It's a GO...
Mood:  incredulous
Now Playing: By John
Topic: Update
"The good news," said Dr. Majhail, "is that both your bone marrow biopsy and spinal tap show 0% blasts, meaning the cancer is still in remission."

Dad let out an audible sigh of relief.

"Your twin brother is also an 8-by-8 donor match, the best possible through HLA blood protein-typing," he continued. "However..."

We waited for the other shoe to drop.

"Your heart has suffered some damage," the turban-wrapped hematologist stated matter-of-factly. "

I was attending Dad's final meeting after his week-long screening process of test upon test upon test. The purpose was to determine his overall "fitness" for a Bone Marrow Transplant. The risk factors and procedure percentages the doctor threw out at us were mind-numbing.

- Four to five out of ten BMT patients live and are Leukemia-free in one year.
- Twenty to thirty percent of BMT patients die in the first six months.
- Fifty percent get "early" or acute Graft-Versus-Host-Disease.
- Twenty-five percent develop life-long, irreversible chronic GVHD.
- The donor marrow may fail to "take" or engraft, which may be fatal.
- The bone marrow may recover too slowly, or not at all, and infections or bleeding may not be able to be stopped resulting in death.

Possible side-effects from the combinations of drugs include fever, skin rash, nausea, low blood pressure, vomiting, diarrhea, malaise, fluid retention, wheezing, seizures, hair loss, mouth sores, sterility, kidney failure, coma, brain damage, irreversible damage to vital organs, hemorrhagic cystitis, cardiomyopathy...

"What if he waited to see if the Leukemia comes back," I asked. "Or went with the old method of consolidation chemotherapy treatments?"

The doctor ran his fingers through his thick, black beard. "It would probably come back within 4-to-8 months," he replied. "And when it eventually did return, the cancer would be more aggressive and much harder to treat."

In Dad's favor: his relatively good health (for a 66-year-old), best possible donor match, the reputation of the U of M BMT transplant center, the intermediate chromosome verifying the AML versus CMML diagnosis...

Against his success: side-effects, percentages, some lack-of-oxygen damaged tissue in the apex of his heart, the septic infection he developed from the last Hickman port they installed...

Probable. Possibly. Likelihood. Slight occurrence. Chance of. Risk of. Tendancy... His answers had all these words mixed in. Ultimately, we got the picture. Do nothing, cross your fingers, hope and pray. Or go through with the BMT, cross your fingers, hope and pray.

Nobody spoke for a minute while Dad pondered everything that had been presented to him.

"So, do you understand everything I've explained to you?" he asked both of us.

I glanced over at Dad. He nodded. I followed suit.

"And do you want to proceed with the transplant?" the doctor posed.

"Yes," Dad said, then paused. "I've thought about it, and I think it's the best option."

Immediately the room actually felt brighter, the air a bit less weighty, the lump in my throat dissolved, and I blinked rapidly while having to look away. I don't know how to explain what happened, but for the rest of the 2-hour appointment, Dad and I laughed, shared, joked, and talked with the doctor like we'd known him for a lifetime. He listened intently to Dad's questions. He complimented me on the research I'd done about the transplant. He actually seemed interested in our stories. He was patient and kind trying to explain complicated procedure in layman's terms. He was optimistic, confident, humane, personable, and gave every impression that he cared about Dad's condition and concerns.

In the end, he helped Dad feel like he'd made the right decision.