D-7

Friday was D-7, which means next Friday is transplant day.

D-7 means a new set of helpful poisons start running through me, and I get a new team of in-patient doctors. I am now under the direct care of the transplant service. Same nurses, same great food.

(Note: I wrangled a not-on-the-menu bean and cheese tortilla out of Food Service last night, after getting bumped up a couple of levels in the call chain over my disappointment that we still don't have the Chipotle Black Bean Burrito, which is on the menu but perpetually out of stock. It was very good, and the manager personally delivered it. And left his card.)

My new chemo drugs...

Alemtuzumab (Campath)

Possible side effects: itching, hives, swelling of face and hands, swelling or tingling in mouth or throat, chest tightness, trouble breathing; anxiety, restlessness, nervousness, trouble sleeping; change in quantity or frequency of urination; changes in vision; fast, pounding, or uneven heartbeat; fever, chills, cough, sore throat, body aches; lightheadedness, fainting; muscle pain, tenderness, weakness; numbness, tingling, or burning pain in arms, hands, legs, or feet; shortness of breath, cold sweat, bluish-colored skin; skin rash; sores or white patches on lips, mouth, throat; swelling of hands, ankles, feet; tremors; unusual bleeding or bruising; unusual tiredness or weakness; headache; loss of appetite; nausea, vomiting, diarrhea, stomach pain.

Campath is the only chemo drug I received on D-7, and the only side effect yesterday was a brief spell of chills.

Melphalan

Possible side effects: itching, hives, swelling of face and hands, swelling or tingling in mouth or throat, chest tightness, trouble breathing; bloody or black, tarry stools; fast heartbeat; fever, chills, cough; lightheadedness, fainting; new lumps or growths under your skin; severe nausea and vomiting, seizure, or severe muscle stiffness; skin rash; sores or white patches on lips, mouth, throat; trouble breathing; unusual bleeding, bruising, or weakness; yellowing of your skin or the whites of your eyes.

Fludarabine

Possible side effects: blood in your urine, pain in sides or joints; confusion, extreme tiredness, fainting, trouble seeing; cough, chest pain, trouble breathing; fever, chills, sore throat, other signs of infection; numbness, tingling, or burning pain in arms, hands, legs, or feet; skin rash; unusual bleeding, bruising, or weakness.

These drugs are so powerful, you don't even have to take them to feel some of their side effects. All you have to do is read about the side effects to lose your appetite, feel shortness of breath, or have a fast heartbeat. Don't worry. However, if reading the above causes tarry stools, please consult a doctor immediately.

D-7 brought my first visit with transplant team of doctors. The attending physician poured a lot of information at me. I'll have six days of chemo, on days D-7 to D-2. Most patients tolerate the chemo well, which means they do not experience that sickening list of side effects, or at least not much. On one of these days, I'll receive the one (I'm guessing Melphalan, from the listed side effects) that often causes mouth and throat sores. I've heard from other patients and from the attending that a six-hour course of oral cryotherapy (otherwise known as sucking on ice) is very effective at keeping this side effect at bay.

D-1 is a "rest" day in the sense that none of the chemo drugs are being administered. They're still coursing through your system and doing their work.

D Day, next Friday, is Transplant Day, sometimes referred to by patients as Second Birthday or ReBirthday.

Two birthdays in two weeks. How lucky is that?