It is Day 17. There have been some ups and downs for sure but nothing that landed me back in the hospital. What I could literally feel was my body stirring, struggling, and surprised. As Mariya’s cells populated my marrow, I experienced waves of a cellular identity crisis. My immune system died and I lived 2 weeks without that protective shield. And then, suddenly a little blip of white cells on the daily blood test. After that, they came roaring in, enthusiastic, like dogs on a beach run. Yesterday, the PA calmly said I was no longer neutorpenic and showed me the blood tests. They looked like gold but I had to ask to be sure. Does this mean I am engrafted? When she smiled and said yes, I had to jump up and give Mariya a hi- five!

What this means is my body accepted the graft and now has Mariya’s immune system.  It means I can go out and have visitors. It is amazing and longed for news. I don’t feel any different—some days are good and some not so good. But I have been hiking uphill for a very long time and I just got to the peak. Anyone who has ever done that knows that the way down can be full of hazards and so you don’t let your guard down until you get to the bottom again. As I said before, a bone marrow biopsy next week will confirm how many of my own cells remain. If many remain, it is called a mixed chimerism, and that is not what they consider optimal (they prefer that all bone marrow cells are from the donor). The next stage to pass is acute graft vs. host disease, which can set in within the first 3-4 weeks of transplant. Chronic graft vs. host disease, which can be mild or very troublesome, can go on for weeks or months.

I read somewhere that the definition of an optimist is one who regards the process of “one step forward, two steps back as a sort of cha cha”. Right now, that’s where I am and where I want to stay. I know I will have some setbacks but I think this will be a successful climb, from top to bottom. As I have said before, I feel confident that much of this comes from the prayers and good vibes you all sent my way.

And when I dare, I have started setting my sights on getting home earlier than the prescribed 100 days. I think it can happen if my body can overcome the graft vs. host disease issues.

As I write this, one of my dearest friends is departing the world. I want to honor her vibrant spirit by living the life I have left to the fullest. Together, we explored God, creativity, coming of age, camp life, family life, friendship and work. Her imminent early death and this whole experience I have been through are reminders to do the work you came here to do, and to leave a legacy of love and gratitude. She did that, in spades. What else could be more important?

Well, after 8 days in the hospital I was released. Not much to report me there. A fever landed me in and then I had to essentially pass a bunch of tests before I could leave. Though I wanted to get out, it wasn’t bad except for the lack of sleep. Despite that I had appetite, and energy and did not react badly to the last of chemos. The presence of Steve, Mariya and Elena brightened my days. My cautious doc knew I wanted out and we had an ongoing mild argument about when that was safe. The old protocol was to stay until you engrafted (around 3 weeks) and I knew that that would be murderous on me and the family. So I had my arguments  lined up-arguing the healing power of sleep and nature and exercise against constant vigilance. In the end, he gave graciously gave in to my persistent and surprising wellness, and called in the PA by saying “don’t you think she looks like a rose?” Shortly after, he signed the release papers for Day 8. Walking out into the rainy afternoon with Elena was like the first day on Earth.  And here I am, back at the cottage. Today, I took 3 naps. I will now that things are truly healing when I begin to have dreams again.

To refrain, that was the LAST of the chemos. My hair and eyebrows are growing in, though I am told I will lose the hair again, but I have evidence now that it will grow back (nope, not a blond). But just to be able to say that was the LAST is amazing. I have been getting chemo since the first of March.

Now, we wait. Daily blood draws will tell us about fluctuating electrolytes and blood counts. Right now, my white cells are zero. So, I am all about trying to keep infection away. Mariya’s cells are growing n my bone marrow. When my counts come back, that tells us the graft worked. They will take a bone marrow biopsy on Day 28. What we want to see if that my marrow is all or mostly Mariya’s.

Then we wait to see to see how graft versus host disease goes. But for now, I am in good shape, and absolutely sure that prayers and love carried me here, along with UW Medicine.

Created and sent to me by my friend of 55 years.

Woke up this morning with the desire to express deep gratitude to all those who have prayed for us, or sent positive and healing energy our way. Thank you. So many people have written that I have fallen way way behind in my personal correspondence. But never think for a moment that I didn’t read it and appreciate it. You have held me up and given so generously of your time to write a heartfelt note, send a gift, Facebook encouragement, expressing your good energy for me and our family. This is a generosity that heals the world and draws us closer as community, just as I am sure it is at work now for the recent tragedies on the island.  You have inspired me and uplifted me, and you do the same for others who need it.

So far, on Day 3, though I am in the hospital, not much happening. Still have appetite and energy. I know I have some big obstacles yet to overcome, specifically, accepting the graft, escaping infection, and dealing with graft vs. host disease. I am more aware than ever of how fragile and unlikely our very existence is. It  is a road with pitfalls (and joys) that you can’t foresee. We just go on about our business as if life is predictable. But it never has been.

Tomorrow, I will be hit with the last of the chemos. For two days, I will receive a high dose of cytoxan to tone down Mariya’s cells as they re-locate to my bone marrow and, as I imagine it, they react in a startled manner. In the most positive of words, the cytoxan acts to mellow them out a bit. I just hope I escape without too many side effects.

So I have met myself in so many ways on this journey. I’ve had the time that most people never get, and without the energy that usually has us up and doing things. I have seen myself as a varied landscape, with deep canyons of grief, caves of dread, and exhilarating trails through spiritual dimensions. I have enjoyed the pastoral countryside of family in a way I thought lost forever, though I believe it’s been hard on the girls, we know each other better, and we have learned a lot about ourselves at the same time. I have wandered into the deserts of anguish but I have also felt such peace and gratitude in our borrowed abode, and relished its quiet, right in the middle of the city. Being forced to drop out of social engagement for a spell has been healing to my ever busy soul. Still, I have startled myself by how pettiness can creep along, like a shadow, right behind you. I have unmindful, wanting hours of entertainment rather than anything more worthwhile, tough and whiny all at once.

Crazy experience, to be a human. We have all of these dimensions but we rarely acknowledge them all. I would say, from this journey–it’s worth it to take the time, as you can, to touch the fullness of it. As you can’t see around the corner, more reason to try to keep waking up. I don’t think it’s a steady climb–but maybe more like bursts of awareness, then back to “normal” life. But if you catch yourself noticing these flashes, then you can start to bring more of that consciousness into your life. That’s my hope, anyway. That’s my goal for my second life.

Well, I felt fine all during the uneventful stem cell transfusion. The family was there. They and the nurse sang happy birthday to me. We left and I felt fine all the way home. Took a nap and woke up with a fever. Since I am neutropenic, we had to take it seriously and guess where I ended up. Yep. The hospital. The good news is the fever is trending down and I still feel fine. I feel completely surrendered to the process and calm. Not all births are easy. A peaceful energy is deep within.

I came out to our parked vehicle in the basement of SCCA to drop off some unwanted Shann baggage and found on the windshield two red berries still attached to the stems.  It somehow seemed significant to me, as upstairs on the first floor radiology for Shann, and the 5th floor infusions for Mariya, two of my red and rare and beautiful berries were doing their respective work to join forces on yet another new trail—–stem cell transplant.

Mariya has been going through daily neupogen shots to ‘goose’ her body into overproduction of new blood cells—-so much so, that her large bones are actually aching as they ooze out the cells through the porous bone as she is now quadrupled her output in 6 days.  Meanwhile back at the ranch, Shann has  submitted her precious and fragile body to 5 days worth of chemo infusions and just now TBI (total body irradiation), as her old cells are killed off and her body prepared as best they know how, to receive Mariya’s stem cells tomorrow (August 21) which will henceforth be referred to as day 0.
On day + 3 and 4 (or more, depending on how Shann does) we will be up at U.W. Medical Center on the 7th floor as she will be given heavy doses of chemo to still Mariya’s cells, so that they aren’t being too aggressive in their battle with Shann’s cells.  And so will begin the watch for a grafting of the two bodies cells, and a hoped for minimum of harm, due to the dreaded GVHD (graft vs. host disease).  We have a drug regime in place,  that in some cases brings us out to day +180.  But for now its this next couple of weeks that we will be focused on, and will from time to time report out to you about.  Shann’s system will be significantly compromised and exposure to germs/fungus/virus’s —everything the world at large has to offer, will need be kept at ‘arms length’ .  Visits will most likely not be allowed for awhile.  As Shann feels fit, she will be reading notes of encouragement and humor and responding with her wonderful prose—mostly on  this blog site.

If you have business or general queries feel free to contact me.   Good cheer et al, use this blog or our joint email.

Onward and Upward!    Steve

Ps  For what its worth Shann tells me the sun is in Leo and the moon  is in Acquarius and there is a full moon tonight.

Time has a way of moving ahead even when you could swear it was standing still. We are at Day minus 6. Five days of chemo, one of Total Body Irradiation (40 minutes worth) and then I receive the stem cells that have been harvested from Mariya. That is called Day Zero. My second birthday.

So today we meet the chemos with the oxymoronic term “conditioning”. I have always thought of conditioning as a positive thing: you condition your hair (if you have any), or your body. Conditioning in this world start with two consecutive days of 12 hour chemo drip and hydration at the SCCA. Cytoxan and fludarabine. We came in chipper and feisty but after about 4 hours, I could feel the nausea right through the anti-nausea meds. It will be my companion for many a day, so I can only hope to develop a regimen that will keep it tolerable. After that the chemo days will be shorter. Guess that peach fuzz starting to grow back on my head will go away again.

If you pray or mediate or send thoughts/energy out to me, please focus them on the next 6 days: that the conditioning and radiation are tolerable and don’t knock me for a loop, so I come in strong for transplant. I appreciate it so much and experience great gratitude for thinking of me.

The transplant, in and of itself, will be like any blood transfusion, and it will be anti-climatic. It’s what my body, mixed with Mariya’s immune system, does next that could be dicey. So I am praying for her cells to recognize me as part of her and to be nice to my system. This, I figure should be easy for Mariya, though our immune systems have their own minds.

I would like to dedicate to the UW Medical Center, the SCCA, the Fred Hutch center and all the donors, my companions in cancer here, Mariya my donor and bright spirit, Elena my energetic mover and shaker, and their friends, especially Will, who help them cope—Steve who makes me laugh and stay feisty, my funny dog, my devoted women’s circle, the whole wonderful and caring cast of friends and family near and far who send me so much, I can’t count the ways. Thank you.

So, we crammed in as much as we could cram over the last two weeks of freedom. Now it’s time to switch gears to a quieter and more careful time and really put the entire focus on a successful transplant with no complications.

Depending on how I am doing, this may be the last blog entry from me, personally, for awhile. Or not. However, Steve, Mariya and Elena are all eager and ready to write, so that should a treat.

They say a picture is worth a thousand words and I will close with photos of our trip to the Olympics. The whole family had to work together with our tight timing to make it happen but for all of us, it was something we really needed for the tough times ahead.  We went to Hurricane Ridge, Rialto Beach, the Hoh River Rain Forest and Sol Duc Hot Springs. I’ll let these photos tell the rest of the story.

 Hurricane Ridge

Rialto Beach

Hoh River Rain Forest

Sol Duc Hot Springs (taken through the screen window)

My 14 vials of blood history.

The countdown to the transplant has begun. We said goodbye to my oncologist—until the transplant team releases me, in about 4 months. On Tuesday, the 30^th of July, Mariya and I went into the SCCA together and began the process with a blood draw—12 vials for Mariya, 14 for me. Blood holds the key to so much on our lives, and each vial will tell a story of past or current infections, whether or not we have enough potassium or vitamin D, the current status of our red and white blood cells, and more. We each have our own team, from doctor to nurse, focused on us and our well-being separately from the other, as it should be.

We have left behind the smorgasbord of every cancer imaginable to a single-minded focus just for people with blood cancers who are getting transplants. “Transplant” is its own world and held well away from the rest of the hubbub of the SCCA, mostly to keep our fragile and weakened immune systems safe.

In this past week, I met with a bewildering array number of specialists—from oral medicine to pulmonary function. I got another bone marrow biopsy and spinal tap to be sure I am still in remission. I got another unit of blood while the nurse and PA came in to tell me what new drugs I would be taking. (The one I find most interesting: synthetic bear bile). Each night, I have come home, my head spinning, my heart wanting to hide in a Netflix fantasy, and my body feeling like a horse at auction that has been thoroughly probed and examined.

Sorting through the reams of paperwork.

Steve and I had a hair raising meeting with the attending doctor who warned us about all the side effects and possible things that could go wrong in the transplant. After that meeting, I seriously wondered if having a transplant was the wrong direction. Especially when she said the medicine had focused on quantity of life but they were just now really looking at quality of life after transplant. But it is no use asking questions, for the answer is always the same: “everyone is different”. So they don’t know. I don’t know. No one but God knows.

Don’t ask me what I feel, I don’t know that either. I feel the innocence of my body. It feels happy now that it is not assaulted with chemo and I don’t want to whisper out loud what I know is coming. The nausea and fatigue and big risk of infection that will follow the so-called conditioning chemo, radiation and the transplant itself.  People tell me not to focus on that—to be hopeful. And I am, but also as Maya Angelou says: “Hoping for the best, prepared for the worst, and unsurprised by anything in between.”

I have lived my life by meeting it with energy, even if I had to hide out for hours or days afterwards to repair myself. That is how I know I am more an introvert than people know and why I fool them and often myself in the process. I could do that now—by telling you that all will be well. Instead, I will confess the things I fear before I tell you what lifts me up again. During the dark moments, I come to a place where there is no fooling to be done. I feel like a soldier who has been through several hard battles. Now on leave, knowing I must return to the battlefield, I struggle to stay in this moment—this goodness; where vigor belongs to me once again and appetite feels like the kiss of life itself. A cold shudder runs through me as I consider meeting once again with exhaustion so deep I feel more zombie than human. Nausea will wrap its cold arms around the center of my being. I will feel like a burden to my family. I become an existentialist who has painted herself into a philosophical corner.

Painting on the Transplant Floor.

 And then, I do that crazy imaginative thing. I paint a window and I climb out of it. From this place, I witness myself holding all that dread. And I know fear of the unknown future is quite literally insane. I take a deep breath and I let go. When the Future is Now, I will know it, moment by moment. Until then, it is just thought. With my Beginner’s Mind learning as it goes, this happens several times a day—the apprehension, the epiphany and the rescue. A bright light shines on my family and friends, the life I have been lucky enough to lead, and the beauty I have beheld. My spiritual practice is to participate in life, just as my church is Nature. I wouldn’t want it any other way. I welcome this education. I never imagined that Cancer would be the teacher that it is.

17 days to transplant.

“By not knowing, not hoping to know, and not acting like we know what’s happening, we begin the access our inner strength.” Pema Chodrin

Gasworks Park.

Reflection is something that comes easily to me but last week was so dreamlike that my thoughts and memories about it are equally surreal. You, Google, and I all have a picture in mind when we use the term “a near death experience”.  I don’t know what to call a casual recognition that I could have died last week. It comes and goes, along with musings, like—this is how so many women died in childbirth before modern medicine. They bled to death. And I could have done so too, with a blood pressure so low that it causes organ failure and a rapid pulse that wears out the heart. I look back on it, how I went from “fine” to “not fine” for a few days to “emergency” abruptly without pain or trauma and observe that I was on a downward slope with a free fall at the end but for intervention of a modern Intensive Care Unit.

The week began easily enough. I was enjoying walking and visiting with friends. I will spare you the grittier details but I got a GI (gastrointestinal) bleed. I had no idea how precipitously that would lead to the situation above. Only in hindsight do I realize I lost a fair amount of blood. At the same time, my blood pressure started being consistently low enough for me to feel a bit light-headed and my pulse hovered around 125. On Tuesday, I went to the SCCA and based on my blood work results, got 2 units of blood and another unit of platelets. It is common to need blood and platelets after chemo.  But by Thursday, I could barely make to the bathroom without passing out. Back to the SCCA for more blood tests and this time the results were alarming. My red blood cells and platelets were scary and dangerously low. My white blood cells were nonexistent. Acting quickly, the doctor called the ICU and told them they had an incoming patient.

And suddenly there I was, in the ICU, which was a very different experience than the oncology floor. Stripped down, given back a simple gown and then essentially hogtied to the bed with tubes. Everything was monitored. Resistance really was futile, and so I surrendered while they worked on me like mechanics over a failing race car and received another 5 units of blood in the time it normally takes to get 2 and another 2 units of platelets. Meanwhile Steve and first Elena and then Mariya sat by and were simply present as they had no role in the ICU process.

The rest of my story is simple. After the infusion of blood and platelets to keep me from continuing to bleed out, I came back to life. I actually felt fine again. After one night at the ICU, they put me back on the oncology floor.

This next part reads like a novel where the characters encounter one intense challenge after another. Mariya came to hang out with me and on the way home she was hit by a drunk driver who crossed the center line on 15^th Ave. Luckily, she was driving an Explorer and therefore much taller than the Mercedes that hit her. People had already called 911 before her trembling hands made the call. She said her first reaction was pure fury because if she was injured, she might not be able to be my donor.

Survivors! And yes, that’s a wig I’m wearing.

She and I frequently remark to each other about our angels. Both of ours were working over-time. Mariya emerged with minor injuries. The drunk woman was arrested. Unfortunately, the car Mariya was driving (her cousin’s) was totaled, but insurance will deal with that. The next day I was released early from the hospital, in part because my female doctor and PA were mothers who understood when I said “if you keep me here, I will just be a nervous wreck. Cancer takes so many things away from you but the one thing I can still do is go home and be a mother.”

And I did do that. Mariya and I tucked in together and ate some food and joked about our exhausted angels. We watched Yentl, one of my favorite older movies. Meanwhile, Elena was completing a two day relay race with 12 other team embers from Blaine to Langley, on the far end of Whidbey. Steve, as usual, was Support Extraordinaire.

“Life astounds us in an instant” Mary Chapin Carpenter sings. It truly was just a small moment in time. One that had a lucky ending. By Steve’s birthday, the 22nd, just 3 days after the hospital and the accident, we had a picnic at Gasworks  Park and all of us ate heartily and enjoyed the Seattle skyline and the people watching and the glorious July sunshine. We had been astounded by two frightening events, and then astonished at the beauty of the world, celebrating Elena’s victorious race and Steve’s 67 years of adventures.

“Ordinary” (read extraordinary and magical—the same as yours) existence resumed.

Round 3B, you did NOT almost kill me. Thank you. Part of it is that the doctor dialed down the dose a bit; and my gratitude for that favor, small in gesture, huge in effect, is boundless. Thus far, I have had no fevers, kept the nausea in check and generally have felt as good as I could expect to feel. What a relief to feel good enough to enjoy the height of summer. Bright flowers adorn the Maple Leaf yards, summer bees gather and distribute pollen, mornings and evenings are full of birdsong. That I can experience these things is a miracle I do not take for granted.

Now, if I can get through the next few dangerous days of Neutropenia  without infection, and my white blood cells return to protect me, I should be able to arrive at the transplant date (Aug. 20) in good shape.

Something happened the other night that I am still trying to make sense of: the death of tree. This has nothing to do with leukemia and everything to do with just trying to come to terms with how things happen. I take it as a good sign that my mind is working on this instead of just trying to survive.

Let me say this: I don’t take tree deaths easily, especially if they are big and/or old.  When the fine old leaning tree in front of the Office Supply store in Friday Harbor was abruptly taken down (sudden to me, and all who did not expect it), I was devastated. I had to change plans and go sit by Ben White’s grave for an hour before I could pull myself back together (for those who don’t know him, he was a nature activist who died far too early. But Ben would understand tree grief. Many people don’t.). I know trees have a natural life span and that rot can make them dangerous and kill them. I just take it hard.

It seems to me trees are so heroic, innocent and brave all at the same time. They root and grow, competing for sunshine and nutrients until one prevails. The Old Ones are full of sentience, with years of supporting other life forms, from raccoons to birds to moss and lichens and countless insects; providing shade and oxygen without demanding anything in return. Perhaps it’s their vulnerability that touches me so, that they are so big and stately and grand and they can’t run away when danger threatens.

We have certain tree-friends we especially love in a neighborhood that is old fashioned enough to allow and/or still have big trees. One of our favorites was a magnificent old weeping willow, one of my special tees. We went out of our way to sit on the little bench provided beneath this beauty and we felt rich and at peace. When I could barely walk around the block, this tree nurtured and fed my soul like a baby bird. On a still night, a week ago, the 70 year-old cracked from its heart rot and fell apart in a way that the grieving owners had no choice to take down the remaining section.  And there is no replacing it, except in another 70 years.

I am not sure why I have chosen to blog about this. There is just empty sky and a naked view of other houses where once a splendid life flourished. And because of shifting baselines, it is too easy to forget about it, and begin to take the tree-less view as “normal”. I can’t come up with a snappy philosophical turn-around about it.  I don’t even want to try, as it would be callous and disrespectful. I would rather grieve with neighbors I don’t know for a tree we loved for our own reasons.

I do think we are on this earth partly to witness. I want to notice and feel, pause and absorb the circle of life, even when it is hard. It puts my own aging and death into perspective. Life doesn’t last forever. Savor. Be an activist. Save. When you spot an Old One, lay your hand on it, and give gratitude and appreciation for its life energy.

“If the world were merely seductive, that would be easy; if the world were merely challenging, that would be no problem. But I wake up each morning torn between a desire to save the world and a desire to savor the world. This makes it very hard to plan the day.” — E. B. White

I think I will start with the non-medical story of how Steve hustled me out the door when I was still weak and getting sad in the dark cave on a bright sunny Monday last week. Determined to get us both out into the world, he asked me where I wanted to go and I said Rainier. He got a cabin arranged via friends, and Mariya and Will, who had just arrived in Washington, agreed to accompany us. I had never been to Paradise, nor had Mariya or Will. The drive up the mountain started to wake my slumbering senses; the hot day allowed us to drive with all windows open and the sound and scent of the cascading waterfalls, evergreens and ripening berries filled my heart.

By the time we got to the top, my energy was, to be fair, flagged out. Steve positioned the car with a perfect view of the Mountain and while the others romped in the snow, I rested in perfect communion with an elemental presence. Really for me, it was a gift not to move but to literally be LIKE the mountain and just face to face, witnessing the movement around us, the parking lot a half inch lake of water from melting snow, cars coming and going and enjoying the foreign accents of visitors in our national parks. The whistles of marmots mixed with ravensong and helicopters. Wafts of breezes came in through the windows, cool and pregnant with wet earth, snowmelt and emerging wildflowers like the breath of God. The Elemental is a healing place. Eternal, still, expansive. It was everything I needed.

After that, we drove to the cabin in Packwood and settled in. Again, because my energy can drop like a stone, I left the hustle bustle to others and stretched out on the porch recliner watch watching the light shift through the twirling leaves, the cottonwoods spilling their white tufts and all those amazing little gnats and other insects that seem to do nothing but swirl and drift and dance through the breeze. The stillness of my life right now is something I have rarely experienced. I do not multi-task in anyway, but just watch the world. I do this everywhere now, sitting n the car, at the cottage, out the hospital window. It helps me immensely to experience this quiet being at a time when my doing active body is so weak and changed. I can barely open a pill bottle but I can float my consciousness out into the world and witness it. There are so many things happening in the world hidden to humans only because we are all so busy all the time, we don’t notice. Now, that stillness is more common in my life than movement, I am rewarded by this other form of communion with the world. It is something I don’t intend to lose when I get better.

Anyway, determined Elena, who had to work, got off early and doggedly drove herself up in time for dinner. So suddenly we were a quiet woodland setting with the whole fam damily, including 2 dogs and it was, in a word, lovely.

The next day, we played and rested and the girls and Will went home. Steve and I spent another night and went up to Sunrise on the way home for another sheer treat of being above treeline with wildflowers literally springing up through the last of the snowmelt. I even felt good enough for a short walk in the sun. It shifted my awareness of my own health to be in the presence of such well-being and life. Just a little different than the SCCA routine.

And so, I carried that gifted energy into my last scheduled “Hyper-CVAD” chemotherapy (small frequent doses of highly potent chemo; CVAD is the acronym for the drugs used in Round A). “Herman” the IV pole holds only one bag at the moment, Cytarabine. When I have had 4 doses of Cyterabine and when I have been “rescued” (meaning the levels have dropped) from the Methotrexate, the 24 hour drip I had at the beginning, I can go home, hopefully on Tuesday. This hospital stay has been okay so far, busy. I have met with both the physical and occupational therapists to talk strategy about building strength back. All that weight I lost (now up to 117 lbs) was a lot of muscle mass. So, I need to build back strength in my arms and legs. The CMV counts prompted the visits of the Infectious Disease doctors. CMV is something many of us have but it lays latent in the body, suppressed by the immune system. But suppress that hard working system and suddenly CMV is on the prowl and growing in the body, and potentially wreaking havoc. So we are working hard to get the levels down.

And that dry little update is all anyone needs to hear about the hospital. It is that last scheduled chemo time before the induction chemo, which I believe can be done out- patient. It’s hard to believe I have been here for 6 rounds (7 counting the emergency visit where they tried so hard to figure out what kind of infection I had, which we think now was the CMV). By way of cheering me up, one nurse remarked “you’ve done most of the heavy lifting now.” It did not exactly cheer me, but there is comfort in knowing that some of the hardest parts of the trail are behind you. I hope.

Elena teaching Mariya how to do home hydration.

It’s the transplant now that looms up with so many unknowns. What we do know is that we have chosen the haploid or haplo route instead of cord blood. The reasons were subtle and there is not much research to go on which one is better. Mariya will most likely be the donor, unless for some reason, her health assessment uncovers something unexpected. Haploid donors—those that are not a perfect match but rather a half match, a couple of years ago caused horrific issues with graft versus host disease, but the recent studies out of Fred Hutchison Research Center have found a way around that (simple; more chemo). Anyway, now it seems, they can do the transplant all out-patient, whereas it used to require long isolated hospital stays. That is, unless, you run in “roadblocks”. And that list is long and scary. So we won’t go there.

What I do know is this, and I’ll just give it straight and dry, like I have been getting it:  The Induction process for both Mariya and me begins July 30. We will both be checked for health in every possible way. She will have to take the same shots in the stomach that I took to boost her own white blood cells for a few days. I will get to have induction chemo and tests of every part of my body, plus another bone marrow biopsy and many more spinal taps.

The transplant will likely be on August 20. For Mariya, that means a few days before she will have her stem cells harvested from her blood over couple of hours for 1-2 days. They will be replaced by her body over a short time. For me (and Steve), this begins the “100 days with a 30 minute leash to the hospital”. The month after will likely be hard, lots and lots of medications, visits to SCCA or hospital, and the potential for many unpleasant reactions. I will be very vulnerable to infection. Miraculously, this can be done out-patient—unless there are complications. That means the cottage instead of the hospital. Then, as Mariya’s immune system engrafts to me, and starts to work, I will slowly get better. I will have her immune system and her blood type. Maybe I will even be gluten-sensitive, like her.

With any luck, health will find its way back to me and hair will grow back and I will learn to eat again. My intent is to be back on island well enough to go for a walk and ready to enjoy Thanksgiving dinner.

I will be praying for the a successful transplant;  that it goes well, and that my body reacts well and engrafts quickly to Mariya’s stem cells. I will pray for no infections and no complications and quick healing. I invite you to pray with me. Until then, I just need to stay as strong as possible.