Medical: Transplant Day -7

I'm all checked in to room 777 Feldberg. Mrs Blogger is napping. All my possessions (mostly electronics, like laptop, tablet, phone, two mice and two headphones and two pairs of reading glasses) have been wiped down with disinfecting wipes. I've doffed my arrival clothes and donned clothes that were new, hospital-issue, or freshly-laundered and brought in ziplocs.  The door has been officially closed on my room.

It does not have an airlock, but does have positive air pressure and a special door.  I don't have a shower, and will either go without or be moved to a room that has one when it becomes available. Mrs Blogger as "not the patient" has to wear gloves over disinfected hands.  I had to take a sanitizing shower this morning, but can go gloveless.

The best guess is that I will keep my venous line not just through chemo, but maybe until I go home. By then the skin will have healed more around the tube, and it'd be just too useful if I need transfusions or other help.

THE SCHEDULE FROM HERE

Unlike regular chemo, where day 1 is the first day of chemo, this week will be numbered from Transplant Day 0.  So all of this week's days have negative numbers.

Days -7 through -2 will be devoted to BEAM chemotherapy

BEAM is named after the initials of the chemotherapy drugs used, which are:

• BiCNU ® – carmustine
• Etoposide
• Ara-C – cytarabine
• Melphalan.

Day -7: B = BiCNU / Carmustine .  We know it is a mustard-gas family chemical because of its "-mustine" suffix

Day -6 EA = Etoposide & Ara-C (Cytarabine, the "fake Cytosine" that jams the DNA zipper)
Day -5 EA = Etoposide & Ara-C  (Etoposide disrupts the enzymes that mediate DNA division)
Day -4 EA = Etoposide & Ara-C
Day -3 EA = Etoposide & Ara-C

Day -2 Melphalan

By Day -2, all my stem cells and most fast dividing cells (hair, mouth, gut) have reached their nadir,  and I'll have stopped production of new platelets, white & red blood cells, so these will begin their own trip to their later nadir as the surviving blood cells die of old age

Day -1 = Rest day (as chemo clears in advance of giving my cells back.

Day 0 = I get back half--9 million--of the stem cells I donated. The life sustaining minimum would be 1 million. A standard transplant has 5 million.  Healthy humans have billions and by Day 0 I will have near-none.  Growing back from 9 million cells, I only have to regrow by a factor of 100,000x instead of 1,000,000x (which, put logarithmically is an advantage measured in hours, not days)

Day 1 through 7.  I'll probably be sedated, since there's not much to do but wait, and my brain may be foggy (or at least trouble concentrating) from the Chemo.  They say reading is basically impossible, but books on tape or the Food Channel are sufficiently untaxing.

Worse, this is where the mature blood cells will die of old age and I'll be left with low everything (low platelets, low white cells, low red cells) and will likely need transfusions

Day 8 through 13.  Somwhere in here they declare the "engraftment" of the stem cells to have worked.  Engrafted stem cells will have migrated back to my marrow, found a niche, and started dividing, making new stem cells, new platelets and reds, and new white progenitor cells that will still take a little longer.

"Day 13" is 21 days from today.  Sometime around Feb 5th