T minus 3 ............March 1, 2008

Well, since my last update, Jan was admitted to the hospital on schedule on February 27th, which also happened to be my mother’s birthday. So, happy birthday mom. By 9:00 P.M. following admission they had already started the chemotherapy treatment. The initial drugs, Fludarabine and Busulfan, are to be administered over a four day period. A series of blood tests are required after the first and fourth treatment. The analysis required on that blood must be done in Pennsylvania, so it has to be shipped over-night with the results expected within 24 hours of arrival. The Pennsylvania facility is the only location in the country authorized to run the specialized blood tests.

Today is Saturday, so we are at T-minus 3. The bone marrow transplant is scheduled for Tuesday, in three days, thus the T minus 3. In a few minutes Jan is scheduled to be attached to a small pump which she must carry around for the duration of her hospital stay. The pump (pictured here) is used to regulate a new drug which will be administered today called Tacrolimus. This drug is used to inhibit Jan’s immune system to help reduce the risk of rejection of the stem cells which she will receive on Tuesday. The medication has to be regulated very closely, thus the special pump.

Jan's only discomfort the past four days has been some mild nausea, periodic anxiety, boredom, and some claustrophobia. Our room is only about 10 x 10, and Jan is restricted to walking no further than a few feet from her room. On her previous hospital stay she was permitted to walk throughout the hospital, and even outdoors. That’s not the case here. Patients must remain within eyesight of the nurse’s desk.

Jan’s brother, Pack, continues to receive his daily injections needed to promote cell growth for the harvesting to be done on Monday. He is doing well, and has not experienced any side-effects. We have a large calendar in our room which marks the events leading up to the transplant, also known as Day-zero, and lists some of the procedures and/or medications which will be administered following the transplant. The weeks following the transplant will be the most critical, and will also be the time when most of the fatigue and discomfort will be noticed. It’s hard not to wonder what those days will be like. We try to focus on the days following Jan’s discharge when we will be in a near-by apartment and more in control of our environment.