Friday, August 16, 2013

Better Life Through Chemistry

I never had one of those chemistry sets from the Sears Wish Book, but to be sure, that was me from a very young age. Yeah, I looked at all the toys and fun stuff all the other kids did, but I coveted the really cool stuff (ok, cool to me anyway!) like the chemistry and erector sets. My mom saved S & H Green Stamps and got my sister and me toys at the local redemption center, but blowing the house up with chemicals was not in the cards! Besides, I didn’t need chemicals to wreak the kind of havoc most 7 year-olds are capable of. I did that all buh mah-sayulf! I did get the erector set a few years later.
Look familiar? I can't tell you how long I used to ogle those pages for things I just couldn't live without!
I told all my relatives that I wanted to be a scientist and they took that young zeal of mine to heart. I remember my uncle coming back from Vietnam with gifties for all of us.  For me, he brought a microscope in a wooden carrying case. It had slides and cover sheets and it even had chemicals to stain and preserve my finds. It was a way cool present for a budding egghead nerd like me. In high school, I would all but stage a veritable coup d'├ęducat by rather publicly transferring out of my AP Chemistry class and into Aerospace Science - the harbinger of things to come. Some years later, I would forget that nerdiness altogether and become a way cool Navy pilot, complete with leather flight jacket, wrinkled flight suit, cocked garrison hat, and Ray Ban aviator shades! But…
I never forgot my humble egghead origins.
And I actually got called an “Eastern egghead” by a French student in La Place Clichy in Paris. This same student was adept in using English profanity, much to my chagrin – even had the right context. Shows you what a Sorbonne education will get you.
So, here I am today with a long tube connected to my PICC line, infusing that lovely toxic chemical goodness into the vein just above my heart. I can tell this is some powerful stuff by the amount and type of pre-meds I’m swallowing out of that little tiny cup the nurses give me about half an hour prior to 'go' time. I get a tad light-headed from either the pre-meds or the chemo (I’m not sure which), but I’m still feeling decent and able to think clearly. I had the staff psychologist tell me that I may not actually take a nose dive until about seven days post-transplant, but we shall see.  I’m in no hurry to go down that road. Today is actually considered Day minus 5 even though it’s the 3rd day of chemo. Day 0 is the day of actual transplant infusion.
I’ve come to the unavoidable conclusion that *I* have become an incarnation of the Sears chemistry set. Trust me, that is not a narcissistic declaration! Each one of us that comes through the MTU is an experiment of sorts. While each of us has some sort of blood or bone malady that requires a stem cell transplant, we all have unique genetic make-ups that determine the likelihood of survival of such an arduous procedure and ultimately how well, if at all, the graft takes to our bodies. And then there are the statistics and the intangibles. Things like metabolism, physical health, and even attitude all play roles in how well we come out of this on the other side. All of those factors create an incredibly complex puzzle for a team of doctors to work out and solve – and I would be one of those puzzles.
In speaking to another marrow transplant veteran, he told me that this process was nothing short of a pharmacological miracle. Considering I’ll have no outside physical manipulation, no radiation, and no surgery to repair my broken immune system, it is exactly that. It is all chemistry. Until yesterday, I had no idea there was even a field called pharmacological kinetics, but there’s a group of pharmacists that very precisely gage what is happening inside to in turn determine the exact gnat’s buttock of how much toxic chemical goodness I should receive. I also get a handful of pills that stave off really nasty nausea, seizure, and other lovely side effects that probably would make those ads on TV look pretty appealing. I guarantee you, there will be no ad encouraging you to “Ask your doctor if Busulfan® and Cytoxan® are right for you!” This truly is one of those, don’t call us, we’ll call you things. Pray you never get that call!
No sooner than the nurse flipped the IV pump on a few days ago, I went into chemo precaution mode, which means I am a sorta kinda toxic waste site. No one else can use my inpatient bathroom and I have to flush twice when I actually use the toilet.  In the meantime, I serve as an overqualified filter and drink incredible amounts of water, which naturally makes sleeping problematic. I then get to collect said premium, filtered, and processed chemo (i.e. urine) in cute little bottles for them to measure. During my inpatient stays, my intake and output is measured pretty carefully. Do you know how many cc’s are in your little half pint of milk? 236! That’s how many (most just round up to 30 cc's per fluid ounce). I also know that my full bladder is about the same amount as that little half-pint of milk, probably putting me in league with those people with IBBS (Itty-Bitty-Bladder Syndrome). Well, it feels like that anyway.
Yeah, in a sense, my routine has been reduced to intake of one set of chemicals that are prescribed carefully and then processed and filtered into another set of chemicals we monitor so we can start that cycle all over again.
How cool would that be? Adding to the fun, I have friends who ride Harleys for exactly this occasion. No, really!
While I have a little self-deprecating fun with all this, I know there’s a real art to this particular medical science. I’ve come across professionals since starting this that wanted to see me because I was not conforming to the mold. When I was diagnosed, I had 50% blast cells in my marrow. I found out some time later, that should have soundly debilitated me, but I was essentially ignorant to what was going on inside because I felt so good. A team of curious white-coated doctors gathered around my bed wanting to see the guy who felt so good in spite of the numbers. Even Wednesday, the pharmaco-kinesthesiologist (if such a title exists) wanted to see me because my system processed the chemo exactly according to his calculations. I think that’s good, right? He was apparently elated…but he didn’t end up coming to see me.

You know, though, I really hope that these people who attend me get super excited every time things work out; I want them to fist pump the air and with unabashed enthusiasm; I want them to shout for joy when one of us is feeling great and leaves the hospital for the last time because of what they did; and I want them to go home with an ear-to-ear smile, knowing that they performed one of those chemical miracles, that they saved not just one life, but a whole group of people who look to those of us who, because of no clear reason, just got awful damned sick. We…*I*…depend on people like that.

Do me a favor: go tell someone how much you appreciate what they’ve done for you. Bonus points for doing something nice for someone who can’t return the favor.

Be well – so well that you never know what it’s like to be where I’m sitting now.
Stay strong – because there are those who need you; and
Lots of love to all of you.

Music today … I had considered My Chemical Romance’s Thank You for the Venom for the title alone, but the music doesn’t feel like it’s mine.  So, we’re going with Chaka Khan’s Through the Fire

I look in your eyes and I can see
We've loved so dangerously
You're not trusting your heart to anyone
You tell me you're gonna play it smart
We're through before we start
But I believe that we've only just begun

When it's this good, there's no saying no
I want you so, I'm ready to go

Through the fire, to the limit, to the wall
For a chance to be with you
I'd gladly risk it all
Through the fire
Through whatever, come what may
For a chance at loving you
I'd take it all the way
Right down to the wire
Even through the fire

I know you're afraid of what you feel
You still need time to heal
And I can help if you'll only let me try
You touch me and something in me knew
What I could have with you
Now I'm not ready
To kiss that dream goodbye

When it's this sweet, there's no saying no
I need you so, I'm ready to go


Through the test of time


To the wire, to the limit
Through the fire, through whatever
Through the fire, to the limit
Through the fire, through whatever
Through the fire, to the limit
Through the fire, through whatever