Day 0 The Big Show

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	7.9	13-17	v
Platelets	83	140-375	v
ANC	1040	1800-8300	v

As you probably know, the life of a professional baseball player is pretty uncertain. Many a young man who was a high school star with dreams of pitching in the World Series against the NY Yankees (isn't everybody against the Yankees?) finds himself facing some pretty pesky barriers, if he opts for a career in the Big Leagues. I've read stories about guys who virtually never made it out of the minor leagues after spending ten or a dozen years hoping to make it to the "Big Show." That is to say, the Major Leagues, especially the MLB (Major League Baseball). 

It has taken me close to three years to make it to the Big Show in the world of AML, but today I was called up.  I mean to say that today I received a stem cell transplant, also known as a bone marrow transplant (BMT), which is the next step in this journey, if you are lucky enough to have the opportunity. 

As an aside, it occurs to me that this is the A-ml, and the other guys are in the ml-B. Is there a ranking involved here? I guess that's for someone wiser than me to figure out. 

Like a minor leaguer, I had times when I wanted to give up. There were times when I felt, "I can't do this anymore." But no minor leaguer ever made it to the Big Show by giving up or sniveling about how hard he had it. Sniveling is pretty normal for us mere mortals, but it is more of a hindrance than a stepping stone to the Show. 

And of course, once a player makes it to the Show, his striving is not over. Staying in the Show is the trick. It requires dedication and hard work. There will be slumps, and time spent on the Injured List (IL). I expect it to be similar for me post transplant. There are a few landmines along the way. 

The first and worst thing that is a possibility is that, in spite of the transplant, the leukemia could come back. With a new immune system, however there is the possibility of chemotherapy being effective again. The second challenge is graft versus host disease (GVHD).  GVHD involves the grafted cells (new immune system) attacking healthy host tissues, instead of just killing off the leukemia cells and any remaining marrow cells that could produce more of them. GVHD can be controlled with medication. I will begin receiving these medications in the next few days. In the meantime, the docs want a certain amount of GVHD to take place to start the process of the new immune system killing off the leukemia cells.

When I was first diagnosed with AML one of the Hematologist/Oncologists told us that chemo can put AML in remission, but BMT is the cure. That's why I call it the Big Show. At that same time, I was told that BMT was not an option for me, because I was too old, but three years later, here I am in the Show! Praise God for the advances He has revealed to mankind in the treatment of this cursed disease. Here in unit 14K, the BMT unit at OHSU, there are several older folks, who, I presume, are here for the same reason I am. 

The transplant itself was not particularly dramatic. Dr. Meyers had told us at our last consultation appointment that receiving the stem cells is kind of like receiving a blood transfusion (which I have done many times) only with a lot more people in the room. A lot more may have been a bit of an overstatement. There were two nurses and the attending physician, Dr. Chen. He stayed until the transplant was underway and then took his leave. Once the infusion began, the nurses stayed for about 1/2 an hour, and when there were no signs of untoward reactions, they left and returned about every 15 minutes to take vital signs. 

The transplant cells...         

  The recipient of the BMT. Oh, the humanity!

Jill and I read to each other from our latest mystery. I started to fall asleep. It was all a bit anticlimactic after the weeks of preparation. The nurse who actually performed the physical business of connecting the IV bag with the stem cells in it and monitoring the progress of the infusion, asked me, "So have you planned out your life of crime?" 

She was referring to the fact that once the BMT has "taken" I will have a new immune system, including new DNA in my blood elements and a new blood type! As long as I don't leave finger prints and offer to give blood when asked for a DNA   sample, the cops will be led to the donor, instead of me. The effect would be the same as the "Invisible Man," as portrayed by Claude Rains in the 1933 movie adaptation of H. G. Wells' classic novel. 

So, today was the Big Show for me. I have several weeks and months of recovery and supportive treatments to go through to fine tune the immunosuppressive drugs, provide me with transfusions as needed when my own marrow is eventually eliminated, during which time my blood counts will plummet. And even after those weeks and months, I will need close monitoring to be sure all is well. I have had the privilege of talking to some recipients of BMT, and they have indicated to me that they have been able to return to a lifestyle similar to what they had before AML. So, I am ready for the slumps and times on the IL for the joy of The Show.

...looking to Jesus, the founder and perfecter of our faith, who for the joy that was set before him endured the cross... (Hebrews 12:2, emphasis added)