1/4/14 – Pre Transplant Stuff

Yesterday I met with the doctor for my pre transplant consultation.  For those who are new to the blog, I am having a Stem Cell Transplant beginning on Monday 1/6.  A stem cell transplant is the infusion or injection of healthy stem cells into your body to replace damaged or diseased stem cells.  I will have this done at Hackensack University Medical Center in New Jersey.  The idea behind this is to kill all the Myeloma Cancer cells in my body with high dose Chemo (Melphalan) and then put new stem cells in hoping that they produce healthy non-Cancer cells.

Stem cell transplants can use cells from your own body (autologous) or from a donor (allogeneic) depending on the source of the stem cells.  We harvested stem cells from my own body in July and I will be having an autologous transplant.

Helene said she got a lot of calls and texts about what happened at Friday’s consultation and the bottom line is … not much. Nothing that we didn’t know before.  They just wanted to take a look at me I guess and make sure I was healthy enough for the procedure.  I will blog a lot from the hospital but here is a brief look at the calendar for the next couple of weeks:

MONDAY 1/6 – DAY -1:  7:30 AM admission to HUMC.  They will insert a PICC line into my arm so they can administer the Chemo and the stem cells.  Also this will enable them to give me fluids for hydration through an IV and blood transfusions should my platelet count fall below the desired range.  Every day they will give me a complete blood work up.

After they insert the PICC line I will be transferred to the “all day” room which I imagine I will stay in ALL DAY.  I think that’s why it is called that.  My other theory is that it is named after my good friend and co-worker Jason Allday who has become so successful over the past few months that he donated a wing to the hospital.  I am going with the first theory on this one.

Once in the all day room they will give me IV hydration which I am told will give me ankle rolls – you know – where your ankles are so swollen they fold over your sneakers? – and then 30 minutes of high dose Melphalan to kill the Myeloma cells in my body.  The problem with Melphalan is that it will also kill all the healthy cells in my body at the same time.  That is why the hospital stay is 10-14 days.  Once the stem cells are injected back into my body I need to wait until I have enough white blood cells to fight infection.  My immune system will be very compromised over the course of the next few weeks.  Each night around 5 or 6 PM I will be discharged from the all day room and sent to an apartment across the street from the hospital where I will spend the night with an aide.

I hope she looks like this:

images-5

BUT … I bet she ends up looking like this:

images-4

TUESDAY 1/7 – DAY 0:  This is what is now referred to as my “birthday” or my re-birthday.  This is the day of the transplant.  I begin the day in the all day room and at some point the doctor will come in and give me back my own stem cells.  From this day on, the hope is that those stem cells produce no Myeloma cells.  Happy Birthday to Me!

WEDNESDAY 1/8 and THURSDAY 1/9 – DAYS +1 and +2:  Waiting, waiting and waiting until my blood counts rise in order to be discharged to home.  I should be feeling rather good these days.  The nausea from the Chemo won’t hit for another few days.

FRIDAY 1/10 – DAY +3:  Today I get my first shot of Neupogen to mobilize production of cells.  The good news is that unlike the stem cell harvest, I won’t have to give these shots to myself – remember what a baby I was during the harvest giving shots to myself?  There will be plenty of qualified medical professionals at HUMC to give me these shots.

MONDAY 1/13 – DAY +6:  Today is the day I will start feeling bad.  This is the day my White Blood Cell counts will be at their lowest number.  This is all good because I can’t go home until the WBCs go lower and THEN go higher.  It is not enough to have them just be high.  They have to drop first and then rise – SO the quicker they drop, the sooner they rise again and the sooner I go home.

SATURDAY 1/18 – DAY +11:  This is the doctors prediction on when I am most likely to be discharged to home.  Could happen sooner (10% chance he said) but day +11 is the most likely.

From that point on I will be home resting at least until the end of the month.  I can go out – just need to be careful.  Driving is a no-no I believe and I should stay at least six feet away from other people.  It is not going to be necessary to wear a mask.  Germs enter through the eyes and ears in addition to the mouth and nose.  The most important thing is to not touch random things (or anything) and then touch my face.  I have a penchant for rubbing my head when I am stressed out.

IMPORTANT NOTES:

VISITORS:  I am aloud to have visitors but only immediate family.  So if anyone wants to visit you have to tell them you are my brother or sister.  I told the doctor I have a VERY…LARGE…FAMILY.  In all seriousness – I want to see everyone that wants to see me but remember my immune system is compromised and although the all day room is private, there are other patients at HUMC that are in their own all day rooms and you may compromise their immunity as well.

If you want to visit… I want to have you – BUT please call me first.  That way I can limit the number of people at one time.  I really ought to have a limited number of people (if any outside the family) visiting.  We are appreciative of your thoughts and concerns but the most important thing is that I keep my immune system intact.

ALSO… please do not bring food, flowers or anything.  I am on an anti-microbial diet and the hospital will prepare all my meals when I am there and will prepare dinner for me in the apartment.

SPEAKING OF THE APARTMENT:  No visitors allowed in the apartment – except Helene.

FOR INFORMATION ON HOW I AM DOING OR NEXT STEPS OR DAY BY DAY:  I will frequently update the blog while I am there but you can also follow me on Twitter as that will be the easiest way to get information out quickly – especially if I don’t feel like writing an entire blog post.  Follow me at bradstrong (@bradcoustan) for treatment info, tidbits on transplant, NFL predictions and general life musings.  I’m a good follow – promise!

So that’s it.  I am ready for the road to remission.  Life in sweatpants.  30 days of rest and relaxation.  I have gotten so many calls, texts, emails over the past few days regarding this.  I appreciate the concern and care.  I GOT THIS!  I.  GOT.  THIS.

Will post some pictures from the head shaving party tomorrow night.

#bradstrong

6 responses to “1/4/14 – Pre Transplant Stuff

  1. Go Bradstrong!!! All of my thoughts and prayers are with you. You are an amazing man, surrounded by an army of supportive, loving family and friends, with an impressive crew of medical professionals all focused on one goal…yep, I’d say you’ve got this.

    -Schmidty

  2. Sending lots of love and hugs your way Brad!!!! Love you !! WIll be thinking about you every day sending positive energy your way. XOXO Jac

  3. Good luck. Waiting for things to happen is the worst. When my daughter got her stem cells back it was like a miracle day for us.
    My daughters hair didn’t fall out until 14 days after the Melphalan. She was going home by then so one of the nurses shaved her head for her.

  4. Love you!! We will continue to have you in our thoughts and prayers. Thank you for always keeping everyone in the loop on how you are doing and what’s going on! xoxoxo

  5. I don’t know you but I know I love you. Maybe this response makes sense to you … maybe it doesn’t. No matter. God bless you and your family.

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