Here we go.

On Wednesday of this week we head back to Duke for an appointment with Dr. Horwitz, followed by a few final tests.  Then on Thursday I am admitted to the Adult Bone Marrow Transplant (ABMT) unit of the hospital, where I will receive 5 consecutive days of high dose chemotherapy, which is referred to as the conditioning or preparative regimen.  On the following Tuesday I will be dismissed from the hospital and on that Wednesday my stem cells, collected last week, will be re infused back into my bloodstream.  That is followed by a minimum of 21 days of rest and recovery, under the close and watchful eyes of the ABMT medical staff.  For those of you who like the short version, you can stop reading here and check back in a few days for updates.

For those with more curious minds, the high dose chemo serves the purpose of eradicating or destroying the bone marrow and any remaining cancer cells throughout the body.  Unfortunately, the levels of chemotherapy are so high that it also destroys the body's immune system, including most red and white blood cells, and platelets.  During this period I will be at high risk for infections since my immune system is basically nonexistent.  The re infusion of my stored stem cells, while referred to as the transplant, is actually a rescue, in the sense that without those cells my body would most likely not be able to continue to sustain life.  The high dose chemo destroys the cancer and the stem cells rescue me from the unavoidable side effects of the chemo.  The infused cells will find their way back into the marrow portion of the bones, where they will reestablish my bone marrow and then begin the production of new blood components, most notably red and white blood cells, and platelets.

For minimum period of 21 days, following the transplant, Holly and I will be living in an apartment very close to the ABMT clinic.  Each morning we will go to the clinic to have blood samples drawn and the results reviewed.  If everything looks satisfactory we will be released and we will return to the apartment for the rest of the day.  If any problems or areas of concern are identified, we will stay at the clinic for as long as necessary to address the issue.  This might involve a blood transfusion to elevate platelet counts, administering one or more drugs to boost calcium or potassium levels, etc., etc.  When the issues are resolved we will return to the apartment, only to return the next day and repeat the process all over.  Doesn't that sound like an exciting routine to look forward to.  During this period I will be the guy you see wearing the little blue face mask every where I go.

At the end of 21 days, if everything looks satisfactory, we will be released from the daily clinic routine and be allowed to return to our home-sweet-home.  The recovery and rebuilding process will continue over the next 6 to 9 months, before things will be back to "normal".  Periodic visits back to the ABMT clinic will continue until they are satisfied than my system can be trusted to maintain itself naturally.

For those of you who selected the earlier option to continue reading, you now know more about bone marrow transplants than most of the people with whom you have regular contact.  The concept is fairly simple.  The actual implementation is terribly complex.  Fortunately, I have an unbelievable team of specialists that will be watching me day and night to be sure that the end result is achieved as desired.  And I have a Lord that created the universe, caused the mountains and seas to be formed, and created me in my mother's womb.  His omnipotent knowledge and perfect love will be with me every second of every moment.  What more could I ask for?

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