May 3 is Third Time's a Charm

May 3 is the new start day. I will begin hospitalization and have the transplant sometime around May 10 or 11. I am very thankful that this decision came through at the last minute. Had it been even one day later, I would have started the irrevocable process of chemotherapy. Because the recovery for chemo is at least a month, this would have delayed the procedure even further.

As I sit here waiting for the donor, there is alway the fear that my cancer could come back. Usually, the doctors will administer chemo if the wait is about a month or longer. Additional chemotherapy ensures that I stay in remission and am able to move forward with the transplant. If I fall out of remission, my chances of surviving decrease from 40 percent to well below 10 percent. Time is not on my side, and I would much prefer to do the transplant as soon as possible.

Yet it is not enough to just keep pumping chemo into the transplant recipients while they wait. First off, chemo is not without its risks. Second, the real problem with chemo is that it takes about a month to recover once you start. So we could start chemo while waiting, get a response from the donor the next day, and have to delay the transplant another month as I recover. During that time, it is very likely that I could lose the donor for other reasons.

I think when this is done, I am going to advocate for some transparency. I understand that the donor and recipient should be isolated from one another, and I completely respect safeguards against privacy, voluntariness, and anonymity. These are the three reasons that neither I nor the doctors am allowed to speak with the donor center. However, given the situation and the life altering decisions that must be made (should we wait for donor 1, should we push for donor 2, should we commence chemo while waiting, etc), I firmly believe that the privacy concerns are somewhat vitiated by the doctor's need to know. Moreover, all communications with the donor center should fall under doctor patient confidentiality. Although we can argue that the doctor has a conflict of interest between the donor and donee, other professions handle similar conflicts with similar data and the stakes are much less. Again, I am not stating that I should be kept in the loop, but I am stating that my oncologist should be given some information about where the donor is in the readiness process.

Anyhow, May 2 is when finals start. I need to knock out as many of these tests before the transplant. For the next week, I'm going to use all my spare time to exercise and get these finals out of the way.

Please excuse any typos. Rather than proofread this, I'm going to continue studying Health Law, which may spark another entry later on "dying with dignity"--a very fitting thing to study at a time like this.

Transplant Delayed

I was hoping for additional information, but I do not want to delay my update any further. My transplant has been delayed for now.

To answer the question of why, I do not know, and I do not have further information. This baffles many people, but the process is completely anonymous and voluntary. I am not allowed to interact with my donor because I could influence his decision. I understand and agree with this concept; however, what confuses me is that fact that my own physicians are also kept in the dark. My oncologist is not allowed to communicate with the donor's facility. Based upon his limited knowledge of the situation, he does not think that the donor has backed out. Usually, the altruism that carries a donor this far, brings them to follow through with their commitment. Moreover, if the donor did change his mind, he would be unresponsive when called. We can tell that the donor is still responding.

This brings us to Plan A: continue with the initial donor and hope that things fall in line next week. This would be ideal. However, the doctors have initiated Plan B: an expedited search for a new donor. Based upon my ethnicity, a new donor should be found as early as May, and I would continue with my transplant next month. Plan B is not necessarily bad, but it requires that I stay in remission for another month, something that is not guaranteed with my type of cancer. Plan C is also in the pipeline: use my father who is a half match if another suitable donor is not found quickly. This is substantially worse than either Plan A or B, and I doubt it will come to this. Using a half match is controversial and could greatly increase my risk of complications. Also, the durable efficacy of a half match is not as high--per expert opinion.

I will provide more updates as I receive them. For now, the silver lining is that I now have more study time before exams. If things are delayed long enough, maybe I can take a few exams at home rather than in the hospital and under the effects of drugs.

For the Record my Birthday is June 11

I just realized that because of the delay, my transplant will occur on April 20. It is quite common for transplant survivors to use the date of their procedure as a new birthday. In this case, I must admit that I am a bit ambivalent about following the custom, considering Adolf Hitler's birthday was also April 20. It just seems a bit unsettling that someone who is half Jewish by ethnicity now shares a very intimate day with one of the most reviled enemies of the Jews. If I do choose to celebrate April 20, I'll remember that my father-in-law, whom I love and respect, also shares the same birthday.

On another note, I wonder how long it will take for the name Adolf to again become mainstream in Germany or Austria. If you Google the name, you can see a sharp drop in usage after the 40s. Many of those unfortunate enough to have been named Adolf now go by Dolf.

Treatment Delayed by 24 hours and the Capital Asset Pricing Model

I just want to post a quick update to say that my treatment has been delayed until April 12 at 13:00. The reason for the delay is that my donor required an additional 24 hours. That is all I know and no further details are authorized because I am not permitted any identifiable information about my donor.

I decided to spend the day doing homework for an MBA course. Because I'm a bit behind in my studies, I need to get back to cramming a semester's worth of corporate finance into this evening. Nevertheless, I am very thankful for this extra day where I can sit with my family, be in peace, and eat real food. I'm definitely dreading this 40-day stint in the hospital.

Last Day Before the Procedure

Ever since I relapsed, I have been asking oncologists about my overall prognosis. Although I do not put my faith in numbers, it certainly helps me to understand the severity of the situation and realize the true nature of things. Today I had a discussion with my transplant specialist that should have taken place several months ago. Based upon his understanding, it appears as though I have a 30 to 40 percent chance of surviving more than five years. This may sound grim, but I assure you that relative to what I was thinking, this is quite encouraging. For the first time since I relapsed, I was given factual evidence that this grueling treatment could result in me living a long and healthy life.

Tomorrow at 13:00 PST, I begin the most important procedure of my life so far. I will trust in the Lord and rest soundly knowing that I am under the care of the best transplant specialists. The VA works closely with the Fred Hutchinson Cancer Research Center, the leading stem cell transplant center in the world.

Last Week before the Transplant--I hope.

I apologize for not providing enough updates and responding intermittently to individuals. I'm aware of many people waiting on a response, and I really appreciate all those who continue to keep in touch.
Also, I rarely check social media in between hospital visits; when I do, it is solely for the purpose of providing updates or tending to my own page. I won't make excuses, but I will offer an explanation.

Because of my upcoming transplant, life is extremely busy. My mornings and days are often spent at the VA or taking care of some issue and evenings are spent catching up on school work and getting ready for finals. It is imperative that I enter the hospital somewhat ready for my exams. Cancer treatment is not exactly conducive to studying. Even if there is sufficient downtime, chemo brain (a real thing that I did not invent) and other side effects result in little or no quality time for studying.

I was hoping to see Mount Rainier or the Skagit Tulip Festival with my wife prior to treatment, but the VA will not allow me to migrate more than a 30-minute radius from the facility. I could risk them not finding out, but it is very common for me to get a call requesting that I check in for unscheduled medical tests. Let this be a lesson to those clamoring for a national solution to their individual health problems: If you want the government to fix it, be prepared to surrender control and personhood; you will have little say in your care and anything affecting that care, which extends to many other activities--like smelling the flowers, keeping your dog, and continuing with work. Nevertheless, I am very grateful to have VA coverage and my doctors appear extremely competent.

Perhaps it is best that I am not allowed to sightsee too much. Even if I had the time, it might not be beneficial for someone with a compromised immune system. Presently, I am avoiding all crowded places. I want to kick this cold ASAP and move on with this transplant as scheduled. Time is not on my side, and I risk losing my donor if there are further delays. This Thursday I will confirm whether or not I must push back my transplant because of a pesky cold.