George’s Journal

Cheryl and I went to City of Hope, Tuesday morning for a very important appointment with my hematologist-oncologist, Dr. Robert Chen.  At this meeting, we would find out whether I was cancer-free.  Last Friday, I had my first PET-CT scan, i.e., cancer screening, since my Bone Marrow Transplant. We entered the clinic room at 11:30 AM, and soon after Keri Halsema, my primary nurse for the past nine months, entered the room.  She went right to the computer and logged onto the site showing my medical records. After pulling up my PET-CT scan results, she turned to me and said, there is “no metabolic activity”. Which means, “no cancer in your body”!

We’re obviously thrilled with this result. Our prayers have been answered! You see, there was no guarantee that I would be cancer free as a result of the BMT.  I’m not completely “out of the woods” yet. We will continue to pray for a cancer-free result in my next screening, which takes place in two months.  A cancer-free result in that screening will serve as confirmation for today’s diagnosis. Dr. Chen says my outlook is good, but it’s premature to consider myself “cured”.

For all of you that have been praying for me, thank you, thank you, thank you!  Your care and support is deeply appreciated. Your prayers are working! Please keep them up.

GETTING BACK ON THE HORSE

Monday, I woke up and decided I had to jump-start my physical conditioning. Since arriving home, I’ve been very fatigued.  That’s one of the primary side-effects of a BMT, it takes months to regain your optimum energy and stamina.  As I alluded to last week, my shoulders and legs, in particular, are rather weak.  Plus, I was really getting cabin fever!  Anyways, I had to do something bold to start “getting back on the horse” conditioning-wise. I decided to go for a one-mile walk, figuring if I really needed to, I could stop for a rest.  Well, about 30-minutes later, I completed the walk, though did stop once for a 2-3 minute rest.  This walk totally exhausted me; but it’s a victory, a start!

My goal is to get back to my 2-mile runs. It will take some time, maybe two, three, four months, but I’ll get there. Also, I’m extremely eager to get back to work; though, based on my present status, that may take another 30-60 days.

NO RESTAURANTS OR TAKE OUT?

Have any of you ever tried going without “take out” food or going to restaurants for 3-4 months?  Three weeks after being discharged, I’m discovering that it’s not easy!

My diet is very restricted.  It’s called a low bacteria diet. The purpose of this diet is to help me avoid foods that are more likely to cause food-related infections.  It consists primarily of cooked foods from my regular diet. There is a limited selection of allowable fruit.  Fruits I can eat are “thick skinned”, such as apples, bananas, pears and melon. Foods/beverages to avoid include:  berries, freshly squeezed juice, bottled drinking water from dispensers, raw vegetables, beer, wine, potato salad, pasta salad, raw nuts, raw meat, sushi, ceviche, pre-prepared refrigerated foods, uncooked cheese, refrigerated salsa, etc.  You get the picture!

As I mentioned last week, fortunately for me, Cheryl is an excellent cook! My BMT took place, May 6th, and I’ll be on the low bacteria diet for 100 days from that date (August 14th).

EDUCATIONAL:  STEM CELL TRANSPLANTATION BECOMES AN EFFECTIVE OPTION

If you’re stretched for time and/or not too interested in some educational material, then just scroll to the bottom. I picked up a publication from The Leukemia & Lymphoma Society entitled, Blood and Marrow Stem Cell Transplantation. The booklet provides information for patients and their families about blood or marrow stem cell transplantation for the treatment of leukemia lymphoma, myeloma, myelodyplastic syndromes or other cancers of the blood and marrow. In order to promote knowledge of Bone Marrow Transplants and demystify a complicated matter, I wanted to share some of the information, including a brief history of Transplantation, along with some glossary terms.

“In the mid-19th century, Italian scientists proposed that the marrow was the source of blood cells. The idea that a factor in the blood-forming tissues from one individual might restore the injured marrow of another individual was considered a century ago. Some thought this factor was a chemical that could be transferred by eating the marrow!  At the turn of the century, scientists began to formulate the idea that a small number of cells in the marrow might be responsible for the development of all blood cells. They began to refer to them as “stem cells”.  Attempts to use the marrow cells of a healthy individual to restore the lost marrow function of another person are more than 60 years old. Early attempts at human marrow transplantation were largely unsuccessful because the scientific basis for achieving successful outcomes was not yet known.

The scientific exploration of marrow transplantation as a form of treatment began at the end of World War II.  Stem cells are very sensitive to irradiation injury.  Thus, marrow injury was an important and potentially lethal side effect of exposure to the atomic bomb or to industrial accidents in the atomic weapons industry. In the late 1940s, studies of marrow transplantation as a means of treating radiation-exposed combatants or civilians were spurred by the Atomic Energy Commission’s concern about the spread of nuclear technology and weapons.

The basis for stem cell transplantation is that all blood cells and immune cells arise from stem cells in marrow. The idea that medical disorders that affect blood cell or immune cell formation could be cured by marrow transplantation encouraged research by civilian scientists as well. These research efforts led to the current success of stem cell transplantation as medical treatment. Estimates from the data reported by the Center for International Blood and Marrow Transplantation Research (CIBMTR) indicate that about 7,880 patients received allogeneic stem cell transplants, the type I received, in 2005 (the most current data available).  CIBMTR estimates that about 10,840 patients received autologous stem cell transplants (uses patient’s own stem cells) in 2005.”

WHAT DOES IT MEAN?

Below is a selection of terms and definitions from the Blood and Marrow Stem Cell Transplantation booklet. As an interested observer, a more complete knowledge and/or review of these terms may be useful.  In my earlier journal postings, I’ve provided some insights to a number of these terms, as they relate to my situation.

Bone Marrow: The bones are hollow and their central cavity is occupied by marrow, a spongy tissue that plays the major role in the development of blood cells. By puberty, the marrow in the spine, ribs, breastbone, hip, shoulders, and skull is most active in blood cell formation. In the adult, the bones of the hands, feet, legs and arms do not contain marrow in which blood cells are made.  In these sites the marrow is filled with fat. When marrow cells have matured into blood cells, they enter the blood that passes through the marrow and are carried throughout the body.

Hematopoiesis: The process of blood cell development in the marrow. The most undeveloped cells in the marrow are stem cells. They start the process of blood cell development. The stem cells begin to develop into young or immature blood cells like red cells or white cells. This process is called “differentiation.”  The young or immature blood cells then further develop into fully functional blood cells. This process is called “maturation.” The cells then leave the marrow and enter the blood and circulate throughout the body.  Hematopoiesis is a continuous process that is active normally throughout life.  The reason for this activity is because most blood cells live for short periods and must be continuously replaced. Red cells die in 4 months, platelets in 10 days and most white blood cells in 2-3 days. About 5 hundred billion blood cells are made each day!

Lymph Nodes: Small structures, the size of beans, which contain large numbers of lymphocytes and are connected to each other by small channels called “lymphatics.” These nodes are distributed throughout the body. In patients with lymphoma, Hodgkin lymphoma, and some types of lymphocytic leukemia, the malignant lymphocytes grow and expand the lymph nodes so that they may be enlarged.

Lymphocyte: A type of white blood cell that participates in the body’s immune system.

Stem Cells: The multipotential cells in marrow required to make red cells, white cells, and platelets. Generally, the stem cells are largely found in the marrow but some leave the marrow and circulate in the blood. The stem cells in blood can be collected, preserved by freezing and, later, thawed and used for stem cell therapy.

I hope the above history and definitions provided you further insight into the medical world I’ve lived through. The human body is a very complicated organism. For those of you who have experienced a life of good health, it almost amazes me because of all the things I’ve learned that can go wrong.  Good for you, and continued good health!  Up until I was diagnosed in November 2001, I was the picture of good health. Rarely needed to visit a doctor, whether medical or chiropractic. Typically in very good physical condition, ate the right foods and worked out several times weekly.  Who knows how I attracted Non-Hodgkin Lymphoma.  You learn quickly not to spend time thinking about that.

Right now, I feel extremely blessed. Our good Lord has been taking care of me.  I give Him all the glory for my dramatic improvement since March 12th.  I pray to remain cancer-free.  As mentioned above, I have one more PET-CT scan in August. Our hope is that screening will confirm my present diagnosis. As always, I’ll enjoy each day, and count my blessings.

Lastly, for those of you who have made a donation, Cheryl and I are monumentally grateful.  Your generosity has really touched our family, and eased much of our financial burden.

God bless you and yours,

George

…”With God all things are possible.” (Matthew 19:26)


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