'T need to match!) A perfect match is a 10 out of 10. Many people never find a 10 out of 10 match and have to settle for something less which is more likely to be rejected by the recipiants body or cause dangerous graft vs host disease (which is when the body fights with the donor cells). The donor goes through a very thorough health check and if they pass then they are given the drug neupogen for a few days which encourages their body to create extra stem cells. (basically stem cells are the bone marrow) Then they have one IV put into each arm. In one arm their blood is taken out, a machine filters out the stem cells, and whatever is left is put back into the donor in the other arm. This process is called extracting periferial stem cells. This is a fairly new method. The old method is to actually drill into the donors hip bone and use a hollow needle to extract bone marrow. This is a very painful process and is now rarely used.
So, where I fit into all this is.....I have recieved stem cells from a 10 out of 10 match donor. The stem cells never began producing blood. The doctors speculate that perhaps I have a few fighter t cells left in my body and they killed off the donor cells. That is the reason the doctors had me go through total body radiation before being given my second transplant. I personally believe that if their were fighter t cells that survived, then there were also cancer cells that survived. I think the radiation was nessicary for me to stay in remission. Thankfully my donor sent enough stem cells for 2 transplants. So after the radiation I was given the other half of the donor cells. We are currently waiting to see if this time they graft into my bone marrow. I have to remain hospitalized for all this because with my bone marrow being obliterated, and the new marrow not grafting, I have 0 immune system and I have to recive blood transfusions every 4-5 days to stay alive. With 0 immune system if I got an infection it would be extremely dangerous.
The doctors have given me until Thursday to show signs of grafting. If I haven't by then they will perform yet another bone marrow biopsy (ouch!!) to get a closer look at whats going on. If I don't accept this graft then it is most likely a problem with the donor cells, not my body. They have already contacted a new 10 out of 10 match donor for a possible third transplant. The new donor is currently undergoing a health check and should be ready to donate some time next week if need be. So right now I get to sit, wait and try not to get an infection!! I hope this all makes sense to everyone. I am no doctor so I apologize if I got something wrong, or just ended up confusing everyone!!!
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