Radiation sickness
By yesterday afternoon Sam was feeling himself again. Nausea and pain were under control and he has is appetite back! As a family we had a good time sharing the notes of encouragement that we have received from the recent post on Facebook.
Today Sam completes the TBI treatments.
I am writing from BC Children’s Hospital, it is in the morning of Day -5 leading up to Sam’s bone marrow transplant (BMT; transplant day is Nov. 14). Yesterday Sam began his BMT conditioning treatments. This started with two rounds of total body irradiation (TBI) at 8:00am and 2:30pm. Following these treatments Sam was admitted, as planned, to the hospital.
The days leading up to the BMT will be full of various treatments to prepare Sam’s body to receive the donated bone marrow. We had expected this to be hard, but I had not expected it to be immediately hard. This new treatment has hit Sam with a new intensity. He has been nauseous and ill, has had distinct new pains, and slept most of the day and continues to sleep now. Talking with the doctors all of the new symptoms are common to the TBI.
Sam continues to be strong. Halfway through the afternoon treatment he was nauseated, he took a few minutes to puke, then with a let’s-do-this-determination positioned himself to complete the second half of that treatment.
Current treatments
The goal of these pre-transplant treatments are two-fold: 1) Make room for the donated material, and 2) Suppress Sam’s existing immune defenses to allow acceptance of the donated material.
Making room
Between today and tomorrow Sam will receive another four treatments of TBI. Over the weekend he will receive chemotherapy. The intent of these treatments will be permanently remove Sam’s native immune system. More specifically, the blood producing cells in his bone marrow will be destroyed to make room for the donated material. There will be no going back.
Immune suppression
Also on the weekend Sam will start receiving immune suppression treatments to prepare his body to receive the transplant material. Where the TBI and chemotherapy remove the body’s ability to generate new blood including immune system blood cells, the immune suppression therapy will manage the existing immune defenses. Sam’s existing mature immune defense cells will be suppressed so that they do no attack the donated material – facilitating the acceptance of the donated bone marrow.
It has been half a day since I initially wrote this. This morning’s TBI therapy went much the same as yesterday’s. Since we have been back to the hospital the team here has made extra efforts to manage Sam’s symptoms. We should have a better visit to the BC Cancer clinic this afternoon.
Victories and concerns
Immediate concerns for Sam: Sickness and pain from the total body irradiation (TBI).
It has been amazing to see Sam out from under the influence of chemotherapy. To see him return to strength of mind and to have capacity for more activity. It is hard to see him have this strength pulled away from him.
Thankful for friends who have chosen to meet regularly to pray for Sam. If you would like to join them talk with Beth H., Krista C., or contact the Westwood Church office.
We have completed a major chapter in Sam’s treatment. With the completion of this last/ sixth round of chemotherapy and targeted radiation. We now pivot to the bone marrow transplant – this current and upcoming treatments brings hope of removal of the disease but also anxiety about both the challenging process and the potential for long term side effects. We hope and pray that this treatment will be effective in beating the cancer for life.
It is flu season and covid is still out there. If any of us get sick it will add challenges to Sam and the BMT process as he will be entering a phase where he has no immune system for weeks.
We are continually thankful for our medical teams here. They continue to provide incredible care. They are always open to conversation and answering questions. They have been incredibly pro-active and I am glad we are prepared for the next steps.
Thankful that the chemotherapy has been effective at initially reducing the cancer and keeping the cancer contained (as indicated by the PET scan). Thankful that these results allow us to move forward.
In preparation for the BMT there are numerous items that need to come together:
- Due to some timing and logistics we have had to change donors. We are thankful for this current donor who will provide a peripheral blood sample and is a good match for Sam.
- We are desiring that side effects both immediate and long-term would be limited. Ideally, that there would be no measurable side effects long term.
- The medical team has a huge coordination task ahead of them. From our meetings with them it seems all of the pieces are coming together, but with so many moving parts it is easy for things go wrong.
We are thankful for the support of family and friends. Thank you for your notes of encouragement.
There is always concern as the cancer remains. We long for the day when Sam is clear of this disease.