Pre-transplant

I am in Rochester, Minnesota, at the Mayo Clinic, beginning the stem cell transplant process. The name "stem cell transplant" is maybe a little misleading, since it doesn't involve a donor (rather, I am the donor and the recipient). Sometimes it's called "high dose chemotherapy with stem cell rescue," which is more accurate but cumbersome.

The basic process is: 1) stimulate growth and "mobilization" of my bone marrow stem cells with injections of a drug called neupogen (filgrastim); 2) harvest mobilized stem cells from my blood (much less painful than getting them out of the marrow); 3) use a massive dose of a chemotherapy agent (melphalan) to kill off all the stem cells remaining in my marrow; 4) return the stem cells collected in step 2 to my blood, and encourage them to colonize the marrow and start reproducing, with the help of more neupogen; 5) ride out a few weeks of recovery time until the newly reconstituted marrow is functional enough that I can return to a more or less normal life.

I am on my third day in step 1, which is scheduled to last until July 5th (coincidentally the 30th anniversary of my marriage to my true soul mate and idol, Liz). Step 1 is pretty easy unless there are side effects of the neupogen injections (so far, just a headache). From all accounts, the steps get increasingly obnoxious as we go along, up until the last part of step 5, where things should start getting much better.

Rosie has been with us so far, and she brought a cold with her, residue of having moved herself from Durham to Boston. So when we go to Mayo complex and hang out in the waiting areas, Rosie dons a face mask to protect all the clinic patients (who are truly sick) from her cough. It seems strange that the youngest and healthiest among us is the one wearing protective gear.

Soon enough, I'll be the one with the mask. Should be interesting.