Today officially marks 1 year since my chance AML diagnosis
^ I originally posted this on the day I started induction chemo (7+3 with the red devil)
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TL;DR - 1 year since diagnosis and I don't know when I'll truly come to terms with treatment and transplant.
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Today marks exactly 1 year since I first heard the words "you have leukemia". I was in the ER triage room all alone, and heard it from a doctor surrounded by a bunch of residents after I had been poked multiple times over by phlebotomists who wouldn't listen to my pleas for a vein finder/ultrasound. They blew two veins before success, and even that was a struggle. I still have the bruises in both forearms all this time later.
The shock threw me into a panic attack. They finally let my mom and best friend back into the room, as they had accompanied me there. The doctor then told me I was being admitted and was going upstairs. I got up to walk and was immediately shut down and required to be pushed in a wheelchair the entire way.
That was the moment - the before and after moment. Being wheeled through the under belly of the ER, down a long hallway filled with dialysis patients, to a patient elevator I would come to know very intimately. I knew this signified a loss of control, but every new piece of information I would get that night and the following days just buried me deeper.
I met with the head of the Haematology/Oncology program and his PA. The news was heavy - you have leukemia, you're going to receive chemotherapy, and there's no telling how long you'll be here. Still in disbelief of all of this, I asked what happens if I don't pursue treatment. I received a simple two word answer: "You die."
I had so many plans for that summer: It was memorial day weekend, two weeks from then I was supposed to be joining my family for our first group vacation in almost a decade to Canada. I had tickets for a music festival in Vegas a few months later, and a 2 week trip to Japan planned with the man I was finally making things official with after 6 years of will they/won't they. But now I was being told travel is out of the question.
Then came the dietary restrictions; I asked if I could eat sushi. Nope, absolutely not. That's when the tears started. It felt silly, and still does, but the scope of my loss of control and autonomy just kept expanding. In one week I had gone from feeling like life was finally coming together to my entire world falling apart.
That next morning was my first bone marrow biospy to confirm the disease and mutation. From the beginning we knew I was headed for a transplant.
During induction I developed a stomach ulcer, which stole my appetite and caused me so much pain while it took 5 days to determine what it was. Then finally, after the uncertainty of 5 weeks, 2 bone marrow biopsies and complete hair loss later, I was told I was MRD- and could go home for a week before needing to return for my first of two rounds of consolidation. 1 week to be back in my own bed. 1 week to make up all that missed time with my cat. 1 week to pretend I'm not sick.
I had missed family travel, my best friend's birthday, and lost out on a career that was just beginning. But I was alive.
I went back for my first round of consolidation and missed another holiday with friends and family: fourth of July. I suppose lucky for me the BMT unit is on the top floor of the hospital, so affectionately referred to as the penthouse, and I could see fireworks for miles all around me.
My next round of consolidation was set for a month later. I got to go home and enjoy my freedom for another short while. But it ended up being even shorter ... I developed an infection in my pelvic region. The pain was unbearable and I wasn't allowed Tylenol because my counts were so low. I waited 4 days before finally agreeing to go to the ER, I knew what it would mean to show up there - another admittance. This was by far my worst hospital experience through it all, but that's a story for another time. The medical trauma from just that 5 day stay could be a post of its own.
I got another week at home before being admitted for my next round. I was getting to be a pro.. blood draws were at midnight, so by the time I was opening my eyes around 5am, I'd check my chart and know blood and platelets were coming. I knew the room service menu inside and out and had my regular orders. I brought comforts from home: my own clothing, my own pillow and blankets, photos of my cats, my Roku for streaming. I built a schedule to have some semblance of normalcy: ordering breakfast as soon as I woke, showering before lunch, walking no less than 3 times a day settling in with a show for bedtime.
When my second round was done, I knew the next hurdle was transplant. I had remained MRD- since induction and was fortunate to have three 10/10 matches on the registry. The first individual my team contacted agreed and I will forever be grateful for his generosity to give.
Throughout the entirety of my treatment every nurse, doctor, specialist, and patient testimony warned me how brutal transplant was going to be, from the pre-tests, to the Hickman line placement; from the conditioning chemo to the preventative IV meds. I'd lose my appetite, struggle with basic tasks, develop mucositis, and be admitted for an undetermined amount of time. I fought hard, through pain and low appetite, I forced myself to stay active and keep my established routine. I was determined to get out of that hospital as quickly as I'd be allowed.
That feeling of losing my freedom was suffocating. A 12 by 12 room and a single hallway was all the space I was allotted. I wasn't sure how long I would maintain my sanity. I'd already had a panic attack during the transfusion.. each day my mental health was chipped away at. I craved fresh air, sunshine. Day +17, it was a rainy Monday in early October, and I finally received my discharge papers.
I wasn't going home though. My mother as my caretaker and I as the reluctant patient moved across the street from the hospital in the provided recovery housing. The physical space opened up, but I still felt trapped. The restrictions were intense and if I wanted to survive, I needed to follow them. No going outside within 24 hours of rain, wear a mask wherever you go and avoid the public as much as possible, keep the dietary restrictions, be at the hospital every day, and no chance of going home until at least day +100.
Numbers progressed, bone marrow biopsy results were clear, chimerism numbers were trending in the right direction. The anticipation to go home was overwhelming. Due to my LFTs doing a fun rollercoaster ride, I wasn't released to go home until day +129. Would my cat even remember me?
I have now been home for 4 months. My cat is on my lap every chance he gets. My hair has finally begun growing back in. Doctors visits have decreased some, but are still happening multiple times a week. I still can't work. I still can't travel. I still bear this Hickman central line. But I'm alive. I'm officially in remission. My chimerism is at 100% and my blood says I'm a man (lol).
Despite all this, and all the details not included in this post, it doesn't feel real. I feel I dissociated too strongly that it was like watching a stranger undergo this life altering diagnosis and subsequent treatment. Being stuck in limbo doesn't help, and the state of the world makes it even more daunting. Most days I want to fast forward to put it so far in my past or rewind and find a different timeline.
I know how truly lucky I am, and I don't want to be ungrateful. I'm sure I'm not entirely alone in these feelings, but even rereading what I've typed seems like a distant story I didn't truly experience and will forever struggle to claim as my own.