009 - Greetings From Denver

"It is tiiiiiime" - Rafiki

There is part of me that feels like I need to apologize for the lack of updates over the past month, and another part of me that knows all of you would be doing the exact same thing that I was doing over the past month if you were in my position — spending time with my wife and kids before leaving them for roughly three months. The last month has been emotionally and physically exhausting. While I have been finishing last second projects at home, I have been thinking a lot about this next chapter.

According to my physician, this procedure has roughly a 2% mortality rate. Being told that I must bring copies of an executed medical power of attorney and living will at thirty-six years of age is a sobering experience to which I do not recommend. Hugging, kissing, cuddling, and spending time with Sloan, Cohen, and Whitney over the last month was the best. It wasn’t enough, and I’d do anything to have them in Denver.

This update is coming with good news — I am currently IN Denver right now, sitting in the apartment that I will call home for the next three months. It took far longer than I ever wanted, but I am finally here. The transplant was delayed largely due to a sinus infection that I could not get to go away. The original plan would have put me in Denver roughly a month ago, but just before leaving a CT scan revealed that the sinus infection was still there. Mentally preparing to say goodbye to your family is hard and having that change just a few days before leaving was even more difficult. The next day I saw a Rhinologist (kinda sounds fake, right?) who put me on a 21 day course of high-dose antibiotics which has thankfully taken care of the sinus infection.

One of the positives of being delayed is that I got to celebrate Pesach (Passover for you gentiles) and have a Seder on my last night. The irony of this last supper with my family was a Seder, held on Good Friday, prior to me being gone for three months — after which I will return — reborn, even with a new birthday. I promise, this was not planned.

The Drive

Last Saturday morning my Dad picked me up at 6am and we started the drive to Denver. It was long and pretty uneventful. We stayed the night in Buffalo, Wyoming and got to our apartment in the early afternoon on Sunday. The main highlight was getting OVER the Rockies and watching Liverpool thankfully draw against league-leading Arsenal.

The apartment that my Dad found is absolutely perfect. It is the perfect location, we are only five blocks from the hospital, I have a walk-in shower to reduce fall risks, and it is only 50 feet from the handicap parking spot to our front door. The building is new, so the likelihood of there being fungus or mold is extremely low — something which is unfortunately relevant for someone like me. Monday and Tuesday was spent doing multiple grocery pick-up’s, ordering bleach wipes on Amazon (SaniCloth’s IYKYK), and getting settled in.

For my Nursing & Healthcare Gnomies

Yes, I Consent

On Wednesday, I had my first appointment at the clinic. They had to re-do a substantial amount of the bloodwork from January because it had been more than thirty days, and I needed a COVID test. After the blood draw and brain tickle, my Dad and I got led into one of the Consent Rooms. Dad stayed in the room while I went with Dr. Nash — my transplant doctor — to complete my pre-transplant physical. After the physical, Dr. Nash and I joined my Dad and my transplant coordinator, Callee, in the consent room.

The pen I used to sign forms was handmade by my friend Daniel out of whiskey barrel staves provided by our friend, and Master Distiller, Caleb. Also, here is a view of my medicine cabinet after visiting Dr. Nash.

I have never felt like a physician has known my medical history as thoroughly as Dr. Nash does. He then took my chart with all of the test results from pre-transplant testing and went through every single test, explained what the test was, what the results were, and if there was anything abnormal (there wasn’t any). There were a total of five different consent documents that Dr. Nash went through with us. He went into great detail of the positives and negatives to treatment, and the individual risks of each document. After 90 minutes or so, Dr. Nash signed all of the consent forms and left the room. Callee then answered some logistical questions for us, I signed all of the consent forms, and she went over the six new prescriptions that I needed to pick up. To finish off the good news, Callee called me yesterday afternoon and let me know that all of my bloodwork has come back normal and the COVID PCR came back negative. I honestly cannot believe that it is finally happening.

Next Steps

For the next few days, I wont be doing anything other than staying in a bubble and shaving off my stem-cell playoff beard on Monday. Next Tuesday, the first phase — stem cell mobilization and collection — begins when I get admitted for 24-30 hours to place a triple-lumen catheter and I will also receive one infusion of Cyclophosphamide, a chemotherapy that is used to lower my blood counts prior to them going up very high for stem cell collection. I will get discharged on Wednesday after my first dose of Granulocyte colony-stimulating Factor (G-CSF), which is used to stimulate the growth of new hematopoietic stem cells in the bone marrow.

My Stem Cell Playoff Beard

Once discharged, I will go to the hospital every day to receive a G-CSF injection and get bloodwork done to see how my body is reacting to the Cyclophosphamide and the C-GSF. When blood counts have reached a particular threshold, I will go into the hospital for a day or two of stem cell collection.

From now on, my plan is to do one update per week, on Fridays. I am so thankful and grateful for the people who are in my life — without all of you, this would not be possible. You all have done your part and it is time for me to do mine. I am ready to kick the absolute shit out of this God-forsaken disease.

Much Love to you all,

Aaron