The Big Day

Big Day

The big day arrived. Pam had her first appointment to meet with Dr. Holtan, who will be heading up the team for Pam's bone marrow transplant at OHSU.  Dr. Holtan is delightful. She is very young looking, has a great sense of humor (I can tell  because she laughed at my jokes) and, obviously, VERY sharp.  Being on the cutting edge of bone marrow transplantation is her passion. She told us about her background, which includes a residency at Mayo Clinic.  She explained the transplant process and spoke very frankly, but compassionately, about the risks. 

Long story short, Pam really doesn't have an option other than doing the allogeneic bone marrow transplant.  The odds of a cure with chemotherapy alone are dismal since Pam has a"very special" genetic abnormality called FLT3.  Dr. Holtan nodded in the affirmative when I said the decision to do a bone marrow transplant is a no-brainer.

Requirements

Dr. Holtan outlined some requirements for the transplant from her brothers.  It only made me reflect some more on how lucky we are:

• Her brothers will need to be willing donors:  I told her I could have Mark in her office in 10 minutes (he was plumbing one of the buildings on the OHSU campus).  Mike would take longer, but he could be there within an hour.  Turns out that they don't need to be quite that responsive.
• We need to stay within a 20 mile radius of OHSU:  We live 3.1 miles/11 minutes away. I work 1.7 miles away and Google Maps says I could bike up to OHSU from my office in 21 minutes. (I think Google Maps is being very optimistic.  There is a big hill.)
• Pam will need a constant caregiver after hospitalization:  I will have to fight off her family (aka, the Aloha Mafia) and friends to keep them from overrunning the place when we need them.  Not a problem.

Next Steps

Tissue Typing and Donation from Mike or Mark

Mike and Mark will receive a call from the clinic to let them know they will be receiving a kit in the mail so they can submit an oral swab for analysis.  Assuming one of them is a good match, they will have some additional blood tests.  The process for donating stem cells is pretty easy and it is about a 4 hour process.  The donor's blood is processed in a machine to remove the stem cells and the rest of the blood is recycled right back to them.  They usually take more than they need for the stem cell transplant and hold some in reserve.

One of Two More Rounds of Chemo

While we are waiting for the transplant, Pam will go through at least one more round of chemo under Dr. Weinstein's direction.

Stem Cell Transplant

The transplant will be done at OHSU.  Pam will be in the hospital for about a month. (Don't worry, I am confident that they will have maple bars in some cafeteria nearby.)  It will probably happen around the latter part of November to the first part of December.

After the Hospital

Pam will need to have a caregiver 24 hours a day for 100 days after discharge from the hospital.  The main reason is that she will need to make sure that someone can make sure she takes her medication on a strict schedule and take her to the hospital, if needed, on a moment's notice.

After all of that...

we may elope.  Who knows?