Funeral, Chickens and My 60 Day Test Results

What an emotional week. I am back in the saddle at home with not much energy to chase the kids around. Cassie was a champ with all three kids for four days as I flew to Florida to commemorate the life of my Grandpa George and share in family time. I was given an opportunity to speak at the funeral and share how my two grandparents, who were both only children, started something known as the Brabbs' Family which today includes 17 grandchildren and currently 10 great-grandchildren. Although I was born and raised several states away from my Grandpa George, it was made clear this past week that I am very much similar to the man he was and that I hope to be. On a lighter note, my uncle Jeff hosted my parents and me at his legit guest house which is home to three chickens (shown below) that provided some awesome breakfast (eggs) served up by my uncle Jeff.

Yesterday, I had bone marrow biopsy #5. I really don't mind them, partially because my PA at UMCCC knows how to dominate the procedure without dominating me. Those results will be on there way in a few days and will tell us what percentage of Myeloma plasma cells still exist in my bone marrow. Below is a picture of me waiting to see the BMT Doc, showing of my new watch which was given to Grandpa George for his High School Graduation at Flint Central. I am also wearing a silly band which I just learned about. I think the dominate bracelets are much cooler!

Also, I received my 60 Day (from transplant #1) test results and my M-Protein dropped from 0.6 to 0.5. This is positive because it is showing that my body is responding to the high-dose chemo (Melphalan) that I received. My goal is still to get this to 0.0 after my second transplant and some consolidation (more low-dose chemotherapy). I feel like I am at the mid-point of my treatment and I am very excited with the results although we still have a little more way to go.

On a side note, there are some really cool things going on with the Cancer Kicker Foundation as the Facebook Fan page is now over 4,o00 members and almost all 100 dominate shirts have been pre-ordered. I must say all of this work on CKF has been dominated by Zak Branigan who is such an inspiration and good friend to our family. Cassie is sporting her dominate shirt today and she looks hot for having Ruby only 6 weeks ago. Score.

A Gem of a Day!

Amidst all the chemotherapy, stem cell transplants, tracking cancer numbers....there is a gem in this for all of us. Her name is Ruby Carroll Brabbs and she was born today around 12:15pm, weighing 8 lbs 10oz and 21 inches long.

This is such a special moment for us because with only two months before we decided to start chemotherapy to dominate my Multiple Myeloma, which will inevitably make me sterile, we decided to roll the dice and see if the Guy upstairs had a blessing in store for us hidden behind all these dark and gloomy cancer clouds.

Some people say cancer is a gift. I am not sure exactly how I feel about that quite yet, but I can definitely say it helped forge a gem of a girl today and we will be forever grateful. Ruby is our hope and trust that life goes on after cancer, chemotherapy and stem cell transplants. Every child is a miracle and this one is no different....and extra precious to us in light of the circumstances.

BMT? SCT? WTH?

An awesome new friend that I gained through this MM journey suggested that I explain what the crap a bone marrow or stem cell transplant is, commonly called a BMT or SCT. I often forget that people don't eat, breathe and live maroon ribbon disease like Cassie and I do, so I often assume that everyone understands what all this means. My bad.

The good and bad thing here is that I am a dummy when it comes to this stuff. Good because I will be able to explain things in simple terms. But bad because I probably misspeak 10-20% of the time so you may get some wrong information. There is a reason why we called our blog MM For Dummies and not MM for Really Smart people. If ONLY Cassie were blogging, we probably could have gone with the latter.

First, here is a simple timeline of the BMT activity:

• 3/16: NeoStar Catheter placement
  
• 3/17: Cytoxan - Chemo
• 3/18: Phil doesn't remember this day (thanks Ativan)
• 3/21: Daily neupogen shots begin
• 3/28: Last neupogen shot
• 3/29: Stem Cell Collection (my stem cells), also called apheresis
  
• 4/4: Christ is Risen, Hallelujah.
  
• 4/5: Receive Melphalan - Chemo
• 4/6: Phil checks into the hospital for a minimum of 15 days
• 4/10ish: Phil's cells die
• 4/10ish: Phil receives his Stem Cells back
• 4/11+: Phil recovers until Phil is Risen, Hallelujah.
  
• 2 months later (Take 2): Phil goes through this process again starting with Melphalan.
  

So what is a BMT and what will recovery look like? For most, the bone marrow transplant will take place only once and if they slip out of remission five years down the road they may go for a second. In my case and for probably 99% of the folks seen down at UAMS, we will be doing a tandem (back to back) transplant, roughly 60 days apart.

Here's how I describe the process for my autologous (my own stem cells) transplant/s. A BMT or SCT is not a surgery, though that seems to be a common misconception. They give me a nasty drug that I just learned is mainline therapy for fighting breast cancer, they start shooting me up with a crazy drug/protein that pump fakes the body out to produce an overabundance of stem cells and pushes the excess into my blood stream, they connect me to a machine where they pull blood out and dump it back into me all while collecting about 6 million of those baby stem cells, they give me the big gun chemo to kill everything and admit me the next day into UMHS, my old under-performing cells get dominated in roughly five days, they give me back a bag or two of my baby stem cells who have missed me, my counts start to return to safe levels during my two week stay in the hospital and they eventually kick me out and tell me to return home and live in a bubble now that I will essentially have no immune system, but hopefully also no cancer and lastly, if that wasn't fun enough the first time, let's do it again to complete the tandem. The End.

So now that folks understand that I am NOT about to undergo a surgery, the next question is what does the recovery timeline look like? First, for a single transplant, I typically hear that the majority of people are out of work for 3-6 months, closer to 6 although the line of work and how you feel are trump cards. For me, expect a six month recovery with a tandem..which of course will be subject to change based on whether I complete a tandem and how my body responds to the above process. My energy levels should be shot for a while and since I will be rebuilding an immune system and will be extremely susceptible to the most innocuous of germs , I will be chillin' like a villain in my house for a long while, trying to limit my exposure to infections that would send me back to the hospital. I hope to return from the ashes just in time for the 2010 Michigan Football season and the Big House Big Heart Run I ran last year.

So was that helpful? MM experts....feel free to humble me with correction where I have mis-spoken. I am new to all of this... -Phil

And here's Cassie's edit to Phil's original post:
To keep it even simpler, I'd just say:
1. They give you drugs to make your marrow over-produce stem cells and push them into your blood.
2. They pull your blood-and-stem-cells out, collecting the stem cells and replacing the blood. (A simple and painless but time-consuming process.)
3. They give you high dose chemo to kill everything.
4. They give you back your stem cells, which will graft back into your marrow, creating a new immune system over the next few months.

It's not the Dex...this time

I was awaken at 3:03 AM with all guns a blazing ready to take on the world. I haven't done this since my Dex days and I want to say it feels good! I have sent a number of emails, posted a bunch of comments on Facebook and even got a blog post out of it!

I feel like I haven't updated folks lately on my whereabouts and that's probably because I still can't even recall what happened on Wednesday and Thursday. I am blaming the Ativan for inhibiting my recollection of those days events, rather than the Cytoxan. Although I am open to blaming chemo drugs for doing bad things :)

We are about a week away from stem collection and two weeks away from transplant. My neupogen shots kickoff today and I am excited to start producing a bunch of baby stem cells which hold my future.

I have been harboring some deeper emotions lately, mainly do to having to prepare and give a TEDx talk at the University of Michigan. They did a recording of my talk and they will present it at the event on April 10th, which actually coincides with the day I'll probably get my little stem cells back and also the big Relay for Life event on campus.

As for the emotions, I won't go into them in too much detail because I honestly haven't gone into them in too much detail myself. Given that I am so go-go, when I pause to consider being ejected from this world and leaving my son behind it just rips my heart to pieces. The thought of my little guy, who is now four, not recalling memories of me nor having the opportunity to play soccer together and go for runs is unbearable to think about. I find it a little healthy to ponder....

It's very easy to be inpatient with Ocean (and Iris who is 2 for that matter) and forget the joy that is available in the present moment with them. Our kids are truly amazing and I look forward to many more years with them.

So I started out talking about Dex and then finished with my kids. Sometimes I feel like my kids are on dex full-time! The End.

Here's a photo of Ocean looking "Dexy"

Baby Drama

Being young with Multiple Myeloma presents some really difficult challenges. One of the biggies is that for men, chemotherapy followed by a stem cell transplant will most likely make you sterile. That means no more biological kiddos once this is all said and done. Knowing this, we took a chance at our two month window and got pregnant right away, which was pretty miraculous. The pregnancy is going well and it looks like the Brabbs kiddo count will make it to 3 (Ocean, Iris, Girl Child-to-be-named later).

Here's where the baby drama comes in to play. Due to all the additional rounds of chemo (RVDD), the first transplant is looking to hit a few weeks before the due date. The first issue with moving forward with the transplant before the birth of girl #2 is that we could run into the problem where Cassie goes into delivery at 38 weeks which would leave me behind to watch online courtesy of Skype or iChat. To add to the difficultly, just last week the Doc said that he does not think I should be returning to the hospital for the birth immediately after transplant due to my lack of immune system. Therefore, their suggestion is that if I want to be there for the birth, then continue to soak in chemotherapy (RVD) until the baby has arrived and then go in for my bone marrow transplant. Today we meet with Dr. J and we really want to see whether or not I could go up just for the delivery in my space suit and then return home.

The latter option seems much more difficult on our family given that Cassie will be caring and nursing a newborn while her hubby is on his back a few miles away at UMHS. My preference would be to get the transplant out of the way and start the recover process before the baby has arrived. There is definitely no right answer here and unfortunately for us most people diagnosed with MM are in their 60's so there isn't much to lean on in terms of folks who have gone down this path before.

Two roads diverged in a wood, and I— I got tossed down the one less traveled by, And that has made for a roller coaster of a journey.

What to do....????

P.S. Today's stars Cycle #7 of RVDD...time to return my 24 hour Pee-Pod