Friday, February 20, 2009

Weather Forecast: Storms Approaching

This is one of our intense medical weeks – a referral to a colleague who works with Dr Sheehan, a meeting with folks at the Access Clinic about the next-step surgery Sabine needs to get her fistula working… but now, with Dr Longho, we hear another possibility – a stem cell transplant – which is a long process of intense chemotherapy to knock out the cancer and then a process of harvesting Sabine’s own stem cells and re-infusing her with them.

It may not sound so bad, but we have heard about the stem cell transplant process (some good, some bad) from some of the members of our support group. It is a scary and somewhat dangerous process.

Nevertheless, what Sabine would gain from a successful stem cell transplant would be a period of time (one or two years or more) in which she would not have to take the debilitating chemotherapy drugs (various chemotherapies eventually lose their efficacy).

A stem cell transplant should improve her longevity and, at the same time, keep up her quality of life. In order to become a candidate for this procedure, a number of tests will be undertaken along with establishing a baseline for her cancer. It’s her decision what to do and my job to support her decision.

I have a feeling that we are going to be entering some tough times in the months ahead. Sabine will have to put off the vein/fistula procedure until she recovers from the stem cell transplant (which generally takes about three months for a full recovery). We met with the access clinic today and they confirmed that the vein/artery hookup would not be compromised by waiting three to six months.

This new round of chemotherapy will cause Sabine to loose all her hair again. I’m thinking “redhead” this time! The downside is that she will be very sick as her white blood cells drop along with her immune system. She will have to be in isolation for a while and be very susceptible to infections. In between all this, we will have to keep the cancer from getting aggressive… and Sabine will have to continue five dialysis sessions a week.

Dr Longho also talked to us about kidney transplants and said that kidney transplant patients have to undergo a lifetime of drug therapy to prevent rejection of the new kidney. In Sabine’s case, those drugs would compromise the drugs necessary to control her cancer -- therefore eliminating the possibility of this course of action in the future.

Yesterday, after meeting with Dr Longho, and presenting hearing about our next course of action, I can’t help but feel the uneasiness and worry (oftentimes, terror) that I felt a year ago when Sabine was first diagnosed.

Maybe it’s the fact that we have had a wonderful ten months without chemical intervention and wanting (again) to “freeze-frame” the good times. As Sabine said this summer, “If it wasn’t for the dialysis, I would have forgotten that I had cancer!”

Today, reminded me that the cancer has not forgotten us… So, we saddle up again and prepare to move out… The poem I wrote below captures the feelings I have…

the restlessness

it slowly begins

as we contemplate

a change

a “modification” of

the program

why can’t it stay just like it is?

why the changes?

why the modifications?

we were holding a course

a comfortable one

and now

there’s this new thing

this new assault

on our deadly disease

we’ve been in “r and r”

(that’s “rest and relaxation”)

for these long months

and now

the front lines still are there

we’d almost forgotten about them

now they call us to forward

the engagement unavoidable

the hand-to-hand combat


a deadly wrestling match

with cancer

it does not cower

nor easily yields


it beckons

come, it says

such mocking words

are you up to

the match, you two?

it’s to the death

you know?

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