Wednesday, January 28, 2009

It seems I start off every posting excusing myself for taking so long to update. So this time, I'll spare us all that and just say a hearty howdy, folks. What I've been doing since last posting in December? Waiting on docs to agree on a treatment plan, researching into what that might be, writhing at some of the results of that research, and reflecting on what I'll ultimately do. For all the proposals the docs can give, the choice is, after all, completely mine. So I had been withholding posting my thoughts because, honestly, they woulda been some real downers. Now that I have some good news to share, and as relief sets in, I can talk about 'em.

Thing was, my two chief docs (one the Hema-Oncology dept chief, the other the Stem Cell Transplant center chief) were, and still are, split on what treatment course I should take. Back in late December, I was told that the allogeneic transplant (stem cells from a donor) would be "too risky" with the one existing donor (in 12 million), who matched on some traits but mismatched on other key characteristics. And as my research showed, she mismatched on the kinds of things that make an allogeneic transplant the medical prognosis equivalent of a 4th and 20 from inside your own five (for Europeans: down 3:1 in the 89th minute and your star striker just got the red card). Not unbeatable odds, but stacked heavily on the side of the defense (and as history and commentators tell us, defense wins Super Bowls -- and World Cups). And so I waited on the sidelines as the coaches conferred. Then, to kick off the New Year I was basically told, and I paraphrase, "What the hell, let's give it a run with the allo transplant, it's our only shot, now or never." To unparaphrase, the choice was either:

> the allogeneic transplant, risky but with a good majority of patients making it through and then averaging 8+ years until their respective "BOATs" come sailing back in (I should note here that many of those years are spent battling off a slate of unpleasant side effects); or

> A safe-bet autologous (own stem cell) transplant, which'll give patients on avg. 2 years of clear sailing (I should note here that the 2-year avg. statistic factors in patients of various ages and wills to live; whereas I'm young at heart, body and soul and wanna live like nobody's business, and at the very least not be outlived by, say, Keith Richards).

Oh, and whatever I chose it would be final because the pre-transplant "conditioning" chemo treatment could only be administered once as it wreaks too much havoc on the body. The conditioning is a radioactively charged chemo called Zevalin (which, if I may harp again on the uncool names they give this illness and its treatments, if its makers had wanted it to have a really cool name they woulda called it "Led Zevalin").

So those were my choices and today I finally had my 1:1 talk with the chief Transplant doctor. He listed four options, of which I can't remember them all and one of them may even have been "go bowling" for all I know or care because I already had my heart and mind set on the safe-bet own transplant (plus a hearty portion of the bigger-bet own self will to beat this BOAT). I asked which one he recommends and he said exactly what I hoped he'd say: own transplant now, then wait-and-watch, then if need ever be, the allogeneic. And as for the one-time-only Led Zevalin thing, he said whatever doctor told me that was off their rocker (and obviously never listened to albums II through IV).

And in the coming weeks, as I wait for a room to open in the Transplant Inn for a dose of my own bad-ass self, I'll be gathering some 2nd opinions in hopes that they corroborate my own and the Transplant doc's opinion and contribute a piece or two to the peace of mind I've already found. And if they don't, I'll tell em, "Thanks for coming but the boat has sailed." And in a matter of months, I'll be able to get back to work and play in a life more-or-less ordinary and all the more extraordinary for all these trials and tribulations. I'll call today's sighs King Sighs and invite you all to join me in breathing a few yourself.

Inhale, exhale, inhale, exhale...