Wednesday, April 4, 2012

Lymph Journal # 51 I've got bone marrow in my bone marrow!


4/4/2012

Well, I’m checked into the Uniklinik for phase 2 of the autologous (my own) stem cell treatment.  This consists of another round of chemo (probably tomorrow) and some preliminaries today.  The first was more blood drawing – 6 vials – through my Frankenport.  The pros here love it when I bare my upper right chest and demonstrate that I’m a fully equipped cancer patient with the chest port option.  I know the drill pretty well and come prepared with the right sorts of shirts to facilitate access.  I know you’re supposed to swell out your chest as they drive the needle straight into the lump formed by the subcutaneous bubble that is the port.  The gal today demonstrated the chest puffing technique for me and instructed me to pose like – you gotta love this – Stalin!  (I no longer have “hair like Stalin” for all you Seinfeld fans – Kruhschev might have been the better comparison or, the non-communist chest-sweller lookalike might be old Il Duce himself) She went on to explain that she’s from the GDR (former East Germany), home of many a Communist monument.  I’ve always wished, as a card-carrying historian, that I could have picked up a smallish genuine Lenin bust after the Wall fell – not out of admiration for the monster man but as an interesting artifact and possible rotten fruit target.

From blood draws I went on to the EKG octopus.  I guess it’s fairly routine but until Germany I’d never had an EKG that used suction sensors – kinda freaky and, yes, there were eight tentacles clinging to me until release.  From there, Diane and I walked across campus to the center where stem cells are harvested to fill out forms, sign waivers and learn the drill.  Somewhere around ten days after this chemo I’ll be hooked up to a sort of dialysis machine that pulls the required bits from my blood.  This five-hour process could fulfill the target amount in on go round or I may require a second and even a third filtering – I’m in favor of the one-time deal.

Then it was back to the main hospital where I was sent up to Station Thannhauser, my home away from home.  We were shown to a private room – the excitement built – but we were quickly disabused of this hope when the nurse came in and said she didn’t think it would last.  In fact, it lasted long enough for the next step, the bone marrow biopsy.  I wimpishly (but really, who likes bone pain?) stated my preference for a drug induced nap for this and they obliged and an hour later I woke up with no pain, slightly less bone marrow and a transportation team that shifted me next door to one of my rooms from the last stay.  Not the balcony room but I scored the window bed.  I also scored a late lunch – tortellini, not bad.

Once fed and barely settled it was off to a lung function test. This is a three-stage process that begins with a daub of goop on the left earlobe.  The technician said it might get to feeling hot – it didn’t.  Following a few minutes of having the goop on the lobe another techie came out and pricked the ear (with a suspiciously high degree of vigor) and secured a pipette of blood.  I should have asked for a gold ring for that ear while they were at it.  Then it was into the glass booth for breathing into the snorkel followed by more snorkeling on/into a device outside the booth.  I passed with flying colors and was sent on my way.  I did not pass the find your way back to the room test with flying colors however – I took a few wrong turns (I hadn’t paid close attention on the way there) until I found a few land marks outside the windows that set my personal GPS back into the right mode.

So, back in room 5 and finally unpacked there was another flurry of personnel doing vitals, asking questions, giving me information I already had, etc. when another Transporter (person, not a device from Star Trek) showed up to escort me back to the zone where I’d had my EKG, this time for an echocardiogram (sonogram of the heart).  This was to be my third in three months.  Apart from jelly all over the belly it’s a pretty easy test and you get to see your heart valves flap on the screen and who wouldn’t want to see that.  Alles gut! (nothing has changed through all rounds of chemo – all is good).

Back again to the room – no wandering this time, the route was familiar.

Somewhere in the middle of all this I met the roomie.  He’s an electrical engineering student who had a successful bone marrow treatment but is in for a “graft versus host” infection – something I won’t face with my transplant because I’ll be both graft and host. 

When I first got to the room I “kipped” the window (for you Auslanders, most German windows are casements that swing in or can be tipped diagonally inward hinged at the bottom or “kipped”) to let in some nice fresh cool spring air.  The window was closed when I returned from testing – hmm.  This can be a point of tension. Many Germans, including highly educated and experienced medical personnel, believe the root cause of many ailments is a breeze.  Literally, a breeze, meaning moving air.  Air conditioning is a close second as a chief suspect behind ill health – after all it’s just artificially cooled MOVING AIR!!!  I remember back when we were in Germany before and our daughter Amanda needed an evaluation for some breathing difficulties she was having, the first questions asked by Professor Klein (Dr. Little) were, “Have you been sitting near an open window?  Have you been riding in the car with an open window?  Does your car have air conditioning?”  I suppose that would have made us bad parents if any of those were answered in the affirmative but, being wintertime, we passed the test.

Now, the bathroom window is open and it’s nice and cool in there but the door to it remains shut.  Here we see the principle of “lufting” (airing) in action.  Daily lufting is part of the German haushalt routine. You see one wants to change the air in a room but one doesn’t want to be there when it’s happening – too dangerous!  If you don’t luft for at least fifteen minutes a day you’re considered a slacker in the home maintenance department.  There is some degree of sensibility in this especially in newer German houses that are built especially “tight”.  Lufting can prevent molds from building up.

Dinner was a less than appetizing cold chicken schenkel (leg&thigh) but the evening meal is usually not too big a thrill in the hospital.  European custom puts the big meal at midday so some cold something is usually the supper star.

After dinner the attending doc and his entourage came in with some good news – No lymphoma in my bone marrow.  When I was first diagnosed I had nothing but lymphoma where my bone marrow was supposed to be.  So this is very good news – actual data (in addition to the CT scan of a few weeks ago) that reinforces the conviction that I’m responding well to the therapy.  This is also a good sign for the transplant to go forward.  What we don’t want to see happen is a transplantation of lymphoma back into my system and this test increases the likelihood of a good stem cell harvest.

The sky has cleared and it looks like we’re setting up for a sweet sunset.  I close this awaiting an infusion of saline to prime the pumps for tomorrow. 

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