T-1 One minute to midnight!

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	8.4	13-17	^
Platelets	100	140-375	^
ANC	1330	1800-8300	v

One of our favorite "Christmas Movies" is "Holiday Inn," which really is only a Christmas movie in the sense that part of the story takes place at Christmas, and Bing Crosby sings "White Christmas" twice. If you are not familiar with the movie, Bing Crosby plays an entertainer who is tired of the daily grind of multiple shows and all the traveling. He retires and buys a farm, but he soon finds out that farming is way too much work. 

Rather than give up the farm, he decides to turn the huge farmhouse into an inn that is only open on holidays. And of course, he, being a performer, performs on each holiday. There's a girl (Linda, played by Marjorie Reynolds) and a rival (Fred Astaire) and all of the usual RomCom stuff, but there is one song that came to mind today. It is the feature song for the New Year's Eve show. Bing and Linda (also a performer) are preparing for the show, and Bing breaks into song (don't they always in musicals?), singing "Let's Start the New Year Right." The first verse goes like this:

One minute to midnight
One minute to go
One minute to say good-bye
Before we say hello

Of course, he is singing about the end of one year and the beginning of another, not to mention his budding romance with Linda. Now the reason this song came to mind for me today is that today is Total Body Irradiation (TBI) day. In a sense, this is a step over the threshold into not a new year, but a new paradigm. To me it represents a total commitment to the transplant treatment. 

Prior to today, things were familiar: staying in a hospital room; Jill coming to spend the day with me everyday; chemotherapy for several days; the inevitable drop in my blood counts, which by the way, hasn't really begun yet. But the step of TBI is designed to kill off what bone marrow the chemotherapy hasn't. There is really no turning back now. TBI is, in effect, my "one minute to midnight." Tomorrow the new year arrives, in the form of a peripheral infusion of marrow stem cells, which will eventually replace my immune system with that of the donor. 

To be truthful, Dr. Chen, who is the attending physician on the 14K unit this week, said he has not heard the ETA for the stem cells. If they arrive too late in the day, the infusion will happen on Thursday. That's OK. I'd like the medical team to be well rested and fully awake for this procedure!

Now the TBI procedure is kind of strange. I pictured an x-ray machine, perhaps, like the ones that are used for chest x-rays passing slowly over my body. Instead, I was seated on a gurney with my knees bent, feet at the same level as my seat, and reclining slightly. Here's a diagram* of the position: 

And this picture**, while not of the actual machine that was used, will give you an idea of the size of the beast.

I was amused as the technicians prepared me for the procedure, positioning me in the pose pictured above. My hands, elbows and knees had to be positioned just so. When they were, the techs taped them in place with masking tape. You can't beat OHSU for high tech equipment!!

Once the treatment began, I had to remain very still for about 15 minutes, something I've been called upon to do in the past during MRI imaging. I've found that, for me, running something though my brain helps me keep focused on something other than the uncomfortable position I am trying to hold. In this case, I silently recited some of the verses on my Bible memory list to myself; I prayed; I even recited Jabberwocky to myself. The strategy worked! Before I knew it, the techs came in and said, "Take a break." Then they repositioned me for irradiation of the other side of my body (right side was first). Another 15 minutes of entertaining myself in my brain, and it was all over. 

I was told people can get nauseous and fatigued after such treatment. My nurse gave me some anti-nausea medicine before  I went to the radiation room, and I have done fine in that department. As for fatigue, we'll see, when Jill and I head out to the unit floor for our daily walk. I'm off the IVs today, so we should be able to move right along. 

Stay tuned. Tomorrow is scheduled for the main event!

* https://radiologykey.com/wp-content/uploads/2016/06/C18-FF4-2.gif

** https://i.ytimg.com/vi/NN3XtrexLkU/maxresdefault.jpg