August 23, 2022 – When we got married at the farm on the hottest day of the year; we never imagined ourselves celebrating our 8^th anniversary here.  Chilling out in the air-conditioned comfort of Mott Children’s Hospital complete with room service; a room on the 7th floor with a view. Today is Day +6 (post-stem cell transplant) for Scott.  He’s no longer taking long-acting morphine or short acting oxy; his need for pain medication has been greatly reduced already.

For those following to learn more about the transplant process, he had his days of nausea and is still working through off and on intestinal issues.  My greatest fear was having several days of vomiting to witness but they have so many potions to tackle the nausea that he didn’t have to suffer that way for long.  Medications have given him high blood pressure and he is seeing a change in his eye sight so we had to invest in a different pair of readers.  He’s been up and walking regularly and his appetite is slowly improving as his sore throat lessens.  This morning he received another gift of platelets.   Insomnia is a problem most nights so then some days he can’t stay awake to finish a conversation. 

We’ve talked to others in the halls and even if they are here for BMT it sounds like everyone has a slightly different story and regiment.  Others have taken chemo before coming here while Scott didn’t receive any until he was admitted here.  The number of days of chemo also varies depending on the type of cancer.  Scott is up and dressed each day and walks a lot; something fellow bloggers have indicated they felt was key in getting sprung from here early. 

For me, retirement from my full-time job less than a week before transplant day has allowed me to spend almost all my time here.  I stayed for the first ten days before taking a break and going home for a day and good nights sleep.  Being with him 24/7 has been very helpful in a few ways.  While you can summons a nurse with your call button, usually issues are more time sensitive than the average turn-around time is.  Managing a tree of IV’s plugged into an electrical outlet makes urgent trips to the bathroom a bit tricky.  I have a power strip on my list of things to bring back with me.  That will allow him to go to the bathroom without having to unplug before taking off.  

Even when he’s not feeling chatty, he says the companionship has helped pass the time.  There’s a noticeable difference in the patients that have full-time visitors and those that don’t.  Walking the halls, it’s difficult to see the sadness in the eyes of those that are always alone; and their bodies seem to sink into the bed.  So even if your loved one has to work remotely; we certainly recommend having someone stay if you can manage it.  As the caregiver, you feel like a third wheel when your patient has scheduled procedures and activities; it’s hard to know where you fit in. But when the door closes and the nurses leave you are there to help out when needed.  Think of yourself like training wheels, your patient needs that extra stability you provide to feel safe after transplant.  Here the window seat converts into a bed that is probably more comfortable than the hospital bed and I’m able to use the same rest room and shower as Scott.  The nurses have been very appreciative of the extra eyes and ears I provide.  It feels awkward at first but you will get into a comfortable routine in no time.

Sitting right on the 100-mile limit from the transplant center, we are looking for housing for the next few weeks.  Nailing down the perfect place has been a challenge since we don’t know exactly when he will be released.  We will have to book a hotel in Ann Arbor for a few days once we know when he will be released.  Yesterday, I secured a walk-out lower- level duplex style home in Dexter for most of September.  Looking for housing whether it’s a hotel or a VRBO or Airbnb house, is challenging in the Ann Arbor area during football season; most places are booked on the weekends and rates are higher as well.    We decided against pursuing an apartment as after application fees and minimum lease requirements, we determined it would end up being more expensive than the other options and require us to move furniture and cookware.

Scott is heading out for a walk with Zeke in P. T. so I think I’ll go peruse the gift shop in search of an anniversary present.  He mentioned that he would like a U of M coffee mug.  I might be able to manage that.  We have some food-gift cards so maybe we can do delivery or a Grub Hub to put some flair on our menu tonight since we have no choice but to dine in.  What I would really enjoy would be a much-needed pedicure; if I can fit it into my busy schedule. It’s been years since I’ve treated myself to one and I think I’ve earned it.  Happy Anniversary to me!

It’s been a challenge for them to find the right balance of pain medicines so that Scott’s comfortable but not too loopy.  He’s seeing and hearing things and that’s kept him up at night.  He’s been providing us all with a good deal of entertainment.  At one point the room was flooding with water and I needed to run and get some towels, or better yet the time it was filling with worms.  He got after the cleaning lady for walking through all the cobwebs in the room and not taking care of them.  They are trying yet another regiment tonight and our hope is to ward off the boogie man and hopefully he can sleep better.  He hasn’t been able to work on the farm since February but he sure has worked a lot of cattle with Steve in his dreams since then. 

The pain in his body has retreated a little and now his sore throat is a problem.  Also, to be expected; were some temporary (we hope) changes or damage to his taste buds.  Nothing tastes good so he won’t eat.  We’ve ordered and tossed out everything from chocolate pudding to milk shakes, burgers to baked potatoes. Tonight, I put in an emergency call for Kathy’s chocolate chip cookie bars that have kept him going over the past few weeks. 

Left – very careful handling of the frozen stem cells.

Right – when frozen they looked pink. After thawing looked just like thin blood.

The actual transplant took less than an hour and started at 2 p.m.  The cells were brought into the room in a storage container similar to what is used to store semen in when artificially inseminating the cattle.  That conversation kept Scott busy while nurse Emily prepared the work area.  We were told earlier that the hospital requests 2-5 million cells be provided for transplant and our donor provided 4.1 million.  I could be wrong but I think each of the two bags contained 1 million cells frozen at 100 degrees below zero.  The extra cells remain frozen in case they want to give him more down the road.  Once removed from the container they had 15 minutes to infuse them.  The nurse manually pushed them through the line with a syringe rather than a machine.  She explained the potential side effects but he really had no pain or problems at all during the process; she did a great job.  There was a small break in between the two bags to check vitals and follow protocols but it went quickly and efficiently.  The preservatives used to keep the cells causes an odor to be released when pushed through the system.  A number of smells have been reported but the consensus of our group was that the room and Scott’s breath smelled like creamed corn.  Very strange!

It was probably less than an hour later that he felt up to taking a walk around the “block” with the walker.  Tonight, we are watching the movie Tombstone for the 3^rd or 4^th time.  We don’t have access to a DVR yet so Yellowstone will have to wait until we get to the next stop.  They anticipate a few more difficult days as his remaining blood cells do battle with the new ones.  He is receiving a multitude of drugs via IV to combat the side-effects of his part of the process.  I anticipate him to get antsy and bored but he probably won’t be up for calls for a few more days.  The internet won’t support the picture frame the kids bought or Facetime calls but we can do that as soon as we find the next resting place. 

We continue to be so grateful for all the texts and messages of prayer and well wishes over the phone and social media.  He’s not out of the woods yet but we have a great team of people here keeping track of his every move and we are very confident that we are in the right place. 

Aug 15, 2022 – Rather than wake to the sounds of Scott shuffling around at 6:30 a.m. and the smell of freshly brewing coffee, I woke abruptly to the sound that I have been dreading.  The sound of vomiting.  Since I was a child, the sound of vomiting has been extremely disturbing; maybe it is for everyone.  But nothing prepares you for a bowl of green to black liquids; the reality that the medicines they are pumping through his veins are lethal.  You see the nurses handle the triple bagged products while wearing gowns, double gloves and disposable eye glasses; telling signs of the seriousness of what he is taking in. 

Last night I reached a point where I felt comfortable leaving him watch television; figured I would get a little exercise and fresh air.  I headed to the courtyard and phoned a couple friends.  Returning to Seven West, refreshed and baring gifts of Raisin Bran and instant oatmeal, I find the room a flurry of activity.  In the 30-40 minutes I was gone, his temperature had spiked.  Combined with a sore throat and climbing blood pressure they felt cultures and a chest ex-ray were necessary to make sure that his lungs were staying clear.  That led to him nearly passing out and having severe abdominal pains while in ex-ray.  The doctor was called and did an assessment and he went to bed with a few more medications.  All things they claim are very common and part of the process.  As the chemo attacks the cancer it causes different flair ups for each person.  They do consider him orthostatic which means that his blood pressure changes (in his case increases) greatly when he changes positions – stands up – so they label him as a risk for falling and don’t want him moving around without assistance.    

The nurses have been great and mixed in all the seriousness and caring we have managed a few laughs.  As the masked nurse was just doing her handoff this morning, she asked if there was anything else she could do for him and Scott heard something more like was his diaper ok.  Obviously, somewhere in the back of his mind he must be fearing the need to wear a diaper before this is over.  You probably had to be there to appreciate it.  It was a pleasant change from the last 12 or so hours before. 

To help combat the restlessness and feel like I am making a difference, I agreed to take part in a caregiver study while I’m here.  It will consist of taking some surveys and wearing a Fitbit, which I can keep.  They are studying the effects of positive reinforcement for the caregiver as it relates to the patient’s recovery.  One group will basically get the Fitbit and be left alone and the other group will take part in activities.  Guess which one I am hoping for?  I’ll learn more about this tomorrow when they officially get me signed up. 

Up until now my writing has been very emotionally driven.  Writing has helped immensely when I was feeling scared, over-whelmed or frustrated.  The stories just flow out of me and I feel instantly healed or calmed.  Now thankfully I am just bored but feel the need to keep you all informed.

We (I) rushed around like hell on wheels to finish tasks to leave on this journey.  Getting the business situated so that the others can do business for a while without me and getting the house and yard ready to be gone until potentially Thanksgiving.  The refrigerator is empty and the laundry was all done and put away.  Unfortunately, we will be missing out on our first real peach crop.  The little twig we bought on clearance a few years ago at TSC has really outdone herself this year and is has limbs hanging to the ground with beautiful fruit.  Thankfully the neighbor has offered to pick and can some for all of us so they won’t go to waste.  We have so many good people in our midst, keeping an eye on things and helping with all kinds of necessary chores in our absence. 

Thursday, or Day T-6 (transplant minus 6) was busy with testing, installation of his Hickman catheter (port) and getting settled into the maize and blue that will be our home for the next 30-45 days.  It’s hard to even imagine being away from home and daily life for a week let alone being confined to a hospital room and a few hallways for a month or more.  Due to the severity of the process, stem cell transplant patients cannot leave the unit and visit other parts of the hospital. Friday, aka T-5 started with chemotherapy at 5 a.m. and was full in introductory visits, lots of blood samples taken and blood transfusions.  Being hindered by the terrible back pain, they wouldn’t let him shower without supervision; so, rather than have him shower with the help of a nurse technician, I stepped up for the job.  He might have been up for it but I wasn’t ready to share my man yet.  Trying not to get myself soaked while making sure he didn’t fall or pull out any of his IV lines was a challenge.  Not every day you are expected to shower, while getting a blood transfusion but we made it work.  Scotts TO DO list for Saturday, T-4, consisted of walking the halls, brushing his teeth, rinsing with medicated mouth wash 4 times a day to limit inevitable mouth sores, using the breathing tool 10 times per hour and taking a shower.  Doesn’t sound like much but it seemed to fill the entire day and he only accomplished half of the list.

He has already been given half the chemotherapy necessary, and has been fortunate enough to have avoided any severe vomiting or diarrhea.  Every day without it is a blessing in my eyes and we are both very thankful for that.  Unfortunately, the side-effects of the opioids necessary to control the bone pain have given him other very uncomfortable troubles.  They are trying multiple products to relieve that with no success but we expect that if nothing else the chemotherapy will turn that around very soon.  In situations like this, something we all take for granted is suddenly a real problem.  All things considered; he’s taking it like a champ. 

I am able to stay in the hospital room with him 24/7.  The small sofa converts to a bed that is probably comparable in width to a twin bed.  Being short in stature helps to make it tolerable.  Having a room across from the nurse’s station makes it a little more difficult to sleep with bells and alarms going off all the time.  Things on my “should have or glad I brought with us” list include a good set of head phones, ear plugs and a small reading lamp.  He isn’t tolerating any noise so listening to music on my computer is a great way to pass time.  Ear plugs to sleep with all the outside the room noises and the reading lamp would be nice for when he’s ready for bed at 9 p.m. and I can’t sleep.  Add to that list would be food that doesn’t smell or make noise when you eat it; for obvious reasons.  And mints or gum since breathing your own breath all day in a mask is not all that pleasant.  Helpful hints for those reading that are finding themselves facing an upcoming hospital event.  The snacks and books are nice and I have even started coloring in my new adult coloring book.  Being forced to slow down is something that will take me a while to adjust to; but I’m willing to learn. 

July 19^th – On our return from Canada, Scott took a call from the coordinator from U of M and agreed to another bone marrow biopsy there on Tuesday.  She said that they were working on scheduling his pre-admission testing and would get back with us on Monday.  Hearing nothing, we pulled up MyChart and sure enough he had several things scheduled; including admission to the hospital on August 4th.  Along with being able to research your own diagnosis, you need to be computer savvy too.  EVERYTHING is on-line.    

With my week already filled up with catering commitments, that meant asking sister Kathy for another favor.  She gladly agreed to be his driver.   That worked well because after a disagreement over burnt pancakes, we weren’t talking any way.  That’s a story for another day. 

Rewind to our visit to Mayo Clinic.   They wanted to do their own biopsy because the one done locally showed only 5% blood which was very concerning if accurate.  Option A was to have it done without anesthesia in one hour or Option B – we could stay in Minnesota and have it done in four days.  Knowing we all preferred to head home, he took one for the team and agreed to go with Option A.  Only he can tell the story as it deserves but short story he said NEVER again. After three drills with an ice pick, they had their samples and we were on our way back to the VRBO with a plan to head home in the morning.  Mission accomplished.

So – fast forward.  He shows up for his appointment at U of M only to find that we should have gotten a call with instructions to not eat prior to the procedure.  Sister Kathy, being the hostess that she is, had a spread of snacks available for their 2-hour drive.  There he was again, left with no option but to go forward wide awake again.   I guess it took some sweet talking but according to him, the gal convinced him that she was very good at her job and he would be just fine.  I’m not sure what they ended up giving him for pain but several hours later, he was telling me all about the pretty gal that rubbed his back while another did the drilling.  There was more to the story but I kind of tuned out after it started to feel like I was the third – or fourth wheel in his fantasy procedure.  Still making lemonade out of lemons I guess – but at least we can check that procedure off his list for a while and we didn’t argue tonight because he was passed out by 8:30 p.m. 

On the way home, they stopped at the kids’ cottage and had the rest of their picnic lunch.  Next week we go back for a full day of testing.  Looks like I’ll have to bring my “A” game to make it more memorable than today.    

July 1st – Independence Day had a new meaning this year. I am husband and dog free for a week for the first time since we got married. As Scott showered in preparation for his trip to Batchawana with Mom and Sis, I found myself getting emotional. Not so much that I will miss him over the next few days but because I realize how much I miss the man he was six months ago. I miss our near fairy tale predictable life. Months of his extreme pain and the need to medicate for pain every two hours around the clock has stressed us both. He has had much better days with the Jakafi but is still struggling to learn how to manage his energy and time. While it would be nice to be able to just hang out together as we wait, duty still calls me. His life has come to a skidding halt; but my daily obligations continue and we both struggle with that. Thankfully my days with at my full-time job are numbered. I’m working in a training capacity for another month and officially retiring on August 5th.

I’m glad that it’s working out so that he can go back to his comfort place. He tells me he will enjoy a break from me and sadly I know he means it. More than anything he needs to feel like he can manage – on his own. He needs to get away from the sights and sounds of the farm so he isn’t reminded that he’s not contributing. The break will be a chance for me to recharge before we head into the most challenging thing either of us have ever done. I’ll join him at the cabin at the end of the week for a few days together with Luke and Alli. Hopefully when we get back, we will have an official transplant date and be ready to hit this thing head on – together. More rested and relaxed than we have been in months.