The lead consultant I am now dealing with is Dr Amit Khot who specialises in Bone Marrow Transplants (BMT).
On Tuesday Jan and I spent time with Amit to go through the myriad of tests I had performed in the previous two weeks. Amit was pleased with the results saying all was good especially in relation to the leukemia count and in his words ‘this is perfect’. I argued this point with Amit saying there is no such thing as perfection. In my view chasing perfection will take you to an early grave! He summarised by saying I was in the best possible shape for a transplant………with a few provisos.
The reduced renal function (kidney) is of some concern. It has become clear that the IV Ambisome treatment of my lung infection has negatively impacted on my kidney function resulting in unacceptably high Creatinine levels. This needs to be addressed before the BMT can go ahead.
He has called for yet more tests – this time a nuclear medicine scan of my kidneys which will take place next week. This is a much better indicator of kidney function that a simple measure of Creatinine level in the blood apparently.
In the meantime in consultation with the Infectious diseases specialist, Romana, Amit has changed my lung treatment from the IV Amibsome to the oral drug, Voriconizole. The side effect of this drug should be less on my kidneys.
My heart appears to still be in good order after the ‘gated heart pool test’ and ECG. My lungs are in good order although the exchange of gases was deemed a little low, indicating that the lung infection has had an impact and will continue to do so for some time.
My dental check up was all OK.
The team have determined that my critical organs will be OK for the transplant December 20.
My chemotheraphy “work up” will start December 11.
As part of the process the doctors needed to check my donor – my brother Tony.
He travelled down from Forbes on Tuesday afternoon ready for a day of testing on Wednesday.
We had some good chats including the big news that as Managing Director of his corporate farming enterprise in NSW he has been very busy taking the company into an IPO (Public float). This will happen in January. Look up Duxton Broadacre Farms (DBF) for more information. I must say I am immensely proud of his achievement (and very grateful that he has taken time out of his busy schedule at harvest for the tests!)
His tests included an ECG, general checkup, chest x-ray, multiple blood tests and a briefing on what to expect.
Tony will have to self-inject a growth compound called GCSF which stimulates the production of Stem Cells (immature blood cells) by his bone marrow, 4 days prior to the donation. His Stem Cells will multiply up to 8 times what his body would normally produce and flow out of his bone marrow into his blood stream.
Gone are the days where they scrape the bones and suck marrow out for the transplant (although they can still use this technique if need be). The process now is simply to harvest his Stem Cells and transfuse them into my blood stream.
They do this by ‘spinning off’ about 300ml of Stem Cells over a 5 hour period. He is hooked up with a line in each arm so that the rest of his blood cells and plasma are returned to his body.
In all the machine will process about 10L of Tony’s blood to harvest the required 300mls of Stem Cells (not bad given humans only have 6L of blood!)
It is this Stem Cell transfusion that will hopefully save my life. (Read more in the drop down box on the home page at Haematology 101).