March 23, 2007

Today is a real milestone. It is day+50. I’m ½ way to the magically day+100 when the acute period of the transplant process is over. By that time my circumstances will have given the doctors a good indication where I will probably end up to be. Again, there will be no guarantees, just some statistical data.

I am feeling so much better than last week. Today I made it up the stairs without using my arm muscles, which has been a major goal for me since I came home from the hospital. The last 4 steps were really hard though. Later in the day I had my laptop and with just that little extra weight, I couldn’t go up the first 3 steps without hands. I still have work to do.

At my appointment on Tuesday my nurse practitioner gave me a great explanation as to why I’m so weak and progress is slow. She said I’m a big man, who at 6’ 8” and 230 pounds should have a calorie intake of about 2500-3000 daily. However, when I was in the hospital for the transplant, my daily need was probably closer to 5000 calories because of the trauma of the transplant process on it. Again, when I went back in for the bout with GvHD (Graft versus Host Disease) my daily need was held at the 5000 calorie level as my body continued to try to repair itself and fight the GvHD.

However, because of the sloughing of the lining in my digestive tract I was not absorbing much at all from any food I ate. Coupled with the fact that I was only eating broths and little else, my muscles were atrophying as my body was channeling the calories to repair itself. The other circumstance is that the steroids attack the larger muscles and further weaken them.

My absorption is much better now and my appetite is very much improved. Here’s how I’ve been eating. Yesterday at 6:00am I had a large bowl of chicken noodle soup with carrots, onions, and corn and a cup of tea. At 10:00am I ate 4 pancakes and a large pork sausage that was very lean. Then at 1:00pm I had a thick tuna salad sandwich containing water chestnuts, boiled eggs, olives, pickles, onions, mustard and a little mayo. Along with the sandwich I had a large bowl of applesauce and banana slices. At 3:30pm I had another thick tuna salad sandwich and a Snapple. Then at 6:30pm I had a pork steak, baked potato, and 1 ½ cups of steamed carrots. I finished out the day by eating two big bowls of popcorn while watching the UCLA game. Needless to say my appetite is coming back very well.

By monitoring certain medicine levels in my blood we can tell that my digestive tract lining is rebuilding because my absorption of the medicines is much improved. I’m hoping that I will stop losing weight soon and stop the muscle atrophy. My weight is 197 pounds, which is about what I weighed when Barbara and were married 34 years ago, instead of 230 pounds where it had been hovering for the past 6 months prior to the transplant.

Being an engineer it really helps me to know where I am in the scheme of things while going through a process. When I told the nurse practitioner I wish I knew what the yardstick was to measure my progress, she smiled and said I was the top of the yardstick. If all patients were where I am with what I’ve gone through she would be very happy.

So again I sit here in total awe of God and His provision and grace in my life. I don’t understand why He chose to bless me and certainly don’t feel worthy of it. However, I am truly thankful that God has chosen to glorify Himself by protecting me from so much more pain and suffering.