Latest Meeting with the Lymphoma Guru

Brigid and I met with Dr. Zelenetz at 9:30 this morning and he laid out the upcoming plan.

My second and last RICE chemotherapy is this weekend. I will then be injecting myself with Filgrastin, a medication designed to “speed the recovery of white blood cells after chemotherapy has been given”. I will do that for eight days following the chemo.

A few days after the injections are completed I will have my stem cells removed by a Dr. Reich. I met her today (she introduced herself as “The Vampire”). She decided the cells could probably be harvested by IV through my veins – I wouldn’t need a new catheter installed. Dr. Reich wasn’t happy with my left arm, but said it would probably go OK.

My already installed port can’t be used because it only works one way – going in – and they need a system where the blood is taken out, sent through some machine and (I believe) centrifuged to get what they’re looking for – and then returned to me.  So I’ll have large IV’s in both my arms – a blood going out IV, and a blood going back in IV.

The date for this is not settled – but probably around the 8^th or 9^th of December. Around that time I’ll also need CT and PET scans, and I have another meeting scheduled with Dr. Zelenetz on December 14^th.

I am slightly anemic. This certainly contributed to my tiredness in the gym while doing cardio. So I will receive another red blood cell booster shot, Darbepoetin, in two weeks, on Dec. 7^th. I had received this med with my prior chemo’s and this is the first time I will get it outside of a chemo session.

Dr. Zelenetz reviewed the rationale for the stem cell transplant. He said that 99.99% of the cancer cells would have been destroyed by the chemotherapy protocols. It’s the remaining “hardy” cells that are targeted by the one week of “high dose chemo” and “these are the tough cells I’m interested in”. As a side effect, this also destroys my immune system. Hence the need to rejuvenate the immune system by returning my own stem cells to me.

The high dose chemotherapy runs for one week. Then it takes 7 to 10 days for my immune system to be rebuilt. But Dr. Zelenetz reiterated that the hospital stay could be up to four weeks. H was pretty emphatic about that.

The hospitalization date for this is not set. It usually is about two weeks after the stem cells are harvested. This would take us to just before Christmas. I am hoping they’ll hold off until just after Christmas!

After our meeting, I received the first part of RICE – the rituxin. As I’ve mentioned, rituxin is supposed to “set up” cancer cells for the chemotherapy. This is the only time I’ve actually gotten an outpatient treatment at Sloan Kettering in NY, and it was the same sort of reasonable experience I’ve had receiving chemo in Sleepy Hollow. I also got an injection of Darbepoetin.

I will never complain. The girl receiving chemotherapy in the lounge chair next to me was 23 years old.