Thursday afternoon we got the call we’ve been waiting for. 233 days after we received Corey’s diagnosis, we got the call that they’re ready for transplant. No more MRIs, no more biopsies, no more rounds of chemo… This is it.
(Thursday is also the day my beloved Los Angeles Dodgers won the National League pennant and a long-awaited return ticket to the World Series. Roughly 10,580 days since they won their last World Series title, but who’s counting??)
I’m sorry… Where was I?
Oh yeah, no more MRIs, no more biopsies, no more rounds of chemo… This is it.
Let me explain.
No more MRIs >> We left off last post with our visit to the cardiologist and a scheduled cardiac MRI to determine if there were cancer proteins present in the heart. When we met with our team this past week, they let us know they’d called off the MRI because, unbeknownst to us, they had ordered some pretty extensive blood work last time Corey was admitted to the hospital. The proteins they were going to check for on the MRI had been checked for in this round of blood work – and had come back clear. It does not appear that there are any cancer proteins in the heart. Obviously very good news.
No more biopsies >> We also left off with me expecting our oncologist, Dr. Eagen, to order another bone marrow biopsy. He was consulting with some of his colleagues and waiting for the “M Spike” test results, which had come back as well. The news wasn’t great, but wasn’t terrible either. The M Spike showed that the cancer protein in his blood did not go down as a result of that extra week of IV chemo Corey received a couple weeks ago. The goal of that week of chemo was to get the remaining cancer, which was still in somewhere between 10-15% of his bone marrow, down below 5%, which is the ideal number for transplant. (It goes without saying that the lower number you go into transplant with, the better your chances for a longer remission.) Since the number was the same as it was when they last did this test, they didn’t feel the need to do another bone marrow biopsy at this time. Pretty sure Corey danced a little jig at that news. (Not quite as epic a jig as I danced with the Dodgers winning the pennant, but a jig nonetheless.)
No more rounds of chemo >> So the M Spike didn’t go up, but it didn’t go down either – so what now? There are three different roads we can go down, and there was a lot of discussion about which one to take. What makes it hard to know for sure which one is the right one is that there just isn’t a lot of data to go on. Because Corey is so much younger than the average MM patient, and because there have been so many advances in treatment of MM (which, make no mistake, is a good thing), there isn’t a whole lot of historical data to go on here. It’s one of those things where you look at all the options – and go with your gut. After looking at all 3 options, we all decided against any further chemo right now, moving forward, instead, with the transplant. Unfortunately, this likely means more chemo on the back end of the transplant because the remaining cancer is higher than they want it to be, but that’s a bridge we’ll cross after the transplant when we see what his final numbers are.
So… this is it.
Seven months (and one extra week) of chemo got Corey’s cancer down from 70-80% of his bone marrow to 10-15% of his bone marrow. Then they beefed up his bone marrow (quite sufficiently, I’d say) enough to be able to remove his stem cells for the transplant. Talk about a good ROI (return on investment), they were looking for just north of 112,000,000 stem cells and Corey turned out somewhere north of 490,000,000 cells, enough for around 10 transplants. So now, with a-l-l of that done, we’re ready to go.
This week will be full of last minute blood work, classes, reviews, meetings, signatures, and conversations about what’s coming next. Then Saturday, also known as “Day -2” Corey will get “blasted” with the big-guns chemo. The kind that has all the really gnarly side effects. We don’t really know what to expect about the actual infusion, although I’m sure that’s a lot of what we’ll talk about this week. We do know it’s an all day infusion and he’s been instructed by everyone, I mean, every nurse, doctor, fellow patient, past patient, even the lady in the office at the transplant house, to chew ice chips for 4-5 hours during the infusion. It constricts the blood vessels in the mouth and cuts down on the burns/sores you can get in the mouth as a result of this particular chemo. It’s something called mucositis and chewing ice chips helps cut down on the severity of it in your mouth. Not so in the rest of your body, but in your mouth at least.
Disclaimer: Do not google this phenomena if you’re weak in the stomach.
Anyway, Sunday is “Day -1” and is a rest day. We’ll go in for lab work first thing in the morning then head back to the apartment because this chemo is the stuff that obliterates your immune system.
Monday (October 30) is “Day 0,” the day they refer to as “your new birthday.” This is the actual “Transplant Day.” It’s the day you get your stem cells back, all fresh and cleaned up and in their Sunday best (or, in this case, their Monday best).
It’s 30 days from this point that he’ll pretty much be in lock-down as his body begins to recover and rebuild. Hopefully there are no hospitalizations, pushing that 30 days out to 40, 50, even more. I think it’s somewhere around 85% of patients that end up in the hospital at some point during this part of the recovery, so I honestly don’t know what to expect during this next phase. He’s reacted so well to everything so far, but they say this is the Major League stuff.
Good thing we serve a Major League God.
I still don’t have any fear, and I am grateful to a gracious God for that. I just honestly pray that, when all of this is said and done, that we are the very best versions of ourselves – no matter the outcome. That whether we’re part of the 15% who can say, “Praise the Lord, we skated through unscathed!” or we’re part of the 85% who really struggle and have some pretty awful side effects, that we’ll still be saying, “God is still good. Even when we struggle, even when we’re sick, even when everything looks broken and helpless, He is still good and He is still for us.” Because He is.
We know that today, when we’re home for one last day, carving pumpkins and playing games and sitting upright, feeling good. But it is my deepest desire that we still know that – I mean really know that – if in 10 days sitting upright is an impossibility and every smell makes you lose your lunch. We’re heading into the arena now, not sure what waits for us on the other side and my prayer is that when we have weathered this storm, that we have not wavered in our faith. That we will shine, not just for the doctors and nurses, fellow patients and shuttle drivers, but behind closed doors where no one else sees but our precious kids and closest family. To be truly unshaken is my deepest prayer. Because if we keep the Lord at our “right hand,” then we can face anything #StupidCancer throws at us.
(Oh yeah, and it’s my second deepest prayer that God really is a Dodger fan like I think He is and that we sweep Houston in 4. Please & Thank You.)