D -2 End of the chemotherapy

D -2. That’s how they label the doors in the BMT unit of the hospital to signify where each patient is with regards to the transplant. D -1 tomorrow and then D 0, transplant day, on Wednesday. The day after will be D+1.

Today went much like yesterday for Courtney, but worse. She experienced quite a bit more nausea after being given her second and final dose of cytoxan. Fortunately one of the nurses found a drug combination that seems to have helped control the nausea and allow Courtney to actually eat a bit for dinner. When I arrived this evening, she was already quite relaxed and resting well. Right now it kinda seems like War of the Drugs. Cytoxan = bad vs. Morphine = good. Although, as much as Cytoxan is kicking Courtney’s butt, we sorta have to root for it, since it’s a key element to the transplant, and ultimately helping to cure Courtney.

As bad as Courtney’s day was, Tracy’s was seemingly worse. She went in this morning to have the Quinton catheter surgically placed in her neck, where it will stay for the next two days. This is basically like a large soda straw inserted into her jugular. Not a comfortable procedure by any means, but rather simple and routine. That is, until you have an allergic reaction to one of the drugs. Apparently, things got rather dicey in the OR, when one of the drugs sent her into antiphylactic shock and temporarily made breathing quite difficult. The doctors responded quickly and got things under control and were able to finish the procedure without further complications. Tracy’s day wasn’t over, as she still had to go back to the BMT clinic today for another round of Neupogen shots.

While tomorrow should be a quiet one for Courtney (they refer to it as her “day off”) because she’s not getting any heavy hitting drugs for the first day since admission, it’s the biggest day yet for Tracy. Tomorrow is “harvest” day. By a process called apheresis, Tracy’s stem cells, which the Nuepogen is causing to be produced in extra quantities, will be harvested. Apheresis is the process used to separate out a specific part of the blood such as stem cells for transplantation. Tracy will be connected to a machine via the Quinton catheter. The blood is removed through one branch of the catheter and run through the machine which separates the stem cells. The remaining parts of the blood are circulated back to Tracy through the other branch of the catheter. The process is expected to take 7 to 8 hours. If they don’t get enough stem cells, an amount predetermined by Courtney’s medical team, Tracy will have to go back for another day of harvesting. Otherwise she is done and they can remove the straw from her neck.

At the end of the day it’s still so hard to believe that we’re actually going through all of this. It’s still hard to say the word cancer and to accept that it’s directly affected our lives as it has so many others. And while it’s hard to believe that Courtney has had to endure chemotherapy three times in the past three months, it’s nice to know that that part of her life is now officially in the past.