A Marrowing Experience

It’s been a long time since I’ve written, and it’s partially because I’ve been BUSY BUSY BUSY.

One of the last times I wrote, I explained the need for me to donate bone marrow to my brother. Well, my family did go through the donation process back on April 23^rd.

That was an amazing day! It was exhausting and emotional, but amazing nonetheless. I think it would be good to summarize the process (in relation to my hips) in case it could be helpful for anyone else. So here you go:

To start, I’ll say that Dana Farber Cancer Institute, as well as Brigham and Women’s, are pretty spectacular places. I had an unbelievable experience with them, as did the rest of my family. I can’t thank them enough for all of their efforts and support throughout the process.

So I started working with my donation team in February/March to determine my validity as Jody’s donor. Even though I was a viable match, I still had a lot of prep work to do before I could be solidified as a healthy and worthwhile candidate. The first step was to determine if my previously performed osteotomy would pose any potential issues for the surgical team performing the harvest. Since I still have my surgical screws, they had to spend some time analyzing my screw placement.  It was determined that because my screw heads are all in the front my pelvis, and the harvest team harvests the marrow from the back of the pelvis, the screws would not be an issue. We could proceed with the rest of the screening process.

In addition to the pelvic analysis, I had to have a series of blood work (they took 29 vials of blood!), physical examinations, and a psychological exam to be sure that I am in both a good mental and physical condition.  Thankfully, I passed everything with flying colors and we went ahead with the donation.

Right side insertion points. 

The harvest procedure consisted of a large gauge needle inserted into the iliac crest of the pelvis, and into the spongy bone space inside my pelvis where the bone marrow is located. The needle is then used to extract a previously determined amount of marrow, based on your weight and the weight of the recipient. In my harvest they utilized four insertion points and extracted approximately 1150 mLs of marrow.

Harvested Marrow

The procedure itself was pretty short; I believe I was only in the operating room for about an hour, hour and a half. I woke up pretty uncomfortable, but mostly I was just exhausted from the anesthesia and blood loss. Because I woke up with some back pain, they gave me a dose of Dilaudid (my nemesis from PAO!). I actually tolerated it okay, but it made me extremely sleepy, just like the last time. So I slept most of the afternoon. Sometime later that afternoon I started to feel a bit more human and I think by evening I was up and chatting. I felt good enough to go home that night, so they discharged me sometime later that evening.

Post-op bandage.

The days that followed were a little tough, but it had nothing to do with my hips, which was great. It was just an intense stiffness in my back. There was some pain for a couple of days, but nothing that this old hip warrior couldn’t handle. Overall I’d say that it was a pretty great experience as far as my hips were concerned.

Hopefully no one out there will ever have the need to read this entry for reassurance, but if you do, note that my PAO had absolutely no impact on my ability to donate or in my recovery from the procedure.

Here’s hoping you all are healthy and happy, and that you are heading into the holiday season with love and good fortune!

-D

The Core of the Issue

Hello!

It’s been forever since I’ve written! As far as my hip goes, things have been really great and there hasn’t been much change. I’m still feeling great and doing really well.

I’m writing today because I’ve been going through some rather heavy family stuff, and I’m dealing with a situation that may affect my hip. 

The short version of a long story is as follows: My youngest brother, Jody, was diagnosed with Chronic Myelogenous Leukemia (CML) in late September. He's 34 and expecting his first baby in a few weeks. It's been a tough time for everybody, needless to say. However, he’s since been through intense chemotherapy, and he’s now in remission, thanks to all the amazing people at Bay State Medical Center and Dana Farber Cancer Institute (DFCI). It’s been an extremely stressful, exhausting, emotional time for all of our family. He’s in a better place now and we are all thankful for that. He’s an amazing guy, that Jody!

Unfortunately, even though he’s in remission, he’s got a tricky type of leukemia. His team at DFCI is afraid that if they don’t do something to try to cure his CML, he will relapse within a year or two. So, in order to ensure he doesn’t relapse, he needs to have a bone marrow transplant. This bone marrow transplant, if successful, will actually cure his CML. DFCI tested family members and scouted the donor list to determine the situation with possible matches. After all their research, it looks like I am the best candidate to donate bone marrow to my brother. Obviously, I am honored and thankful that I am a viable match and I will be able to help him in such an amazing way!  It’s an amazing thing, and the sense of responsibility is like nothing I’ve ever felt before. I’m just so thankful that he has a match, and that, if all is successful, he can be cured. This whole process has been so stressful, I just want the donation and transplantation to be smooth and easy for him. I feel like he deserves that! We are looking at an early April donation and transplantation process. 

I am writing this entry because this process will be a bone marrow harvest procedure. They will need to core into my pelvis and aspirate and collect the marrow from inside my pelvis. This would normally not be a big deal, however, as well documented here, my pelvis is not my strong suit. The biggest concern is that I still have my surgical screws from my RPAO in October of 2012. I’m working with my donor team at DFCI to figure out if this is a problem, and how we will address it if it is.

There are two reasons for this post:

1. I’d like to know if any other PAO’ed people have had to go through this; and 
2. I’d like to document how this affects me (if at all), for others who may have this same situation someday. (Though I hope you don’t).

A few things:

• Here are my latest x-rays:

• My donor coordinator at Dana Farber asked me specifically about my iliac crest, and if any of the screws were interfering with that area. This is where your iliac crest is located:

http://www.rst-art.com/ana-t61.jpg

• I’d also like to note that this harvest occurs on the backside of the pelvis, so I would be lying on my stomach during the procedure. I think this is important because my screw heads are all in the front of my pelvis.

• I’ve spoken with Dr. Schiller and he is perfectly fine with me going forward with this process. He said I could take new x-rays any time if Dana Farber needs a different angle to determine screw placement. He also stated that he would work his schedule around to take my screws out if that is something that Dana Farber is worried about. The recovery for screw removal is about 4-5 weeks (non-weight baring)…so that is something that we’d need to figure out sooner rather than later.

So, right now, I am in a waiting game. I have sent my latest images to my donor coordinator at DFCI who will pass them on to my DFCI clinician for analysis. I’m hoping to hear from them this week regarding their initial thoughts.

In the meantime, please pipe up if you’ve had this harvest procedure before. Even if you haven’t been PAO’d. I’d love some donor insight in general, someone who’s had pelvic surgery would be a plus, but not a prerequisite!

Thanks all, I hope you’re all well and everyone is hip-happy.

D