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Battling to the bone
Monday, April 10, 2006
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Editor's note: This is the first in an occasional series in which Register outdoors columnist George Carl and his wife Andi Carl chronicle their experience as George battles leukemia and goes through a bone marrow transplant.

Cancer was always something that happened to the other guy.
No one in my family ever got cancer. They died of old age and other complications. So I worried about my heart and tried to stay active. I got a checkup annually and always felt good when my doctor said, "Your heart and pulse are good, your blood pressure is fine, and your cholesterol count is fine." I knew I needed to exercise more and lose some weight, but that was all.

Life was good until Andi and I were in Europe in the summer of 2004, and I couldn't keep up with her. I chalked it up to the fact that she is a runner and loves to walk and swim. She thought nothing of walking a mile to the center of town and then walking around to all the shops. I found that I was good for a few blocks but then tired easily. I chalked it up to old age and being overweight.
When we got back from the trip, I saw the doctor and he said I was fine. I still was tired, and finally ended up seeing an oncologist.

She immediately made me take another blood check, sat me down and delivered the word: "George, you have cancer; you have two types of leukemia."
Wow. Cancer was no longer something that happened to someone else. It was my turn. I started to reflect on all the good times I had had in my life. Is this the end?

First I had other questions. How did I get it? There wasn't really a good answer, only something vague about exposure to chemicals from engines. That didn't add up too well, since Napa doesn't have bad smog or congestion problems and I don't spend much time in big cities.

Of the two kinds of cancer, one had been inside me for two years or more. The other, which was more acute, was more recent and more deadly. That frustrated me because I had gone in for regular blood checks, and they never checked for cancer. Turns out it is just one more step you have to ask for when you are getting a physical. Here's my advice: ASK FOR IT.

So, how long do I have? If not treated, she said, I had maybe six months. But, she said, "We are going to cure you."

"Okay, Doc," I said. "What do I do now?"

First, I would have to clear my calendar and get ready for six months of chemotherapy treatments. I told her I had plans for a trip and a cruise and ... then I took in the meaning of the look on her face: If I wanted to live, I would have to cancel everything for those six months, and enjoy some brief breaks between the treatments.

What are my chances for survival? She said, "With the treatments, 50-50."

The first pint

Chemotherapy was only a word until I saw my first pint of water-like liquid. It would be fed to me through my veins. I would be in the hospital for a week, receiving this every other day.

Then I would be released to go home and tough out the next two weeks of "low immunity." Chemo kills all your blood cells -- and hopefully the cancer -- and afterward you feel weak and tired. Any germ can make you sick with a fever, and then back in the hospital you go for protection and antibiotics until the temperature goes down.

I went through five treatment sessions -- each lasting from a week to 10 days -- with three- or four-week breaks between them.

Each time I learned to be more careful. A few times I ended up in the emergency room because of a high fever, and that meant a week in the hospital until my blood started to come back strong enough to fight the germs. I had to change to a neutropenic diet, which meant no fresh fruit, salads or spicy foods. Everything had to be cooked all the way through. It was definitely a different lifestyle.

I really appreciated the precious days at home. In the few weeks there I would finally get almost back to normal. Visiting with family and friends was a real treat.

After the six months, I had another biopsy. In a biopsy, doctors use a large needle to remove some of your bone marrow. The marrow then went to labs for testing, to see if the chemo had forced the cancer into remission.

Doctors said that if I could stay in remission for two years, I would be able to remain in remission for the next 10 years or more. So six months after I heard I had a 50-50 chance, I was so happy to hear my doctor say, "You are in remission."

Not only did we cure the acute myeloid leukemia, but the chronic lymphocitic as well.

Back up, back down

What a treat. I really appreciated life, and did more fishing and camping than before. I was still a little weak -- they say it takes a year or so to get all the way back after chemo. I continued to have regular blood checks and a quarterly biopsy.

Then on October of 2005, the acute myeloid leukemia came back.

Now what? We had to start the treatments all over again.

Once the cancer comes back, it is tougher to cure -- and there is always a chance it will come back. The return means my blood is not strong enough to fight the cancer. The only chance for me was a bone marrow transplant. I was told that there are more than five million people in the bone marrow bank, and it would take some time to find a donor.

After seven weeks of waiting (none of my siblings or friends turned out to be a match), I was beginning to feel a little depressed. It is not just your blood that has to match, there are 13 areas that have to match. My brother and sister only matched six or seven of these areas.

Then, in March, I was told they found a match.

The donor remains anonymous and now I begin all the prep work and doctor appointments. Soon I will have to move to Palo Alto to be near the Stanford Cancer Center, where I'll be every day for 100 days, at least. Once again I am in an experimental program with a 50-50 chance of surviving.

I'll keep you posted.
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