Post Stem Cell Transplant Day +3

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On August 2nd, Josh received six bags of new stem cells. The stem cells arrived to his room in this frozen canister and were injected through his central line. The stem cells are mixed with a chemical that smells like creamed corn. The smell is excreted through the breath and the skin. It is pungent and quite awful. We will never eat creamed corn again. The day of the stem cell transplant went smoothly, there can be side effects, but Josh felt sufficiently awful that he was drugged up and knocked out throughout most of the procedure. Josh felt miserable and although it was his new “birthday”it sucked.

On August 3rd, Josh’s neutrophils bumped up to 3,400. On August 4th, his neutrophils were 1,400, they will soon drop to 0. Neutrophils are a type of white blood cell. There are many types of white blood cells, whose purpose is to fight infections in our bodies. I have read that neutrophils are the most important type of white blood cell. A normal healthy person has a white blood cell count between 2,500-6,000.  When the neutrophil count drops below 1,000, it is called neutropenia, which means you are at serious risk of infection. In the next few days Josh’s neutrophils will drop to 0. He will remain in the hospital until his neutrophils rise between 500-1,000. Neutrophils correlate with energy, well-being, and general health. He will be bottoming out soon. It already sucks, but will get worse.

As his neutrophils drop and his symptoms increase it is hard for him to focus on activities for any length of time, which is frustrating for him. He spent three days finishing a maze for our oldest, but was determined to finish it.

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The past three mornings Josh awakes about 4am and vomits for a couple hours, the nurses and doctors try to get his symptoms under control through anti-nausea medication. He then is usually knocked out by the medicine and sleeps a couple of hours. We are hoping the strict regimen of multiple anti-nausea medicines throughout the day will keep his vomiting at bay. He has walked two miles every day since he has been in the hospital, which is pretty remarkable given the abdominal pain, nausea, and vomiting. Also, I haven’t witnessed much vomiting, it feels as if he holds it together while I’m around to not upset me and then vomits immediately after I leave or before I arrive. Bonnie, Jerry, and I rotate shifts. Typically I am there all day until I pick the girls up from camp and then come home have dinner with the kids, put them to bed, and return to the hospital for a couple of hours. Next week I will be there 9-5pm, and I will sleep there over the weekend.

It is hard to keep spirits high when you feel worse than you ever felt and you know the worst is yet to come. But Josh is convinced he will keep walking, keep showering, keep drawing mazes, playing games, and eventually his blood counts will rebound. If he has an ounce of energy he sits in a chair rather than lying in bed.

Josh is the best. He sends home gifts and cards to the kids every day.

Words to describe our past couple of weeks and then I’m going to sleep.

Stranger Things (great Netflix show – Xfiles meets Stand By Me), Yahtzee, step counts, laps through the halls, nurses, a koala maze, FaceTime, dot-to-dot, bananagrams, soup, hospital food, FRIENDS, kindness, hope, heart break, tears, hospital bed cuddles, zombie eye (hemoraged eye from vomiting), rock climbing camp, adventure camp, rock star nanny, visits from friends from across the country, family, best friend who sat in the chair with my girls as they fell asleep, stem cells, sci-fi, crazy, surreal, best friends, fluorescent lights, cream of corn, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, LOVE, RESILIENCE.

Our people have cradled us in love and I feel loved by people from across the country and different ages and stages. A strange term, but the image of me cradled literally popped in my head as I drove to the hospital this morning. We are such homebodies, I worried if we had people other than each other and we have people, oodles of them. Who knew two hermits had so many friends. I love you all.

I can’t wait for my family to be under the same roof. It sucks for him because he feels awful, but I feel happy if he is feeling okay and I can curl up next to him in his hospital bed watching the iPad and gossiping about life even if it smells like nasty corn, I’m in a gown, and can’t breathe fresh air. For me home is where Josh is, he is my home and I’m happy when I’m with him, even in solitary confinement. I’m so lucky to have a husband that has the power to make me happy in prison. The kids are my home too, which leaves me split in two. Currently, our home is a bit broken, my heart is a bit broken (all of our hearts are) since we are split in multiple places and the kids and Josh can’t be under the same roof.

The babies and I lit candles tonight and asked that Josh feel better and come home soon. We miss him so much in our physical home, but I will see him first thing in the morning.

THANKS FOR THE LOVE, I AM GRATEFUL. XO

 

 

AL AMYLOIDOSIS SUCKS

BACKGROUND:

For those who do not know, my husband Josh was diagnosed with AL Amyloidosis in April 2016. AL Amyloidosis is a rare blood disease where misfolding plasma cells in the bone marrow produce light chains in the blood called amyloid that attach to organs and cause tissue damage, (by no means an accurate description). There are less than 4,000 new diagnosed cases of Amyloidosis in the United States each year, which makes this an extremely rare disease. Amyloidosis is most closely related to Multiple Myeloma, which is a rare form of leukemia. As such, many treatments for the two diseases are the same. Most people diagnosed with Amyloidosis are in their 60s, but Josh unluckily discovered he had Amyloidosis at 37-years-old.

As a physician, Josh noticed swelling in his ankles tested himself to make sure he didn’t have a blood clot then tested his urine and blood and realized he had nephrotic syndrome. He went to a nephrologist who then ordered a kidney biopsy, which showed Amyloidosis. He then underwent a bone marrow biopsy, which also came back positive for Amyloidosis.

When Josh was diagnosed with Amyloidosis, I didn’t know what it was and immediately googled it. Don’t do this, a google search reports that patients diagnosed with Amyloidosis have 1-2 years to live. SHOCK! WHAT? HOW? WHY? I CAN’T LOSE JOSH! I cried for two weeks straight. I couldn’t wrap my head around losing Josh, I still can’t, and luckily two doctors assured me that I don’t have to. Two doctors assured me that Josh will live a long life with this disease. He will be around to see his children get married and there may be a cure in his lifetime.

“Why did young healthy Josh get Amyloidosis?” I asked Dr. Smith and myself a thousand times. “Is it just like randomly getting struck with cancer without a family history?”

Dr. Smith responded, “One out of three people will get cancer in their lifetime.”I don’t know the exact statistical chance to get Amyloidosis at 37, but pretty much Josh won the rare disease lottery. Although this is all bad news, the good news is with respect to this disease Josh also won the lottery, right now it is only affecting his kidneys (not the heart, liver, muscles, or nerves), which is amazing. He has little kidney damage and he is in amazing shape.

Due to his relative health, Josh opted for the most aggressive form of treatment to achieve long term remission and will be having a stem cell transplant. A stem cell transplant is a bone marrow transplant, except in his case they will be using his own stem cells. July 25th and July 26th doctors collected close to twenty million of Josh’s stem cells, which were then frozen at -130 celsius. He will be admitted to the hospital on July 30th and for two days will be blasted with high dose chemotherapy (melphalan) in order to wipe out his entire blood system. He will rest a day, and then be reinjected with his newly cleansed stem cells. The day of transplant is literally deemed his rebirthday. Every immunity he has acquired in the last 38 years will be completely wiped clean. He literally will be put on an infant baby’s vaccination schedule once his body begins to recover.

Josh will be in the hospital for close to three weeks, until he is deemed safe to reenter the world. He will be able to see me and adult friends and family, but the children are not allowed to visit him because of the risk of infection. He is heartbroken to be separated from the kids. He will be out of work for 2-3 months, which is sad because he just started a new job that he loves. We are focusing on the positive, looking at three months as a blip, like maternity leave, which women take all the time. (FYI, paid medical leave readers is not only for new mothers).

Originally, he was supposed to be admitted to the hospital on July 18th, but because of a lab mishap with Josh’s stem cells the transplant was delayed two weeks. We were upset about the delay and devastated because Josh was put through a brutal collection of stem cells twice, 40 million stem cells were taken within a two week period. The night of his second collection, I thought he might need a blood transfusion, he was sick, fatigued, cold (shut off the air conditioning), but a day of rest and he rebounded. Josh is a champ.

Due to the upsetting delay, we had more day dates than we have had since having children seven years ago. One of Josh’s best friends visited from Pittsburgh and spent the weekend with him. On Monday and Tuesday Josh gave 20 million stem cells, Wednesday we had a relaxing Boulder date and went shopping on Pearl Street, Thursday we played 18 holes of golf, Friday we went for a long hike near Chatauqua, and Saturday Josh checks in the hospital for his first dose of chemo therapy.

Friday night we had a Star Wars pajama party with the kids where they stayed up late, ate Chinese Food, S’mores, ice cream, candy, and watched movies. (Thank you, Sarah for the delicious ice cream). Josh’s last night of fun with the kiddos for a few weeks, he is the best dad.

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Today we checked into the hospital. It was surreal, driving to the hospital on a sunny day, young families shopping at the farmer’s market and riding their bikes on the bike path while  Josh will be stuck inside the hospital for one month. We checked in thinking we could get a cart and together go back to the car to get his things. Nope, once Josh entered his room, he couldn’t leave the hallway. I took the cart back to the car, called my twin, and cried. I can’t believe Josh will be in this small room for almost a month. I can’t believe he has to fight this shitty disease. I can’t believe small tragedies go on around us every day as the world keeps circling and the sun keeps shining.

Yesterday, I was brainstorming what to write as an update. We hiked miles with our dog, our shoulders burned by the sun, our lungs expanding to get us up the steep hills we have climbed so many times. I felt blessed. We are blessed in love, family, and friendships.

Today as we left our home, my five-year-old sobbing and her two-year-old brother imitating her screams. I felt heartbroken. This is officially the hardest day of my life thus far. Healthy Josh driving our car to the hospital to be blasted with toxic chemo and taken to the brink of death to be brought back to life with his own stem cells. It feels torturous. It feels unfair.

I wish, pray, hope for remission. I’m wishing that Josh can come home soon. I hope he will breeze through chemo and this seemingly endless stay in an artificially lit sterile room. I pray he stays sane. I pray my children feel loved and secure. I pray for a cure. It seems desperate and pitiful, but I pray and hope that everyone that has ever known or cared about me, Josh, his family, or my children, send us prayers. I want to believe in the power of prayer, healing thoughts, and love. Josh is private, but I want to rally all the love I can muster and direct it at him. Family, friends, world, we  need some magic sent in our direction.

The first round of chemo starts at 4pm, until then we will be playing Yahtzee, reading, and walking the halls, imagining ourselves in a claustrophobic train car heading through Europe to eat pasta and drink wine in colorful Positano, Italy.

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For the next few months, I will keep family and friends updated on the blog. We appreciate all the friends and family who have rallied around us during this tough time – meals, ice cream, wine, texts, phone calls, emails, cards, have all been greatly appreciated. It is always nice to know people are thinking of us, so never second guess texting, calling, or emailing. We love it. Thank you, thank you, thank you…