To Drill Or Not To Drill...That Is The Question!

O.K...Here are the details:  Amanda, Megan, Nick & I went to Vandy yesterday.  It was a lovely day for a round trip (torrential rains and limited visibility.)  Nick's oncologist had consulted with the entire oncology team at Vanderbilt, and the unanimous consensus was that the transplant should proceed A.S.A.P.  However, the jury is still out regarding the method of harvesting Amanda's bone marrow. 

In general, pediatric patients receive marrow harvested from having drilled holes in the donor's hip bones.  Adult patients receive stem cells harvested from the donor's peripheral veins.  Nick is technically an adult, but his age puts him in the gray area between pediatric and adult for medical purposes.   Each method has its pros and cons:  The peripheral stem cell harvest provides a more aggressive attack against the leukemia, but it also produces a greater "graft vs. host" rejection response.  So, it would potentially give Nick more side effects after the transplant.  The direct bone marrow harvest has less rejection response, but does not hit the leukemia as aggressively.  The experts are not yet in agreement about which method is better for Nick.

Megan asked Nick's doctor how they were going to decide:  "Are y'all gonna sit around a big table wearing incredible hulk gloves...punching each other until everyone agrees?"  The doctor said, "Yea, that's pretty much how we do it."    In all seriousness, I'm very thankful that those who we count as wise counsel do not make decisions without considering all of the details.

Right now all of Nick's labs look great.  His platelets are in normal range, and most of his other blood work is nearly normal.  He is relatively healthy for a guy with cancer.  So, the experts leaning toward the peripheral harvest say that, because of his current strength, he will be able to withstand the increased side effects.  The other mitigating factor is that he is not yet in remission .  So, even though the amount of leukemia that remains is miniscule, he may need the added punch of the peripheral harvest to kick the remaining leukemia's hiney.  Statistically, the lack of remission greatly lessens the chance of cure, but...as I have stated before...We do not serve a God of statistics.  We serve Jehovah Rapha, the Lord our Healer!

What is next?  Even though the experts have agreed that chemo will not give Nick any further benefit, he is currently being treated with oral chemo to keep the leukemia from rebounding before the transplant.   We will go back to Vandy next week for chemo infusion, and the week after that for a lumbar puncture and chemo instillation in his spinal fluid.  After that it should be time to be admitted for the 7 day preliminary treatments prior to transplant.  The actual transplant should be mid to late January.  I knew that this was a big deal, but I had no idea how many details had to fall in line before we could get started.

The first 100 days after the transplant will be critical, and probably very difficult.  However, in the scheme of life...how long is 100 days?  We can endure anything for 100 days.  It will be next summer before we know it.  Right?

We have known for some time that Nick's blood type would convert to Amanda's blood type after the transplant.  However, I didn't realize that, eventually, he would carry her DNA in every cell of his body.  Nick's doctor remarked that about 3 months after the tranplant they would look like identical people on a DNA test.  He will still appear to be Nick, but on the cellular level he will be very different.

I don't think that I have ever understood so clearly how we become new creations when Jesus becomes our Lord.  We still look the same on the outside, but on the inside...on the cellular level...we are very different.  The death that was once rampant and sure in our lives is obliterated.  We exchange the DNA of death for the DNA of everlasting life.  We give up our sin nature blood type, and take on the blood type of Jesus...the spotless Lamb of God...the only "blood type" that will insure eternity with God Almighty.

Do you realize that if you have accepted the free gift of salvation you have undergone a transplant? You are a new creation...on the inside...which is where God looks.

It is well.