Day -1, on the Eve of.

  

  In medical lingo terms, Ruth is currently at Day -1 of her transplant course.  She started off at Day -6 and has now undergone chemotherapy and has tolerated it fairly well other than being ballooned up by all the IV fluids she got.  Her blood counts are dropping like expected.  She's still eating fairly well and has been allowed outside food up until this point.  She's also been allowed off the floor to get fresh air as well.  That all changes tomorrow on Day 0, Transplant day.  No more forays off the floor.  No more restaurant food.  

    Today though, on Day -1, she underwent full body radiation which was interesting to watch as an observer.  Ruth didn't feel anything.  Watching my wife strapped immobile and being shut behind slowly closing 2 foot thick lead doors, about to be zapped by alien-looking technology, felt like watching a sci-fi movie.  I could only find myself joking about it to keep the mood light.  It's over now and the doctors say the side effects of radiation will be a drop in the bucket compared to how she'll feel after the transplant.

    So tomorrow is the big day, Day 0, Transplant Day.  Her sister Kathy will get her bone marrow harvested under anesthesia in the morning, then the sample gets processed, and at some point later in the day, Ruth will receive a bag of stem cells from the bone marrow.  It's given like a bag of blood over several hours through her IV line...so actually kind of anti-climatic...not some big surgery or anything which many people think it is.  Really the stem cells are a kind of rescue from the chemo and radiation obliterating Ruth's old and faulty bone marrow (which produced the leukemia).  Days +1 and up are going to be the difficult phase.  All her counts will hit rock bottom in the next week, while the stem cells try to engraft and grow.  Engraftment may take 3-4 weeks.  In the meantime, lots of badness can happen: the effects of all that chemo will set in, some level of rejection will happen (the graft attacking Ruth's body as foreign), infections, plural, are par for the course, potential bleeding, and potential failure to engraft.  

    All of it is a bit overwhelming.  With prayer, with everyone's support, however, we both really do feel at peace going into tomorrow and the days to come, despite all the potential risks. Ruth got to say goodbye to Naomi the other night, since there won't be any more visits allowed the rest of the hospitalization.  Fortunately, I dropped Naomi off at Camp Kesem yesterday on the coast, a camp for kids with loved ones with cancer.  Timing couldn't have better - it's one less week she has to worry about mamma.  And I can focus 100% on being with Ruth tomorrow.  A boring day would be a welcome one tomorrow.  We haven't talked about how to pass the time during stem cell transfusion yet.  They're saying it could take hours.  Perhaps a movie?  Any ideas?  Or maybe I'll time-lapse the stem cells being infused :)