Day +1: By the numbers

Some people like the numbers, some don’t. The hospital certainly does! They track every thing in/out and all around. Multiple times a day I’m checked for a temperature, blood pressure, heart rhythm, bowel & lung sounds. All of which have been pretty steady and “OK”. Blood work is a bit of a different story.

Daily, there is blood work and here are some of the key factors they are keeping track of as I journey along.

The first two on the chart below are platelets ( the green line) and hemoglobin (the blue line). Apparently this is pretty normal as a result of the chemotherapy and as the stem cells get to work these numbers will start to turn around and return to normal.

The next chart is the white blood cell count which is looking not too bad at this point.

White Blood Cell Count

And then there is the weight! All the up and down is caused by the constant 24×7 IV hydration over the first 7 days and some meds to make you lose some of the hydration account for the dips. All that has stopped now so things should level out unless I’m eating too much . 🙂

Weight

Otherwise things are good, I’m feeling well

Day Zero: Stem Cell Transplant

A major milestone in the journey happened today with the re-introduction of my previously harvested stem cells, all without complications or side effects, except that apparently I smell like creamed corn. Thankfully, I can’t smell it but everyone else can and it will last a day or two.

For the highlights of the process here is a quick video:

The day started off at 6am with the standard blood work and a very kind nurse bringing me a coffee and toast with peanut butter. Breakfast is still hours away.

Breakfast of Champions

At about 8:30 it’s breakfast and a little later in the morning Shirley arrives with Starbucks. We chat and visit and then it’s lunch. Sure is a lot of eating around here!

Lunch, pizza & corn beef sandwich

Shortly after 1pm the process begins when my stem cells arrive with another nurse who looks after the frozen cells. They are extracted from a liquid nitrogen container and then verified that they are mine, quite carefully, which is a good thing.

Out of the deep freeze

They have their own aluminium protection case.

Then they are placed in a temperature controlled water bath to bring them back up to body temperature.

Coming up to body temperature
And they are ready to go

The next step takes place in just under 30 minutes for optimum results. The stem cells are gravity fed into me, bypassing the IV pump which apparently would damage the cells. There is a manual process to force the cells in but it is not required as the PICC line is working well.

Incoming stem cells

This process is repeated for the 2nd bag of stem cells and the whole thing wraps up in under 90 minute. I experience none of the potential side effects, not even the most common one which is a tickle in your throat that makes you cough.

Happy to have successfully completed the stem cell transplant

Thanks to everyone for the prayers, support and encouragement on this milestone day. Shirley and I appreciate you all so much.

Next phase is the recovery of various blood components that have been affected by the chemotherapy, specifically the white blood cell count, hemoglobin, platelets & neutrophils. Once the levels are back up to something acceptable and I’m feeling well, I get discharged home. Current estimate is another 2 weeks in hospital.

Wondering why I smell like creamed corn? They mix some form of preservative in with my stem cells before freezing them. Part of the way the body gets rid of the preservative is to expel it in your breath. Why creamed corn? I have no idea.

Happy Socks are ON! Transplant done!

Day -1: New Treatment Today

The last of the chemotherapy treatments occurred today with a new medication, Melphalan.

This one took place over 30 minutes with a bit of a twist. While it’s coming in by the usual IV pump system, I’m sucking on a mouth full of ice chips. The theory here is to reduce blood flow to the mouth to reduce mouth sores. Apparently, this one is fairly aggressive with messing with rapidly growing cells, such as the mouth lining. So far, so good.

The big treat for the day was when Shirley brought take-out for lunch! Burger, fries and chocolate milkshake from George’s Burgers and Subs. First full non-hospital meal in 8 days, yahoo!

I really was much happier than I look!

Day -2: More of the same

Not too much to report today as the treatment is identical to the last 3 days. I’m still feeling good physically, a bit down emotionally with being stuck in a fairly confined space with quite a few days to go. Trying not to think about that too much and keep myself distracted.

Speaking of distractions, 2-3 times a day the STARS helicopter lands on the top of the HSC Diagnostic Centre of Excellence building which I can almost see out my window. So far, this is the first and only hospital helipad in Winnipeg!

The STARS air ambulance sits on the new helipad at Health Sciences Centre’s new Diagnostic Centre of Excellence on Friday. (Jeff Stapleton/CBC)

I’m on the lookout for a night shot and there was one a day or two ago but I was already in bed and would have missed it by the time I got organized.

Day -3: Gratitude

I’m grateful for a great many things in my life, but at this particular point here are a few things I’m especially grateful for.

I’m grateful for my salvation in the Lord Jesus Christ and 25+ years of solid biblical teaching from Springs church that has laid that firm foundation in God’s goodness, faithfulness, mercy and healing miracles.

I’m grateful for prayer. Both my ever deepening prayer life and the prayers of family, friends, and our extended church family who are praying for Shirley and I as we move through this journey.

I’m grateful for the extraordinary health care system we have in Canada and the excellent care I’ve received from CancerCare Manitoba, St. Boniface Hospital and Health Sciences Centre. Everyone has been so kind and compassionate well above and beyond their medical duties.

I’m grateful for all the extra special love and support I’m receiving during my own “special” 21+ day “lockdown” at HSC from so many people. I have received encouraging and supportive letters, card, texts, emails, phone calls, video messages, FaceTime calls, and special art work some of which I’ll share below.

Cards & Notes
Original Water colour art work…
… with meaningful song lyrics and scripture on the back of each

Hand made cards, stories, art work from all the Grandkids.

All of this and more was organized by Shirley into a special gift pack so that there would be new things every day to discover while I’m in hospital.

Special wishes and surprises for every day

I’m very grateful for Shirley. Shirley is the love of my life, kind, generous, supportive, encouraging, lifts me up when I’m down, makes me laugh and makes me cry (in a good way) and is as I like to say “you’re simply the best”. Love you so much.

My Family

Day -4: Competition

Not a lot to do in the hospital and thankfully I’ve got all my tech devices to help pass the time. However, there is one thing they encourage the patients to do instead of sitting or laying around in your room. It’s not much, but it’s something, we get to walk the hallway!

Its just one straight hallway, not too long, but to make it interesting there is a whiteboard with everyone’s room numbers on it and you’re encouraged to log your laps and walk 4x/day. The board is pretty empty when I arrive but there is one room with quite a bit of activity. I have a look and say to myself “I can beat that!”, so it’s game on. After a day or two I meet my competition, Harold, while walking. We exchange stories briefly and carry on with our walking.

The leader board

I’m 43 and Harold is 42. He’s post-transplant and in recovery, so different but similar circumstances, still a fun little motivator and I think he likes the competition too.

So far I’ve logged 173 laps or 7.2km.

Hallway Lap Distances

Day -4: And now for something completely different

The last number of posts have certainly been medically heavy so I think I’ll switch it up a bit for a day or two since the medications are identical for Days -5 to -2. For a brief status update I’m feeling good and my weight is up quite a bit due to the hyper-hydration they have me on, a 24 hour x7 days saline solution.

Thankfully, the hospital visitation rules have eased up somewhat and I’m allowed a visitor! Guess who? My angel of mercy, love of my life, Starbucks connection and home cooking!

Each day Shirley has driven to the hospital mid-morning, navigated the parking system, picked up Starbucks, passed through two different screening processes all to hang out with me and make my day so much brighter! After a coffee and some catch-up chat we share what we’re calling a “picnic lunch” which is a combination of home cooking and stuff I can select from the hospital food cart.

The “picnic lunch” – Legit chicken fingers, salad & cookie (hospital), chicken sandwich, fresh fruit and cheese (home).

Thanks honey for supporting me so well on this journey, love you! 😍

My window view is of several other hospital building, some of which are quite new and still being completed on the inside. Nothing too interesting until yesterday when I spot two guy on the roof wandering around with full climbing harnesses and a bunch of ropes. Next thing I know one of them is going over the edge!

Going over the edge

I’ve seen this done a couple of times but it always makes me feel a bit queasy when they first go over the edge and get settled into the bosuns chair. Well, they are washing the windows.

Washing Windows


This morning one of the devotions I’m doing was based around Exodus 15:26 where the end of the verse is “I am the LORD who heals you.” or Jehovah- Rapha, a compound name of God combining the personal name and a word referring to healing; hence “the Lord who heals”. After reading this I thought I need to be reminded of this a lot right now so I did a little graffiti art. 😉

The LORD who heals you (me!)

Day -5: New Medication and Other Stuff

Slept much better last night. They changed my IV pump to one that clicks less and much more rhythmically so I found it easier to tune out. A nice sunny day makes it easier to roll out of bed to have blood tests done. The PICC line is awesome for this as it’s totally painless.

So, as I’ve come to learn there are many chemotherapy protocols even for the same types of cancer. In 2018 I had what was called CHOP-R. Now I’m on Benda-EAM (Bendamustine, Etoposide, Cytarabine, Melphalan in preparation for the Autologous Stem Cell Transplantation on Day 0.

So the whole thing rolls sort of like this.

DayMedication
Days -7 to -6 (2 days)Bendamustine
Days -5 to -2 (4 days)Etoposide, Cytarabine
Day -1 (1 day)Melphalan
Day 0Autologous Stem Cell Transplantation
Benda-EAM Schedule

And then there are a few other meds and activities on a daily basis.

TimeMedication / ActivityPurpose
6:00 a.m.Dexamethasone and Ondansetron
anti-nausea
6:00a.m.Blood collectionBlood for analysis. Key indicators are WBC (white blood cell), HgB (hemoglobin), and platelets all which are expected to drop during chemotherapy and come back up to normal levels in time.
8:00 a.m.Vital stats collected at nursing shift changeBP, temp, listen to lungs, heart and gut, mouth inspection for sores, check for swelling and verbal “how are you doing?”
Weigh-inWeight recorded, right before you get your breakfast!
9:30 a.m.Ciprofloxian, Acyclovirantibacterial, antiviral
Aspirin, Coversyl, ArtorvastatinStuff related to stents in 2015
10:30Tylenol, BenadrylPrep stuff for chemotherapy, pain & antihistamine
11:00Chemotherapy of the day
400 p.m.Injection of DalteparinDalteparin is used to treat and prevent harmful blood clots.
4:00 p.m.Dexamethasoneanti-nausea
8:00 p.m.Vital stats collected at nursing shift changeBP, temp, listen to lungs, heart and gut, mouth inspection for sores, check for swelling and verbal “how are you doing?”
My typical daily schedule

More updates later in the day. Waiting for my Starbucks delivery person. 😍

A lovely lunch and visit with Shirley and the rest of the day was uneventful. The next three days will be pretty much the same so I think I’ll shift the focus of the days posts to some more fun and less medical topics.

Day -6: Business as usual

Sunrise on Thunder Bay

Not too much to report today, basically a repeat of Day -7. Same medications and I continue to feel good. Highlights include Shirley’s visit and the change of the PICC line dressing. Tomorrow the chemotherapy medications change to two new (to me) products and I’ll get this combo for four days.

Hmmm, “to two” and “for four” in the same sentence. Is that legit? 🤔

Day -7: End of Day

The afternoon was was much quieter than the morning. I think all the staff are busy with paperwork or other high need patients. I’m enjoying my daily care packages from family and friends, certainly one of the highlights of the day. The other was Shirley with a Starbucks!

Nothing significant to report from a medical standpoint. All my vital stats continue to be good and I’m feeling fine. IV fluids continue all day and all night. There is a bag switch at about 1:30a.m. which I may or may not sleep through. However, I’m thinking sleeping through the night won’t be happening for some time now given the hourly bed checks and various hospital noises. Who knows, perhaps I’ll get used to the place and block most of it out.

I think I’m at the top of the leader board on walking hall way laps. Perhaps I’ll post about that tomorrow 😉

I’m starting to use the iPad more and learning more about the ins and outs of iPad OS and some apps that are quite a but different in the iPad vs. the Mac. specifically, this afternoon spent a fair bit of time with Logos trying to get the hang of the interface etc. Youtube to the rescue.

Tomorrow is a new day.