Tuesday, March 31, 2015

Tuesday March 31

Looking out my hospital window I see a yellow orb, lots of clean pavement and very little snow on any of the green space.  Spring anyone??

Things continue to go well here at 778 Beth Israel.  I am a little tired but otherwise feeling quite strong.  This is kind of a wait and see period - the 'no news is good news' phase.  My blood counts have dropped (this is by design - my counts drop and then rise again as the new donor cells engraft) but, unlike the last two rounds of chemo, I've been spared any nasty side effects thus far.  The doctors are encouraged with how I am doing and that is all I need to hear!

Most likely my counts will soon be on the rise - maybe by next week.

Until then I am grateful for every good day, happy to be eating pretty well and to have decent energy.

Many thanks for your prayers, support, meals, love...all working exceptionally well!

Thanks for checking in
Maureen

Saturday, March 28, 2015

Weekend Update March 28 and 29 - Day +3 and +4

Happy Saturday!

Hope everyone is off to a nice weekend.  The doc was in this morning and said I was the first patient he saw who was out of bed.  That reminds me how lousy folks on the 7th floor of Feldburg can feel at various times during their treatment - and how I have to seize every moment I feel good - to eat, watch law and order, update my blog, 'exercise' (I still feel a little silly pacing my room for exercise but I am hermetically sealed (not really - just unable to leave) my room until  my counts come up.

So I tried yesterday to give a picture of the progression of my treatment - when I speak with my medical team they preface most everything  with 'every patient is different'.  In general I think the progression will look like this

  • Transplant done - things can go wrong here with fevers/hives - nothing went wrong with my transplant but I felt kind of yucky and uncomfortable the first couple days due to all the fluid
  • Now until early next week (est.) - my blood counts continue to drop which is good and intended as my marrow is getting ready for engraphment of the new stem cells - new immune system and an even greater love of bratwurst
  • Early next week plus 10 to 14 days (est) - my counts bottom out and this is when I can feel crummy.  I may have fatigue, stomach troubles (she says delicately) and fevers.  I will also be at the greatest risk for infection.  I will also likely be getting transfusions of red blood which will help with the fatigue.
  • About 20 - 30 days from now (est)- my counts recover courtesy of the new stem cells producing red cells, white blood cells and platelets.  
  • Discharge to apartments (?? when - maybe 30 days - hopefully less)- once my absolute neutrophil count (disease fighting white blood cells) reach a certain number and the doctors are confident I am fit to leave the hospital (I must be eating decently, moving about on my own, etc) I will  be discharged to apartments close to Beth Israel allowing for daily outpatient visits to the clinic.  The apartment stay can last 2 - 4 weeks.
Personally I am cautious about adding up all this time to get an estimate of when I can come home.  In general we think 2 months from my date of admission is a safe bet.  If complications arise with graft versus host disease it may take longer.  The medications I am taking can also do a number on my kidneys but they are watching this very closely - so far no issues.  

Kate and Emma are coming in today - It looks like a decent day so maybe they can get some Aunt - Niece Boston time as well.  Jim and Joseph will join them tomorrow and Kate flies home tomorrow night.

Loving that I feel strong right now - very very grateful.

Thanks for checking in

Love
Maureen


Friday, March 27, 2015

Friday March 27 Day +2

All went well with the stem cell transplant.  As part of the procedure they filled me with fluid - LOTS of fluids - so I've been a bit uncomfortable for the last couple days.  Beyond that, feeling strong and healthy.

So a quick recap - on Thursday March 19 I came back to Beth Israel for a week of conditioning prior to the transplant.   The conditioning regimen used two types of chemotherapy to destroy any remaining cancer cells (even though I have been in remission, the conditioning is protocol for any patient going through a bone marrow stem cell transplant).

On Wednesday March 25 I was given a stem cell transfusion from an unrelated donor (an angel from Germany who  donated her cells).  The healthy immune cells from the donor can recognize cancer cells and destroy them.  This is called graft vs. disease (or tumor).  

A possible problem after stem cell transplant is graft verses host disease (graft being the donor and host being me).  GVHD is a complication of transplantation where the donor graft cells attack and damage some of my tissues - this can cause skin rash, nausea, vomiting and may also damage my liver.

Paradoxically we want graft vs disease to get rid of any latent leukemia cells BUT we want to avoid graft versus host.  I am currently taking prophylactic medications and immunosuppressants to prevent GVHD.  The amount of the medications is a delicate balance and I have frequent blood draws to make sure I have the right dosage.  An art and a science I guess.

Over the next couple weeks my own platelets and disease fighting white blood cells (compromised because of the leukemia) will continue to drop until the new donor stem cells engraft and my new immune system kicks in.  We are probably looking at 4 weeks or so for this process to run it's course.

Kate is in this week and it is great to have the company.  She saw Jim, Joseph and Emma yesterday and was able to get to one of Emma's volleyball games.

That's it for now - thanks for checking in

Love Maureen

Wednesday, March 25, 2015

Wednesday March 25

As my brother John points out,my half birthday. Fitting. Had my breakfast and shower and am a bit looped up. The infusion  has begun ans should last for an hour or so.  The word I've heard most often is anticlimactic. So far that is true. May
Get fevers or hives but that is unlikely.  Will keep you poste

Tuesday, March 24, 2015

Tuesday March 24

Good morning. Wonderful visit yesterday with our good friend Paul who just returned from a wedding in a blizzard to  honeymoon in Hawaii. Not bad.

Today is a day of rest for me and tomorrow is the transfusion. I am told lots of sleepy medicines and liquids all afternoon on wed. I will probably have  the  chemo aftereffects (whatever those might) be within the next week or so. Following that, if all goes well, my new marrow will engraft and start producing blood  cells. Sounds simple but I am on a lot of medications to help this  all work.

Jim is in tomorrow and Kate comes in Thursday for a long weekend visit.

Not much else New. Thanks for checking in

Love Maureen

Saturday, March 21, 2015

Here he comes...Mr North Andover

Last night  was a BIG night for the Staudts, our great friends the Collins and their daughter Megan and all of North America - well maybe just North Andover - Below is a photo of the 2015 Mr North Andover Joseph Staudt and his sponsor and best friend Megan Collins
Here he is..... Mr. North Andover 
Joseph and Megan had an absolute blast  preparing for and participating in  the Mr, North Andover contest.  The contest consisted of an introduction of each candidate, a beach scene for each candidate, (their  sponsor and their  ensemble), a group dance, the talent portion and finally a tribute read by the candidate (Joe) to his sponsor (Megan).  Joseph's talent was a montage that culminated in a tae kwon do exhibition (he  trained at Master  Shins in Andover).
Here he is..... Mr. North Andover 

Joe tells me it was not until after he read the tribute that he fully remembered this was a contest with a winner being announced - he and his friends simply had an absolute blast with the entire event.  There was not a dry eye after the tribute to Megan (his life long friend; side note: my friend and neighbor Karen and I gave birth to the dynamic duo within months  of each other and they have spent most everyday together since.  They've been talking about Mr. North Andover since at least 8th grade.).  Megan is a distinguished athlete (basketball and soccer) and the two of them push each other (literally most times) make eachother  laugh and, to  our delight, treat each others homes as their own.

Jim, Emma and Joe will come see me tomorrow - Emma has a girl scout sleepover tonight with an evening hike - god bless Anne Marie, Kimberly and Marie (our the troop leaders) as there  is still plenty of snow on the ground here.  Emma wrapped up basketball with a fun and winning season.  Though they made it pretty far in the playoffs this was not their year for a league win - a great, year nonetheless and many thanks to Coach Panos (the originator/manager of the sign up genius  meal plan in is spare time).  Emma has started volleyball and it seems to be a  bit more competitive this year in a new league.  So far so good - her team has really nice girls and their play has come together pretty early in the season.  Joe starts outdoor track with one of the first orders of business clearing the track field with snow blowers and shovels!

I am here at Beth Israel on Day - (that;s minus) 4 (started chemo on day - 6).  Wednesday is Day 0 (transplant  day).  So far so  good - I am far enough from the  last round of chemo that I seem to be past those side effects (not quite as tired, my appetite  has returned, stomach is consistently normal, and water tastes better - oddly water tasted AWFUL until a couple days ago),  The effects from this new round of chemo which started Thursday will probably kick in sometime next week,  It feels so good to feel good!!  Whatever comes with the chemo is all part of what I need to get through this.

I am on the same floor at Beth Israel and all my nurses are the same - I am right at home
A nice weekend on tap with my aunt and  cousin are coming by today.  Great few days and so very thankful for all the love and support.

Thanks for checking in

Maureen

PS There was also a nice article in our local news (you may need to copy and paste link into a browser vs link from the UR:.
http://www.eagletribune.com/news/merrimack_valley/here-he-is-mr-north-andover/article_0544853c-9ced-5905-9556-6611d848bb01.html

Thursday, March 19, 2015

Thursday March 19

Returned to the hospital  today for the  transplant procedure.  Today was all about paperwork, admission day evaluations and getting my central line placed.  This line is for the chemo, any IV's needed and blood draws.  The procedure went well and I am ready for my chemo to begin tomorrow morning.  The plan is for five days of chemo, a day of rest, and then the transplant.

On the drive to the hospital I completed my March Madness bracket (Jim was driving) and mailed in just before the deadline.  Never let it be said I lose sight of my priorities.

In other news...North Andover High School announced the 2015 Senior Class Superlatives winners (as voted on by members of the senior class).  Our  own Joseph Staudt was crowned Class Clown continuing the tradition started a generation ago by his Mom (me) when she was voted Class Clown of Lake Catholic High School.  Jim was voted most intelligent and most likely to succeed - we have high hopes Emma takes that path.  Between the four of us  we tell some pretty cerebral jokes.

Will keep you posted on how things progress - thanks for checking in

Love, Maureen


Tuesday, March 17, 2015

Tuesday March 17, 2014

Happy St Patrick's Day!!

Why don't you iron 4-Leaf clovers? Because you don’t want to press your luck. 

Hope your week is off to a nice start.  The Staudts have been busy - over the weekend we celebrated an early Easter complete with an Easter basket hunt.  Growing up my Dad hid the baskets for all four of us kids in the most creative places.  We had a blast hunting for them in the piano, dryer, you name the hiding place.  The tradition continues here and the kids each found each others basket.  We topped off the morning with my Mom's famous Sausage Strata - YUM!

Monday Jim and I went to the clinic for our final visit prior to my re-admission this coming Thursday.  The numbers look GREAT (my Doctors are very excited about my blood counts) and I am going into the transplant in a strong place physically, emotionally and spiritually.  One area of concern had been my kidneys - as of yesterday my creatinine level (a kidney function indicator) is normal - yeah!!.  The spinal tap from last week show no sneaky leukemia cells swimming around in my spinal fluid.  And my platelets and white blood cell counts are very robust (just in time for the chemo to knock them down to 0).

I am heading into the hospital Thursday morning, will have a central line placed and will start chemo. Even though I am in full remission, Chemo is part of the 'conditioning' to get my body ready for the new bone marrow stem cells.  The chemo will last a week and the transplant will happen via infusion on Wednesday 3/25.  No matter how many different ways I ask the question(s), there is no predicting exactly how long I will be in the hospital or what side effects I might have.  The initial side effects (the first few weeks) will be related to the chemo - last time I had fatigue, some stomach troubles, mouth sores, fevers, but all were managed exceptionally well.  We'll see what this round brings but no matter what I know I am in unbelievable hands with the care at Beth Israel Deaconess.  Also, I have so much waiting for me at home!

That's it for now - thanks for checking in!

Love
Maureen

Thursday, March 12, 2015

Thursday 3/12

Good evening!

Jim and I spent most of today at the Beth Israel Clinic.  I've been home 3 weeks now averaging about 3 visits a week.  I've noticed a consistent disconnect with how long I think I will be there (1 hour) with how long we are actually there (2 - 4 hours).  But this is time well spent as I've been getting outstanding treatment including loads of diagnostic tests.

The most recent procedure today was a spinal tap - also called a lumbar puncture - either name screams 'ouch'.  I mean, really, putting puncture in the name of a procedure??

Anyway, it was not that bad...they numb the area below the spine and extract fluid.  The whole thing took 10 minutes.  They want to ensure there are no miscreant leukemia cells lurking in that fluid - if they are there we need to zap them with a directed chemo.  All indicators are there is nothing there but we are better off knowing for certain.

Today I also received confirmation of my return date to the hospital - I am going back to Beth Israel Deaconess on Thursday 3/19 to begin the process for the stem cell transplant (I've been calling it a bone marrow transplant but I am actually getting stem cells from my donor via an IV).  The donor is in Europe (Germany I think) and they are working through a donor center there.  That center will ship the stem cells to my team for transplant to me with the transplant happening on or about Thursday 3/26.

I anticipate being in the hospital for 4 weeks from this date and will be discharged to an apartment close to Beth Israel for daily clinic visits.  We won't know how long I'll be in the apartments until we see how I am doing at that time.

So all good news - many blessings on my donor, the team working overseas to get the stem cells to me, and my team here.

Thanks for checking in

Love Maureen

Friday, March 6, 2015

Friday March 5th

Happy Friday!

Jim and I had a full day yesterday at the Beth Israel outpatient clinic.  We met with our hematologist/oncologists, a cardiologist and a nephrologist (renal doctor).  In addition I had another EKG and ultrasound of my kidney.  All tests show I am ready for the transplant.   Both my heart and kidney function have stabilized (i.e. getting no worse with my heart showing some improvement) and the tests are helping the hematologists make decisions on medication dosing (primarily chemo and antibiotic).  

Regarding the transplant...a donor has been located who is 'motivated' (my medical team's word) and has begun the process of final typing (that was happening yesterday).  We are working toward a schedule that has me back in the hospital around the 17th/18th for a week of conditioning chemo with the transplant happening around 3/24 or 3/25.  These dates are contingent upon the donor availability and our receipt of the stem cells.  I probably won't have concrete dates until late next week or early the following week.  With the previous donor backing out I remain cautious (but very hopeful) until the date gets closer.

Looking forward to another weekend at home - Emma is off to a weekend retreat/snowcamp with some school friends while Joseph will be busy practicing for Mr. North Andover.  Joe is a contestant in the 21ST annual North Andover High School satiric male beauty contest in which eight guys give it their all in beachwear, formal wear and talent contests seeking to wear the 2015 Mr. North Andover crown.  The contest in March 20th.

Good kids – good family – good friends – great life

Love

Maureen

Tuesday, March 3, 2015

Tuesday March 3

I continue to gain strength and enjoy my time at home.  Jim and I met with my Doctors yesterday and they are hoping to sketch out a plan this week for the transplant.  They've identified another good donor match and are in the process of confirming their availability.  If further testing shows the donor is a solid match and they are interested/available and they can work with us over the next few weeks, we will move ahead with that donor.  Early indicators are good regarding the donor's commitment to working with us.  Will keep you posted.  There is a plan B if this donor does not work out and I'll detail that if needed.

Later this week I see the cardiologist again and a urologist.  My heart function continues to improve and does not pose an immediate threat to my health or treatment.   We are hoping the heart function gets back to normal (or closer to normal) with the help of beta blockers and simply getting around and building my stamina.  If no improvement is seen, we are still comfortable moving forward with the transplant but it may impact the chemo used (transplant begins with a week of chemo).

In addition my creatine level (a kidney function indicator) is slightly higher than normal.  This could be explained by one of the antibiotics I was taking and may correct itself since I've been off that antibiotic for some time.  Later this week I am getting a kidney ultrasound and seeing a urologist to see if we can learn any more about why this number is high.

I was reminded by my Doctor (Dr. Avigan) that I am quite lucky to be in remission.  As you may recall,the leukemia did not respond to  the first round of chemo  given in December and my Doctors were very worried I would not go into remission with the second round given in January.  Even if I did go into remission they thought it might  not be durable giving us a very small window to move forward with the transplant.  So we could have faced a situation where I moved into  transplant absolutely beat up from the two months in the hospital and two rounds of high intensity chemo (with no time at home to recover) while not in full remission.  The transplant could still have been successful but it would have been exceptionally taxing.

Well your prayers and my tough Irish body won out and I am in a beautiful remission giving us time to find a donor and time for my body to gain strength going into the transplant.  This was beyond anything we could hope for/count on given where I was going into the second round of chemo.

Not sure if this medical stuff is interesting to my loyal readers - it helps me think through what I've heard at the clinic visits so thanks for indulging.

Finally, it has been so great seeing many of you over the last week and a half.  What a gift!  I am starting to work a bit during the day in  between clinic visits and that has been wonderful.  By the evening I am pretty much shot so thanks again to all who have been helping with the meals and kid car pools.

Love seeing your comments and thanks so much for checking in!

Love
Maureen