Sunday, January 30, 2011

My Transplant Roadmap

My transplant roadmap is outlined below:

Phase I - Pre Transplant Testing (Nov/Dec 10): — MRIs, CT scans, right heart catherization, blood work, pulmonary function tests, etc. (complete)

Phase II — Mobilization (a.k.a. priming)
31 Jan 11 - Admission to the Feinberg Pavilion at Northwestern Memorial Hospital overnight for chemotherapy.
01 Feb - I'll be discharged from the hospital after 24 hours of fluid hydration.  Five days after discharge I'll begin daily shots of neupogen (growth factor) to stimulate my blood cells to move out of my bone marrow and into my blood.
04 Feb - Lab work to check my blood count.  My blood counts are expected to be stable until approx 7 days following my moblization chemo.
07 Feb - Lab work to check my blood count.
09 Feb - Lab work to check my blood count.

Phase III — Harvest/Collection (video from Mayo clinic posted as a link that explains process)
10 Feb -  My stem cells will be collected from my blood through a process call apheresis. I'll sit in a recliner for approx 4-5 hours until sufficient stem cells are collected.
11 Feb - Backup stem cell collection day as needed.
12 Feb - Return to Hawaii and rest in preparation for conditioning and transplant.

Phase IV — Conditioning/Transplant (video from Mayo clinic posted as a link that explains process for a cancer patient.  It's a similar process, but key difference is my protocol is designed to kill my faulty immune system and not destroy cancer cells.  There is a lower dose of chemo and no radiation in my conditioning protocol.)
21 Feb - Return to Chicago.
22 Feb - PICC line placement
23 Feb - Admission to the 15th floor of the Prentice Woman's Hospital on the Northwestern Memorial campus for conditioning & transplant.  The conditioning regimen consists of 4-5 days of high dose chemotherapy to destroy my immune system.  I'll be in a private room with a special filter in the ceiling to helps clean the air.  Once chemotherapy is initiated special precautions will be taken to prevent infection.
  1. Fresh flowers or plants are not allowed in my room
  2. Latex balloons are not allowed as they collect dust (mylar balloons are allowed)
  3. Fresh fruits and vegetables are not allowed
  4. Staff and visitors must wash their hands before touching me
  5. Visitors must wear masks if they have been exposed to colds.  No one with a cold or temperature should visit
~ 28 Feb - The day of the reinfusion, better known as the transplant day or day 0. I receive my stem cells  - similiar to a blood transfusion and usually this is a 15-30 minute process.
28 Feb - ??  I'll remain in the hospital and wait for my stem cells to grow (engraft).  This process usually takes 1 - 3 weeks after stem cell reinfusion.  Prior to being discharged I'll need to meet the following criteria:
  1. Stable vital signs
  2. Engraftment (stable blood work)
  3. Able to eat 3 meals and tolerate fluids
  4. No signs and symptoms of infection
  5. Medically stable
Once discharged from the hospital I'll stay in Chicago for approximately 1 week for follow-up testing.

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