Sunday, August 4, 2013

Part of the Plan


There are two ladies who handle appointments at the Marrow Transplant Unit (MTU). They are amazingly efficient at directing traffic, they are calm under pressure, and they even remember my preferred name instead of simply referring to me as Mr. Park.  I watch the two of them and am amazed at their perpetual smiles and how efficiently they keep things moving. Considering the sensitivity of the work on the ward and that there are double the people (patients and caregivers) who are constantly coming and going, it’s actually rather noisy and even confusing, but these two ladies are cool customers!
After I left the hospital Friday afternoon, I got a call from one of these ladies. She told me that on Monday morning, I would be meeting with the doctors to determine my course of treatment – the next part of the plan. I was left with the impression based on the transplant date that I wouldn’t likely be seeing them until some time around the 12th even though they would be probably meeting on Wednesday to discuss my case. My gut feeling from what I’ve been hearing is that I’ll be undergoing a standard myeloablative transplant rather than the “mini” (non-myeloablative). Because of my good physical condition and age, I’ve been told I can tolerate the rigors of this procedure. If this happens, I’ll be admitted on August 14 and begin a course of busulfin and cytoxan, two very powerful chemicals to decimate my immune system so that the transplanted stem cells will engraft when infused a week later.  There are apparently fewer complications for this procedure than the mini and it will put me on the road to recovery and subsequently home sooner, provided that everything works out well. The other plus – and it’s a big plus in my mind – is that I would not be undergoing total body irradiation. Like I posted yesterday, there are plusses and minuses to both procedures and the big minus to the standard transplant is that it will make me a whole lot sicker than the mini and I’ll be inpatient for about 3-4 weeks.
I met with the transplant coordinator on Friday as well and she advised me that my correspondence with my donor wouldn’t be possible for two years. There are some very strict privacy regulations with respect to donor privacy and my correspondence has to be very generic and can’t even include anything that would indicate the country in which I am living! That leaves things pretty broad, reminding me of the kind of letter a third grader writes to the fireman who visits the class for a super show-and-tell. While I understand confidentiality, HIPAA, and privacy, I have a profound sense of gratitude that generic greetings cannot possibly convey. I’m inclined to believe my donor came from out of the country as the waiting period is two years instead of one, the usual period for domestic donations. When the prospect of a transplant became a necessity back at the beginning of this odyssey, there was some discussion about Germany having a very robust bone marrow donor program. At the time, I joked about coming through the process with a German accent à la Hans and Franz from Saturday Night Live. All I do know as a matter of fact at this point is that my donor is male.  Even though I am genuinely grateful, I tend toward the irreverent (yes, it’s true) and I am inclined to believe my donor is foreign, so I am referring to my donor as Hans from this point forward. He has to have a name after all and I obviously have Northern European genetics. I do hope that I get to meet him face-to-face at some point. I’d very much like to extend my gratitude to him in person. Perhaps by zen, I’ll be talkin vis a German accent and very muscular – ve vant to pump you up!
Hans and Franz from SNL ... pumping me up with stem cells! 
One part of the plan at a time.
In the meantime, I’ve continued to terrorize Seattle as a tourist. The people I’ve met have been wonderful, all great ambassadors of the city. On the road, I’m less inclined to speak in glowing terms and that extends to the parking lot. So, today, instead of playing the alphabet game as I did during the last road trip I took with my sons, my ‘game’ was to spot the most egregious parking job. We came across three pretty good examples in short order. Being a tourist has been both bad and good.  Suffice it to say, anything to move me closer toward returning to life as I knew it, or at least as close to it as I can get, is movement forward. On the other hand, I’m facing some unpleasantness over the next few months, some of which will make me feel pretty durned sick. My sleep schedule will return to the erratic inpatient routine and I’ll get intimate with white-coated folks who are interested in how regular I am. This time, my middle-of-the-night conversations inside my head about mortality will have more gravitas, even though I have no intention of going down that path.
And yet…
There is much to be grateful for and much to look forward to and much to live for, even if it looks different than I had thought it would. It’s all part of the plan
Today’s music from Dan Fogelberg, appropriately enough, Part of the Plan
I have these moments
All steady and strong
I'm feeling so holy and humble

The next thing I know
I'm all worried and weak
And I feel myself
Starting to crumble

The meanings get lost
And the teachings get tossed
And you don't know what
You're gonna do next

You wait for the sun
But it never quite comes
Some kind of message
Comes through to you
Some kind of message
Comes through

And it says to you
Love when you can
Cry when you have to
Be who you must
That's a part of the plan
Await your arrival
With simple survival and
One day, we'll all understand
One day, we'll all understand
One day, we'll all understand

I had a woman
Who gave me her soul
But I wasn't ready to take it
Her heart was so fragile
And heavy to hold
And I was afraid
I might break it

Your conscience awakes
And you see your mistakes
And you wish someone
Would buy your confessions

The days miss their mark
And the night gets so dark
And some kind of message
Comes through to you
Some kind of message
Shoots through

And it says to you
Love when you can
Cry when you have to
Be who you must
That's a part of the plan
Await your arrival
With simple survival and
One day, we'll all understand
One day, we'll all understand
One day, we'll all understand

There is no Eden
Or heavenly gates
That you're gonna
Make it to one day

But all of the answers
You seek can be found
In the dreams that
You dream on the way