New Terms, too

Remission.

This word is an attempt at humor. Maybe it's just an expression of irony. Some cancers are curable, some aren't--Myeloma isn't. Remission in the case of Myeloma is the period between one's last bout with chemotherapy and one of the medical events I described in my last entry, or else some other medical event I haven't yet written down here.

I'm in remission. I'm done with chemotherapy, and looking toward a significant medical procedure. I guess I haven't actually talked about the transplant yet. I'm in line for a peripheral autologous stem-cell transplant. I'll go to Seattle for about three months to get this done. It looks like I'll go up there sometime in September.

The docs there will install a Hickman Catheter in my chest. Over the period of a few days they'll use it to withdraw a quantity of my blood, from which they will extract the some blood cells, clean them up, process them to recover the stem-cells and eliminate any stray myeloma cells that might be there, then freeze these cells, so they can store them for a while. Then they'll hit me with chemicals and /or radiation, which will pretty much sterilize my blood and bone--the immune system will be totally destroyed. Then they'll put the stem cells back into my body. The stem cells will differentiate, then begin to reproduce, and eventually rebuild my immune system.

While this is happening, I'll live in an isolation ward. People will put on gowns and wear masks when they come to visit. I will be weak, and need a nurse to take care of me for a while. Mucus membranes will slough, taste buds will get a chemical thrill, hair falls out. All that. I'll be in the isolation ward for a few weeks. I may develop an attitude problem off this phase of my treatment. It might take as long as a year before my immune system recovers.

According to the stats that describe the state of the art, I'll be symptom free for maybe three or so years. Eventually the Myeloma cells will return. I have a few other temporary remedies at my disposal, but they will only stall the process. I have spent the past three or four months coming to grips with these details. This is where irony blends into that sort of gentle cancer humor I'm learning to appreciate. The word survivor has been re-defined, for example. Optimism has blended shades of meaning, too. Right now, on account of how medical research is still leaping an bounding, optimism is still connected to survival. For example, in three years, someone might develop a vaccine that renders myeloma a mere nuisance. I'm still optimistic. Later on in the process, I may let go of the optimism, and work on the finer details that attend the notion of acceptance. You can extrapolate all that on your own time. I've got all this stuff in the bag already.

Needless to say this is harder on RedBud than it is on me.

I did time on the PICC line this summer. A PICC line was inserted into a vien in my upper arm, and its tip stopped in the large vein a couple of inches above my heart. A valve on the running end of an external infusion line dangled from my arm. I wore a cuff made of cotton mesh on my upper arm to stow and protect the valve when it wasn't in use. I plugged a chemical bag into the valve once a month. I wore the bag for 96 hours. In the bag with the chemicals was a rather expensive in fusion pump. I slept with the pump like it was a newborn baby. A little green LED on the pump blinked every two seconds to let me know it was still alive.

I got a thrombosis during the first infusion cycle. That was sort of exciting. Had to pull the PICC line and take blood thinners for a while. That sucked, actually. I spent a few days in Portland, in ICU, while they shot me up with stuff. It was sort of uncomfortable when the clots were in the vien. The guy that read the ultra sound images said the vein had begun to clot from the insertion point all the way down into my chest as far as he could see. Felt like steel bands on my arm and chest. In the hospital, I had to be hooked up to an IV; had to push the IV stand around with me to the toilet. That first two days, I wasn't supposed to walk to the toilet, but I couldn't deal with the goddam bedpans in any meaningful way. Most of the major discomfort went away the second day, but I had to hang around for a few days to make sure all the clots were gone, and so the docs could figure out how to deal with this development. I got three weeks off from the PICC line for that, but had to have another one inserted for the next infustion cycle.

Anyhow, I'm done with all that PICC line stuff, and I won't have anymore chemotherapy until after they draw the stem cells in Seattle. I'm in remission.