The Biggie : Day Zero

So here it is, the day that took the most intense months of my life to reach. Alex stayed overnight at Hammersmith Hospital, and we got to see her go down to the “theatre” (Its in her blood, darling). Bridget managed to get some excellent footage of Alex “going under” (video, for your viewing pleasure to follow) The procedure started at about 10am and took about an hour. The doctors successfully removed over 1 litre of bone marrow. Incredible.

In the meantime, I received my daily Cyclosporin. This is an immuno-suppressant. The idea is that it will prevent my immunity from attacking my sister’s stem cells which would prevent succesful engraftment. I also was given Piratin and Hydrocortizone to help prevent a major reaction to the transplant.

At about 11.30am the bone marrow arrived, a big bag of darker-than-normal blood. We watched awestruck as it was hooked up and dripped into me via my trusty Hickman line. 6-and-a-half hours later, under frequent monitoring, the bone marrow had been fully transplanted. I only experienced a very slight rise in temperature and moderate drowziness.

Alex’s bone marrow is now inside me.

Alex’s Recovery

Alex is recovering very well and seems to have regained much of her colour. She will be sore in her “lower back” and a little anaemic for a couple of weeks. Needless to say, I am inexpressibly grateful to Alex for giving me the gift of another chance of life.

The Road Ahead

Unfortunately, this doesn’t work like a movie when the sweaty doctor pulls his mask down to tell the anxious family “We saved him!” Not at all. This is just the beginning of my (possible) cure. There are basically 2 phases to my recovery:

The next 3 weeks: It will take Alex’s stem cells until approximately Day 21 to find their way to my bone marrow and start building up a new immunity system. Do you realize I’ll actually change to my sister’s blood type? (From O-Positive to O-Negative)

During this period, my current immunity system will be killed. (The reason is twofold: To make an attack on remaining leukaemic cells and to clear the way for my new immunity system) This is already happening due to the last round of chemotherapy and particular those mother radiotherapy sessions. So I will experience a breakdown in my blood system: I will become anaemic, lower my clotting ability and become open to infection (neutropenic). This openness to infection(neutropenia) is the major danger during this period and will be tackled with extreme hygiene, choice of diet and prolific use of antibiotics. I will also receive transfusions of red blood cells and platelets as necessary to deal with the anaemia and clotting issues respectively.

Another major issue during this period is the fact that the chemo and radiotherapy attacks the fast-growing cells in my body. This causes a painful condition called mucositis where the lining of the mouth and gut become very sore. This weekend I will be fitted with a very attractive nasal-gastric tube (NG tube) that will allow feeding through the nose during periods when my mouth is too sore to eat or swallow. Scrupulous oral hygiene will be employed during this time. If the pain gets bad enough, I have been promised dimorphine (Heroin!). So things aren’t all bad.

There-on: By day 21(although this varies widely) we hope that my new immunity will be in place and my body will start to rebuild to normality. However, the major danger during this period is Graft vs Host Disease (GVHD). Basically this means my new immunity will recognize my body as ‘foreign’ and start attacking it. This will be somewhat controlled by the continued use of the immuno-suppresant cyclophosphamide. There are various degrees of GVHD and although it can ultimately prove fatal, there is also a benefit to a slight amount of GVHD. Namely, it can help ‘scour out’ any remaining leukaemia and prevent a relapse of the disease. So I’ll hope for a very slight amount 🙂

Thanks again for all the support, I will update as often as possible.

Until then, follow your bliss! Don’t let fear and anger spoil the gift of your life. Oh, and no white socks with black shoes. Toodlepip, milt.

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