Stem cell Info

I never know how much information to share on the blog.  I recognize not everyone knows what a stem cell transplant is exactly (we sure didn't before this began!).  So here is a little information for you.

In mantle cell lymphoma, a stem cell transplant after 6 rounds of chemo is recommended to solidify and extend a person's remission.  Technically, Nate is in remission right now as the scans show he is disease free.  However, research has found that if patients only do chemo and not a stem cell transplant, the cancer can return within 12-18 months.  Patients who have a transplant have a better chance at a longer remission.  Obviously nothing is guaranteed, but that is the goal. The doctor is also recommending 2-3 years of maintenance chemo after the transplant, but we are not focusing on that piece yet.  One thing at a time.

So what do stem cells do?  Hematopoietic (blood forming) stem cells are immature, undifferentiated cells that develop into red blood cells, white blood cells or platelets. The type of cell that is produced depends on what the body needs.

What is a hematopoietic stem cell transplant?  A stem cell transplant involves destroying the patient's bone marrow and infusing new stem cells into the blood stream.  The stem cells find their way into the cavities of the patient's bones where they take up residence or "engraft" and begin producing normal blood cells.  Basically, the cancer is destroyed by chemo and Nate's immune system is re-booted with the stem cells.  And how does a bone marrow transplant differ from a stem cell transplant?  The only difference between the two terms is how the stem cells are collected.  In bone marrow transplantation, the cells are harvested from the hip through a surgical procedure.  In stem cell transplantation, the cells are taken from the blood stream through a process called apheresis. (Kind of like when you donate blood.)

Again, I do not know how much information and dates people really want, but if nothing else you can pray for us over the next two months.  On March 7, Nate will have a full day of testing and appointments at Northwestern.  Insurance requires these tests to make sure there are not any pre-existing conditions before they approve paying for the transplant.

On March 16, we need to start giving Nate shots at home to bump up his stem cell production.  I have to admit, this piece is freaking me out. There is a reason I did not go into nursing like my Mom and sister! But, friends who had similar situations have assured me we can do this.  We can do this.

On March 20-22ish Nate will be at Northwestern for the stem cell collection.  He will be hooked up to an IV of sorts for a couple hours every day until they have enough stem cells.  So he could be there 2-5 days, just hard to know.

We have another pre-transplant appointment on March 27.

Nate will be admitted to Northwestern on April 7 and begin the 6 days of intensive chemo.  This part has me the most nervous as they are bringing his immune system down to nothing. Then on April 13 they infuse his stem cells back into him.  Then we wait for his blood counts to rebound (so he has an immune system again) and get high enough so that he can go home. So sometime after April 27 we are hoping he will come home.  Then comes recovery time at home.

Piece of cake, right?!  Ahh! As I write this post the Bible verse, "I can do all things through Christ who strengthens me" is running through my head.  Not sure I always believe it, but I can rest in knowing God will get us through this.

Short term prayer request, Nate has inpatient chemo in Grand Rapids Feb 28- March 2.

Northwestern follow up

We had an appointment at Northwestern on Friday. The Dr looked over the PET scan and bone marrow biopsy and said everything looks great. So Nate will have an auto stem cell transplant. The process will begin mid-March. He will spend 2-3 days at Northwestern having his stem cells collected. Then a couple weeks later he will spend 6 days in the hospital receiving intensive chemo. Then his stem cells will be infused back into him and he will spend about 3 weeks in the hospital. We will be receiving more information from the transplant team over the next few weeks about what to expect post-transplant.

Nate has one more chemo round, inpatient at Grand Rapids on February 28. Please pray for continued health and that we will not be fearful and stressed when the stem cell transplant process begins.

Scan Results

We met with the oncologist today and found out the PET scan results are clear!  There is no evidence of disease.  There has been so much bad news over the past few months that it was shocking to get some good news!  Thank you God that the chemo is working.

Nate had a bone marrow biopsy this morning.  The doctor asked me if I was going to pass out?  That made me laugh.  I assured him I was not going to stand over his shoulder and closely observe, but I was not going to pass out either.

We meet with Northwestern on the 17th to go over the PET scan and bone marrow biopsy results.  Because the scan is clear, it should be a straight forward decision to do an auto (self) stem cell transplant instead of an allo (donor) stem cell transplant.

Nate had outpatient chemo today.  This round is harder to recover from, so please pray for minimal side effects this week.

We know there is still a long road in front of us with the transplant.  But, today we are going to smile, relax and enjoy some good news.

Isaac's Thoughts

It is challenging for two adults to walk this journey, much less trying to help our kids walk this journey.  Sometimes the blunt questions they ask when least expected can take my breath away.  We are thankful though when they ask the questions and want to talk because most of the time we have no idea how they are processing all of this.

Isaac's class recently wrote stories.  Isaac wrote about cancer.  His writing makes us cry and we are so very proud of him for telling his story and sharing it with other people.  Isaac said we can share his story on the blog.

Have you ever been so nervous that you thought it was a nightmare?

It was a warm school night and we were all kind of tired and quiet, but the little kids were kind of loud and we were all around the table.

Suddenly Mom and Dad got quiet.  Somehow this made the little kids be quiet but me and Caleb were already calm.  Then suddenly Dad said, "You know that I've been sick for a while."

Suddenly I got so nervous my hands started shaking.  Then Dad said, "Well we've figured out what it is, it's.... cancer."

Suddenly I remembered my Grandma.  My hands were shaking more than ever.  But before anybody could say something he said, "but if you had to pick a kind you'd pick this one."

Still Julia started crying and we all felt scared.

Finally
Mom said confidently that it's going to be OK.  Somehow it echoed in my brain it's ok, it's ok.

But, I wondered what will happen to my Dad?