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Today my wife met with the transplant surgeon.  There was nothing disqualifying in the medical tests although two were redone just to be certain.

She has talked with her spiritual adviser.

She has considered the concerns offered by others.

She has prayed about it.

Today she signed the paperwork for an autologous stem cell transplant.

She will get shots Saturday and Sunday to stimulate more stem cells circulating in her blood.  She will also begin taking large doses of calcium

On Monday, time yet to be determined, I will drive her to Fairfax Hospital, where she will have a catheter inserted.  She will continue with the injections.

And beginning Monday she will undergo apheresis to gather stem cells from her blood.

This process will continue at least through Tuesday, probably through Wednesday, with an outside chance of Thursday and even Friday.  I am hoping to have a friend drive her to the clinic Tuesday and Wednesday, wait a bit, then drive her to the hospital where the apheresis will be done.  I will pick her up each day at the end of school.

Saturday we have a day with nothing medical.  And on Sunday morning October 13 I will take her to the hospital and check her in.  That is DAY 1, and officially her treatment begins.

The heavy chemo will be Monday and Tuesday, and Wednesday they will reinsert her own stem cells,

Once her white blood cell count recovers, she will be discharged.  The target date for that is October 28 -  it could be sooner, it could be later.

The following day I will take off from school to orient the person who will provide her care while I am away at school.  She is a licensed nursing assistant who does this kind of thing regularly, and she has provided the service for someone with whom I attend Quaker Meeting, and comes highly recommended.

Once she is home, my wife will have to visit the clinic one-three times per week depending upon her white blood cell counts and symptoms.

There will be side effects.  We do not know how severe.

She expects to lose her hair, so she is going to cut it short first - that way she will keep it perhaps a bit longer.

To prepare, she is switching to a vegan diet, and as I consumer the animal products in the house  (a package of hot dogs, some cheeses) I will probably accompany her in that diet in the next ten days or so.

When she loses her hair, I will cut mine short and shave my beard -  I want to show solidarity but she would rather I not remind her of her lose by my shaving my head.  Besides, as I discovered in boot camp at Parris Island, when my head is shaved I look very weird, especially because of the large flat spot in back.

Her confidence is high.  Her transplant team has been doing this for almost a decade and have never lost a patient.

So, having recovered well from the early treatment, she has decided to be aggressive in the expectation of a longer remission.

Because of the sequester, she is losing the income she would have made this week.

She planned to be out next week, and expected to be out of work 6-7 weeks on unpaid leave.  

Despite the sequester, her medical insurance as a federal employee continues - otherwise there is no way we could afford the procedure.  Insurance does not cover the care-giver, but I cannot take three-five weeks off from students.  The salary I earn will basically be taken by the cost of the caregiver, but that is before we are able to deduct that cost from our taxable income, which despite my having returned to work is likely to drop significantly from last year.  We have the resources to cover out of pocket expenses - we may have to forgo other things, such as changes we had planned around the house, or buying a new stereo system (ours was 40 years old and died).  We can pay all our bills without our debts increasing, which makes us luckier than many in our position.

The good news is that she will not be limited in what she can have with her in the hospital.  She will have her knitting, books, laptop, Ipad....  and oh by the way, a wonderful and healing quilt that was a gift from the Daily Kos community, for which we remain grateful.  

I will visit her in the hospital every day she is there, if they will let me come in at odd hours, because there are two occasions where I will be going to events directly from school and not be able to get to the hospital until later, although if they will not let me come in at 10 PM for example, then we will discuss if I will withdraw from those two long-term commitments.  After all, as I have told everybody, as important as what do as a teacher is, as important as my students are to me, my wife comes first.

We know how lucky we are.

We have insurance that covers the vast majority of our medical bills.

We both have multiple supporting communities - her church, my Quaker Meeting, our professional associations, our various social networks (including many people we only know virtually).

We have access to a superb medical team, based at two outstanding local hospitals, in Arlington for the treatments up to now, and then at Fairfax.

Most of all, despite all the normal bumps and bruises along the road of life, after 39 years together we still have each other.

We continue to learn how our hearts can be enlarged by what otherwise might seem like a situation of loss.

We asked that you continue to hold us up in  whatever fashion is appropriate for you.  We know it has made a difference.

Thank you.

Peace.

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