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Popping pills on the road to recovery
Monday, May 15, 2006
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Editor's note: This is the third in an occasional series where Register outdoors columnist George Carl and his wife Andi Carl chronicle their experience as George goes through a bone marrow transplant.

It has been 21 days since the transplant; we are watching for side effects.
It all started with my being diagnosed with two kinds of leukemia in the summer of 2004. We fought off the disease with chemo and transfusions, and I was in remission for almost a year. When it came back, I was told the only chance I had for survival was a bone marrow transplant. I got lucky, found a donor, was accepted to Stanford University Hospital and the process began.

Because of my age and the fact we found a donor who is not a relative, I was told I should expect reactions. I do have a better than 50/50 chance to make it back to normal. To date, I am weak because of the radiation and treatments, but -- knock on wood -- I feel good.
The main side effect for me so far has been a sore mouth. For awhile, the many little sores in my mouth made eating hard, and with the low immunity to infections and diseases that comes with the treatment, they were slow to heal.

I am much better now, but still have some abscesses and a sore throat. Meanwhile, I am learning a new lifestyle -- indoors. It is hard being told that I can't go out in the sun anymore; it could bring on what is called graft-host disease, in which the new bone marrow cells reject the cells already in my system.
I will have to wear long sleeves and a hat when I go outside. I guess I can live with that, even though I love those rays.

I am living on a host of pills, anywhere from 21 to 30 a day. I have to take from four-to-nine Cyclosporine per day. The list also includes Bactrim, Diflucan, Ciprofloxacin, Mycophenolate, Zovarix, Prednisone and magnesium. There are other pills if the counts are too high (or too low), and a pill to protect my stomach from ulcers. One of the pills was causing high blood pressure, and I had to take another pill for that. I feel like my main meals are pills three times a day.

Each day we leave our apartment in Mountain View and drive 15 minutes to Stanford, where they take blood and discuss my condition. I wait for the results and adjust to the cell counts.

It is hard to be so weak that I can just make it to the hospital and maybe a trip to the grocery store; then I'm wiped out and ready for a nap. I feel bad for my wife who is very active, as I can't go anywhere with her.

Actually, I can, but I have to stay in the car.

Then there's the big gas mask contraption I have to wear outside my apartment. I must breathe clean air at all times.

Back when I was doing chemo, I faced bouts of low immunity after treatments, but after a week or so my counts would come back up and I could do things again.

Now, I have to lay low and be careful for at least three months.

Since I've had no major problems during this first 21 days after transplant, I am told I only have to come in to Stanford on Mondays, Wednesdays, and Fridays.

As for the next step, I have to wait and see. I am in the 100-day countdown after transplant, and all is well. My wife has been a good partner and patient with me through all of this. I only wish we could do more, like go out to a restaurant or a play, show, or museum. My wife goes back to work in a week, and my sister is coming up from San Diego to be with me for the next month or so. I sure miss fishing and the outdoors, but I'm getting in a lot of reading and more television than I need. Thank goodness for e-mail.

I have to say the Stanford bone marrow transplant crew is a bunch of pros, and the attention the nurses and doctors give us are very reassuring. We are ready for the next phase. In our next report, I'll try to give you an idea of what all this costs; thank goodness for insurance. If all goes well, I'll be out of here in early or mid-July, in time for my son's wedding.
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