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My Bone Marrow Transplant

Pain is inevitable, suffering is optional.

If it’s Wednesday it must be SGH day. As well as my regular blood tests and check up, today they did a Bone Marrow Biopsy and Trefine which is standard at about Day +100 to check how the donor cells are doing and if the disease has returned. Sadly, BMTs do not always work.

I’m used to these, I know the drill; drop your trousers, pull your shirt up out of the way and assume the foetal position with knees well tucked up. Men above 50 will recognise this position from their annual check ups! This was the longest I have ever had by far. I could tell from the off that the doctor was inexperienced. She had examined me many times while I was hospitalised, and she had an older doctor supervise her location of the correct place to stick the needle. Then lots of lidocaine and off we went. She got into the bone fine after about 5 minutes but could not get enough marrow and bone sample after several attempts, so a second doctor was called. I lay there for a good 15 minutes until she came. More lidocaine and off we go again, she certainly got the marrow but it took 4 sucks. The sucks are weird; they don’t hurt but they are the most unpleasant feeling! The routine is the doctor says “big breath in and out” and as I draw breath in she sucks the marrow out. It makes it a bit more tolerable. Then she tried for a bigger bone sample and that seemed to go on for way to long. Prof. Liang in HK gets that bit done in about 15 seconds. The whole procedure, normally about 20 minutes, took an hour. In HK they make me lie flat on my back for an hour to keep pressure on the puncture site and stop it oozing. Not in Singapore, slap a pressure dressing on and send you on your way as the delay had put them behind.

We won’t get the results until next week unless there is something wrong in which case they will call us, but Dr. Goh said he was 99.9% sure all was OK and the Cytogenetics on the bone would also show no gene mutations. They also check what percentage of cells are my original ones and what percentage are the donors. The more donor cells the better. I’ve met people at the hospital who, at this stage, the donor cells were only 20%.

As for the rest, blood counts are OK’ish, they are roughly where they have been for the past few weeks. My Creatinine level is above normal but has come down again. The Prednisolone dose has now been dropped to 15mg; normally they don’t like to take it below 20mg because this keeps the GVHD under control. But because my disease is so aggressive, some GVHD is better than none to get the new immune system to mop up any remaining Leukaemia cells. Again, medicine as art rather than science. If I start to get nausea, vomiting, loss of appetite, diarrhoea or rashes I am to go in to the hospital for a check up as quickly as possible.

My feet are a bit more swollen than usual so we bought some “flight socks” to try to reduce the swelling. Linds got the biggest size but they were still tough to get on!


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