Thursday, 25th December

 

Thanks to John and Jen for the lovely visit this week, for the beautiful flowers, wine and cake.  You really did spoil us.  It was lovely to see you both again and I hope you enjoyed the rest of your time in Cape Town and your birthday Jen.

 

And to Guy and Shereen and the boys for a chilled Christmas Eve get together.  We really need to make the time to do this more often.  Thanks for the great company, the cousins had such a fabulous afternoon together.

 

 

To all our family and friends

 

 

During this time of faith and family may the true meaning of Christmas provide you with joy.  Wishing you a Merry Christmas and thank you for all your love and support.

 

Lots of love Jimmy, Vivienne and children.

 

 

We had a lovely Christmas Day spent at home with our children and Jimmy's parents today.  Many beautiful gifts and a delicious Christmas Lunch.  Even the pouring rain and cloudy sky couldn't dampen our spirits.  We enjoyed a lazy afternoon with full tummies and visits from Rohan and Patsy & Matthew and Cameron.  Thank you Ewen for the lovely telephone call from the UK.  I think your weather was better than ours today.

 

 

Bradley and Shannon left this afternoon to spend the remainder of Christmas Day and the rest of the holidays with their Mom and her family and my girls leave in the morning.  It's going to be very quiet in the Smith household from tomorrow afternoon.  Thank you kids for a fabulous day and a glorious two weeks together.  The time really just went by too fast.  In our fond thoughts was Megan today, our first Christmas with her away but we had a lovely Skype yesterday and since she is at see today we hope to catch up tomorrow again when she is in Toulon, France.

 

Jimmy's cold is much better, after closely monitoring his temp for a couple of days it did not go higher than 36.4 and I think he is over the worst now.  His back has been a bit sore and he was very quiet today but I think he is okay.  I worry about him but I also don't want to be a pain and keep checking up on him and asking him if he is okay.   He was quiet like this on his birthday too and although these are special, happy times to celebrate I suppose it is also a time to reflect and I am sure I would also be, if I were to walk a day in Jimmy's shoes.

 

 

I couldn't resist sharing a picture of my ginger
bread house Christmas Cake.





Sunday, 21st December

Day 20 - Stem Cell Transplant (going to stop counting from today and resume mid Jan when the next part of the transplant starts)

It's the countdown to Christmas and it's awesome.  There is a fabulous vibe in the house.  The kids all have friends over and there are six of them baking Christmas biscuits and icing them.  The smell wafting through the house is to die for and all this to the sound of Christmas carols.

The biscuit bakers

Our dear friends Matthew and Cameron are on holiday in Fish Hoek from Johannesburg and it has been lovely to see them again.  Ray and Bernadette are also in SA on holiday from the UK and it was wonderful having them and Melanie for a visit.  And then we were also treated to a visit from Tim, thanks so much Tim and come back soon.  We were sorry to miss out on a mini reunion at the Toad the other night.  It would have been nice for Jimmy to see some of his classmates and beautiful Kelly who is in SA on holiday but he was pretty exhausted after stem cell harvest on Friday.  The girls and I had a nice afternoon tea with Maureen, Kate and Sheila and our daughters as a very late celebration for Sheila's birthday at the end of November.  Lovely Champagne and too many sweet things to eat.....just perfect.

Jimmy has been feeling mostly fine.  I shaved his hair yesterday as it is now falling out in huge chunks.  On Friday he showered and scrubbed his head to try and get rid of some of the lose hair and ended up throwing away 2 handfuls of hair.  He is almost completely balled now.  He has been very tired and didn't sleep at all for 3 nights and couldn't sleep during the day so I think it got to the stage that he was overtired and then he would get into bed at night and it became a mental thing....the harder you try to fall asleep the further this possibility becomes reality.  And then his back started getting sore which I think was coming from the tossing and turning during the night.  Of course if Jimmy can't sleep then I don't get much shut eye either.   So last night I phoned Kate, our resident nurse, and went down to fetch some sleeping tablets from her and Jimmy slept like a baby last night.  He only woke up at 9am and already his back is feeling much better.

My almost bald hero

After thinking that we were going to have the worst Christmas ever with Jimmy in F4 Isolation we are now all eagerly awaiting Christmas Day and celebrating it together as a family.  There is only one person missing and that is Megan.  My brother Guy and his family are coming to visit on Christmas Eve afternoon.  We are going to have a family Christmas lunch at home and Jimmy's folks will join us.  And then we are hoping that Rohan and Patsy will visit in the afternoon as well as Matthew and Cameron.  My presents are all wrapped and the shopping is all done.

Megan on duty and in the Christmas spirit
on the Norwegian Cruise Liner - Jade

The children go to spend their second half of the holidays with their Mother and Father on Boxing Day so I am going to stock up the caravan and then on the 27th we are going to go up to Bredasdorp to spend 2 nights with my parents.  From there we'll go up to Graaff-Reinet and meet up with Stan and Michelle (watch this space for some hectic rainfall - they are cursed) at Camdeboo National Park and then we are going to play it by ear.  If Jimmy is up to spending some time with them and camping we'll go to Addo Elephant Park and then Natures Valley but the plan is if he wants to come home we'll just turn around and come back.

I'm not sure if I will blog again before Christmas so would like to take this opportunity to wish you all a Merry Christmas.  Thanks for all your lovely emails and messages that we have received over the last few days.   It is truly is a blessing that stem cell harvest went so well.  A special thank you to Sakkie and Noeleen for the beautiful book you sent Jimmy, we received it on Saturday, thank you so much.

I am super excited - we are 6 page views away from 20 000!!

God Bless you all and please travel safe and take care.

Thursday, 18th December

Day 17 - Stem Cell Transplant

Since today is going to be a very long day I have decided to do updates throughout the day and then post them all this evening.

We set the alarm for 4am and I got up to give Jimmy his Neupogen injection.  He actually asked me if I could give it to him without waking him up.  I told him there was more chance of me giving him an injection without waking up.  One thing is for sure....he has never lost his sense of humour.

09h30
Jimmy has had his bloods taken and just as we were told, his white blood cell counts have more than doubled to over 20 since yesterday.  His vitals have all been taken, as well as weight and height.  An interesting side effect of Multiple Myeloma is loss of height and Jimmy has already reduced from 1.67m to 1.63m.

The harvest procedure today takes place in the Chemotherapy Clinic.  There are 2 beds behind a wall that doesn't go up to the ceiling with curtains, like in a normal ward.  Dr Fine has just finished inserting the PICC line in his groin under local anaesthetic so they should start the whole harvesting process soon.  I had a good laugh this morning when Patsy sent me a message saying she hopes those stem cells are all swimming around screaming pick me, pick me, pick me......so do I.

 

The Chemotherapy Clinic

The 2 procedure cubicles at the rear of the chemo clinic

Jimmy rearing to go

13h40
Gosh, this is a very slow process.  By the time they had Jimmy's PICC line in and he was hooked up to the aphaeresis machine it was 10h24.  So it has been just slightly over 3 hours.  I can see the stem cells in the bag but we have no idea how well or slow he is doing.  About 30 minutes ago Olivia came to get a syringe full of the stem cells to give to Dorothy who measures and works out how many are being collected and at what rate.  The rate of stem cells per ml of blood stays constant, although different for each person, so when we get these results we should be able to get an idea of how long this is going to take.  Jimmy has to lie completely flat on his back and can't move much before the aphaeresis machine and BP machine's alarms start going off.  The PICC line also has much thicker pipes going into his groin this time round so this is a little uncomfortable.  The one pipe is for out and the other for back in again.  It's amazing how this aphaeresis machine separates the stem cells and then everything else goes back into his body.

The aphaeresis machine

Jimmy's PICC line



The screen of the aphaeresis machine

Blood circulating through the aphaeresis machine

14h50
This is getting even more fascinating now.  Jimmy's body has approximately 4.5 litres of blood in it, which is quite average.  At 14h30 Olivia came to tell us that 10 litres of Jimmy's blood has circulated through the aphaeresis machine and Prof wants 14 litres.  We still don't know how many stem cells this produces but according to the nurses he is doing extremely well and we should be finished harvesting at about 16h30.

The stem cells

16h50
Dorothy has just come to tell us that Jimmy has been as absolute super star.  They are going to turn off the aphaeresis machine at 17h00 as they have managed to collect 15 million stem cells which is enough for 3 transplants.  Once the aphaeresis machine is turned off and all the pipes and tubes are removed, Jimmy has to lie still till 17h30 to give the main vein chance to clot nicely.  Olivia will then remove the PICC line and apply some pressure for a while.  We received his blood counts back from this morning and his white blood cell count was as high and 27.2.

17h45
Olivia has now removed the PICC line and Jimmy is still lying flat to make sure a nice blood clot forms.  I will have to wheel him out in a wheel chair and the only walking he is allowed to do is to the toilet until tomorrow.  They have also done another batch of blood tests and his white blood cell count has now gone up to just over 30 (normal is 4 to 11).  This will drop down again in the next few days to what is Jimmy's normal which will be around 2.5 to 3.  He doesn't have to have any more of the many pills he has been taking for the last 10 days in preparation for today nor any more injections and I have to admit I pretty relieved about this.  After something close to 30 or 40 injections it still doesn't come naturally to me.

What would normally happen now is Jimmy would have been admitted to F4 Isolation Ward in the next 3 or 4 days for another heavy dose of chemo to kill everything again prior to stem cell transplant.  The nice thing now is that Jimmy can actually relax till mid to end January when he will be admitted.  We are hoping that Prof will be able to confirm what date he is going in before they all close for 2 weeks because we think he only comes back on the 19th of January but he has assured us that Jimmy will be included in the 1st batch going in for transplant during January.

Homeward bound after 10 hours

Today was a big step and a whole leap closer to Jimmy's recovery and I am very happy that it went so well.  Much better than we had anticipated.  A special little thank you to Jane Pederson (who works at UCTPAH) for popping in to check up on Jimmy xx

Wednesday, 17th December

Day 16 - Stem Cell Transplant

The last week has flown and what a fantastic few days we have had.  I have been giving Jimmy his Neupogen injections twice a day which means his bloods are coming up nicely, I think this morning's was his 15th one.  I really am a pro now.  He went with me to the mall on Saturday morning, just a quick in and out, but it felt like old times shopping together.  On Sunday we joined the Sunshine Corner Golf guys for a Christmas luncheon at Clovelly Country Club.  It was absolutely wonderful to see everyone again and I am sure just as good for them to all see Jimmy too.  On Sunday morning Jimmy announced that he would again pop down to the shop with me.  On Monday evening we did a quick pop in at the Valyland Market where we saw many more of Jimmy friends.  Thanks to everyone over these few days who took time to come and say hello and for your lovely messages and being so positive.  Jimmy felt like a king! Might sound meaningless to many of you but it has really been so nice just spending some different time together.

We had to go through to UCTPAH this morning so that Jimmy could have a full blood count done to see if he is ready for stem cell harvest tomorrow.  I did not get a copy of the results but did see them and his white blood cell count is up to 10.1 (moprmal 4 to 11).   I actually thought it would be much higher, considering that usually it gets to 15 after 3 injections after each red devil treatment.  Just goes to show how strong the chemo is that he had in high care and how it has knocked his system.  They reckon that the next Neupogen injection is the turning point and by tomorrow morning his white blood cell count will be around 20. So....we are good to go and have to be at the clinic tomorrow morning at 8am to start harvesting his stem cells.  They are hoping to get a couple million which should take between 6 and 8 hours.  As each person is different, if Jimmy takes longer then they will transfer him to high care for the night and carry on, on Friday morning.  He will once again have a PICC line inserted in his groin and this is why he can't come home and go back the next morning as there is too much risk of infection.  I think the hardest part of this leg of the process is going to be the fact that he has to lie on his back the entire time with minimal movement.  His back still aches from time to time and gets stiff very quickly so I hope this isn't going to be a problem.

Jimmy tires quite quickly and I have noticed that he also gets breathless.  His hair has started falling out in tufts so pretty soon he is going to be completely balled but he is not worried about this at all.  I must say, but I think this part is much easier for a man.  He has had some bone pain since Monday evening but this was to be expected due to too many stem cells in the space that is available in the long and flat bones.  The worst area has been in his pelvis and the top of his thighs.

We had lovely visit from Jay Jay yesterday.  It's always lovely to catch up with him and thanks too for the delicious milk tart.  Ray and Bernadette are out from the UK on holiday so we had a visit from Melanie, Ray and Bernadette this afternoon.  It was so good to see you again, 7 years is a long time.  Matthew and Cameron also arrived in Fish Hoek yesterday from Johannesburg and as I type we await their arrival for a visit.  Summer has definitely arrived in Cape Town and so has that holiday feeling. 

Well....tomorrow is going to be a big day, one we have been waiting for, for a long time and one more step closer to recovery.  I gave Jimmy his injection as at 8pm and we need to set the alarm for 4am to give him another one 4 hours prior to harvesting.  As Julie says, hopefully Jimmy is feeling like Superman and they manage to harvest lots and lots of stem cells tomorrow.

Please keep Jimmy in your prayers and thoughts tomorrow and I will update the blog once I get home to let you all know how it went.

Wednesday, 10th December

Day 9 - Stem Cell Transplant

It is with much happiness that I am able to say that so far Jimmy has done so well and not suffered too badly at all from those heavy doses of chemo last week.  He has had some difficulty sleeping. I'm not sure if this is some neurological effect that the chemo might have, but we still had some of those strong sleeping tablets he used to use when he was in agony with back pain.  They really have helped to a degree of at least getting some sleep so he has been very tired.  He has also been nauseous but also not really bad all the time.  I think there might still be some side effects to come as his hair will definitely all fall out this time around and this only happens sometime within 2 weeks, but we hope and pray that they will not be too severe.

Some more good news is that we started the Neupogen injections at home this morning, two per day for 10 days.   Today is still touch and go with his immunity and getting infections, we have been taking his temp 3 times a day since Friday.  But from tomorrow his system will already be getting stronger, his white blood cell counts will start climbing and hopefully his stemmies will also start producing and all this is thanks to the wonderful injections.  It has been very quiet around the house as we have not been allowed any visitors but this 'quarantine' is also lifted from tomorrow morning.

  It really has been a hectic year juggling so much.  I'm sure the children are all looking forward to kicking back and relaxing.  They all come to us from today till after Christmas and I can't wait for the house to fill up.  Having all my chickens home is such a lovely saying and describes very well how I feel.  Last week of work for me next week, a quick VAT reconciliation and then I can also relax, well...relax as much as mothers can.

Today was also the last day of school.  Well done to the girls on another year behind them of hard work with good reports. A big congratulations to Loren for achieving half colours for Hockey this year and to Emma who received the JB Swart Trophy for effort and most enthusiastic learner in Grade 9.  You make me so proud!  Emma is also coming on in leaps and bounds with her baking skills and was asked to make Jonathan Ackerman's birthday cake last week.  A group of the girls from the Academy got together to lend a helping hand and I can see why Jonathan was so impressed.

Emma and Jonathan Ackerman



 On Friday the golf academy are taking a road trip up to Sanddrif  in the Cederberg for a couple of days.   I have offered to drive up for the day and tow the trailer with all their goodies. If all goes to plan Jimmy is going to come along and enjoy a well deserved break from being stuck in the house and enjoy some different scenery.

So...this leaves stem cell harvest next week which means the next step in this process is Jimmy having a full blood count taken on Wednesday to see if he is ready for stem cell harvest on Thursday.

Hold thumbs these stem cells reproduce like rabbits for the next six days...

Hey..40 days and 40 nights is a long time..

Friday, 5th December

Day 4 - Stem cell transplant

We are home! Yayyyyyyyeeeeeeee.....my bum is rather sore from sitting on that hard chair ;)

Jimmy is doing really great.  No major changes apart from a little nausea again after his chemo.  He has also eaten better today than he did yesterday.  He had his PICC line removed and I was allowed to stay and watch.  Quite amazing to see, apart from the fact that they pulled at least 20cm of pipe out of his leg/groin.  I had a good laugh because sister Masi removed the line but when he moved Jimmy's gown over so that he could get to it he exclaimed "oh....it's quite small".  He was referring to the size of the tube which had been used and I started to giggle.  He took one look at Jimmy's face and burst out laughing, trying very hard to explain that he was talking about the tube!!  Once the tube was out he had to apply pressure to the area for 30 minutes so that a decent clot could form.

Jimmy has been issued with a bag full of medication ranging from antibiotics to nausea etc which must be taken for the next 2 weeks.  On Monday I will be on a mission to get hold of 20 Neupogen injections.  We have already been told that this exceeds our medical aid allowance of 10 per script.

We are going to have a very quiet weekend watching sport and movies as no going out or visitors but maybe this is just what Jimmy needs while his body deals with all the chemo.

Thursday, 4th December

Day 3 - Stem cell transplant

Whew, what a long day....

Jimmy is doing well.  I spent most the day with him and then came home at 7pm to a mound of paperwork but I am not ungrateful.  Although still very busy we are in the winding down stages of work now and starting to see the light at the end of the tunnel. October, November and December are always our hectic months - note to self to advertise in June next year for customers to book year end jobs by September.  A big thank you to my brother Stan...next year I will definitely be a daily part of the team again.  It truly is a privilege knowing that I have been able to rely on Stan and our awesome team of guys who have outdone themselves this year, yet again.

The chemo is 2 huge bags of Etoposide which take an age to run through.  Jimmy is also getting allot of IV fluids before and after the chemo to stop the chemo from burning his veins as well as anti-nausea medication and mouth rinse to try and prevent any mouth sores.  Within 30 minutes of finishing the chemo he was very pale and feeling nauseous and did not eat his supper.  He is experiencing a little discomfort from the PICC line and they also had him on oxygen this evening.  He will be discharged tomorrow but I am sure this will only be in the afternoon as he needs to get another 2 bags of chemo in and they also need to remove the PICC line under local anaesthetic.

Etoposide

Jimmy's body is going to 'bottom out' over the next 5 days and his bloods are going to drop to below 1 (normal for white blood cells is 4-11).  This is going to be a crucial 5 days until Wednesday when we start with 2 Neupogen injections a day and he will be highly susceptible to infection.  We have to take his temperature every hour and if there is any spike in temp he needs to be taken through to high care immediately. For this reason I ask that we not have any visitors until next Thursday.  It unfortunately is not worth the chance.  Dr Fine explained today that they will not harvest his stem cells if he has any bugs or even if his temp is above 37.  And on this thought....what impeccable timing as school breaks up on Wednesday when the children come to us.

Special thoughts go out to my brother Guy who had a knee operation today.  We hope you are not in too much pain and have a good recovery.  Rest this weekend!!

Wednesday, 3rd December

Day 2 - Stem Cell Transplant


First of all - Happy Anniversary to my darling Jimmy. Thank you for the wonderful years we have spent together. It has been an awesome and very eventful journey and I look forward to many more with you by my side.

Jimmy was admitted today.  He had his lung function test which went fine and then we went down to high care.  Dr Fine inserted a PICC line in his groin area under local anaesthetic which also went without a hitch.  They actually put stitches in on each side of the tube and stitch the plastic parts to his leg so they cannot move.  Apparently this one will be removed again under local anaesthetic when he is discharged and when they ready to harvest stem cells they will put another one in but it will have a thicker tube.  They say these things can easily get infected and this is the reason it will not stay in as Prof had originally explained.

As soon as the line was up and running they had Jimmy hooked up to whatever is in the bags to pre-hydrate him.  He will get his first dose of the heavy chemo tomorrow morning.

Jimmy is such an amazing, positive person.  He was mumbling about the pages and pages of questions he had to tick yes and no to and I was telling him that at least he can do it now.  The last two times that he was in high care I did all the form filling in.  One of the questions was whether or not he is on contraception so Jimmy ticked yes and under comments wrote 'I use my personality'.  To the question about alcohol he answered 'yes please'.  I don't think he will ever change and I cannot tell you how wonderful it is to have a cheerful Jimmy back.

The PICC line inserted in groin to administer chemo
 

I will try my best to do a quick update each evening during this process so that you all know how it is going and how Jimmy is doing.

Monday, 1st December

Day 1 of stem cell transplant programme

We had an appointment at the chemotherapy clinic today for Jimmy to have a whole batch of bloods taken prior to chemo and harvesting of his stem cells.  I can't believe that it is almost one and half months since we last visited the clinic and it was quite nice to see the staff again and some of our fellow cancer sufferers.  Some look really good and others taking a bit of strain.

The only blood results that we got back today where his white bloods which have come up nicely to 3.3 (norm 4 - 12).  Jimmy also had a cardiac assessment which is called an echocardiogram.  This is a machine that  uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart. 

We had about 2 hours to spare between the cardiac assessment and our appointment with Prof so we went up to the restaurant and had something to drink and then went to explore F4 isolation ward.  This hospital is enormous!  Eric, who we know from the chemo clinic, is working in F4 at the moment so he let us in as far as the second set of doors (as far as one can go without stripping down and putting on scrubs etc).  He showed us where the isolation wards are and Jimmy did his level best to try and 'book' the one with the best wifi reception for January.  Two of our friends from chemo clinic are in F4 at the moment so we asked Eric to please pass on our best wishes to them and that we are rooting for a good recovery and excellent results.  I don't want to mention names here as it is private but our one friend is doing very well, he has been in for 2 weeks now.  Our other friend is having a really bad time.  He has already been in isolation for 5 weeks and having problems with his platelets. F4 is not a nice place, there are so many side effects of the treatment and you literally feel like you are going to die.  We pray that he can summon the strength to fight back and pull through victorious.

We then had our appointment with Prof Novitzky which was Jimmy's usual check-up and then he explained the steps to us of the stem cell transplant as far as harvesting, which is what will be done this year.  He had the results of the echocardiogram and noted that Jimmy's heart is slightly enlarged.  I questioned him on this and he explained that this is usually a sign that the heart has had some stress. The most common cause is hypertension but he was surprised at this as Jimmy does not have high blood pressure.  He didn't really say anything more about it.  As I thought, Jimmy does not need to have another bone marrow biopsy tomorrow as his last one was within the last month.  On Wednesday Jimmy will have a lung function test and then he will be admitted for pre-hydration followed by 2 days of heavy chemo in high care.  He explained that the 5 days between chemo and the start of the Neupogen injections Jimmy will be at high risk of getting an infection and we need to take his temperature every hour.  He will be given prophylactic antibiotics whilst in hospital to prevent any infection.  Prof explained that you never know what is lurking in your body and when it is taken right down, like Jimmy's will from the chemo, it is best not to take a chance.  Although he did warn that the antibiotics prevent most infections, sometimes there is that one.  He is going to lose all his hair, probably have mouth sores, lose all taste for food and have nausea and diarrhoea.  Once we start the Neupogen injections twice a day at home next Wednesday his body will quickly pick up again as it brings up his blood counts and boosts stem cell production for harvesting purposes.  Unfortunately there is a side effect to this which they refer to as an 'explosion'.  Basically this means that there will be an over production of stem cells in the spaces in the bones which will not be big enough to accommodate these stem cells and this leads to severe pain in the long bones and flat bones of the body.  These would be arms, thighs and pelvic bones.  But this is a good sign.  On the following Wednesday we need to go back to the chemo clinic for a full blood count to see where his bloods are as this is a good indication of whether or not he is ready for harvesting.  Whilst in high care later this week they will also, under local anaesthetic, insert a line in his groin which they will use to administer the chemo and harvest his stem cells from.  Once the harvesting is complete they will remove it under local anaesthetic again.  He will only have the Hickman inserted under general anaesthetic in January once in isolation.

The good news is that the actual stem cell harvesting does not affect your body so Jimmy should be in a good space over the Christmas week.

So, I think we have a tough 2 weeks ahead of us but nothing that together we cannot handle.  It is our wedding anniversary on Wednesday and since his white bloods are sitting at 3.3 and he goes into high care on Wednesday, I think we have an excuse for an outing and a little celebration dinner in a restaurant. Oooh....so romantic :)

Saturday, 29th November

Isn't it amazing how things can take a turn....we have gone from all this anxious waiting to getting a phone call yesterday afternoon telling us they we are starting SCT (stem cell transplant) on Monday. 

I can't believe the whole process is starting.  I've done some reading up and must admit I am feeling a bit nervous as it is quite a procedure.  There I was all excited that they are going to do the harvesting side of things this year and the transplant in January, which meant that we can after all have a normal Christmas and do some family things but from what I understand is it's going to be quite hectic.

We received a patient SCT programme from Prof Novitzky yesterday.  Unfortunately not for the whole process but up to the 18th of December.  But maybe this isn't such a bad thing because the transplant side of things is going to be really rough and it is probably better that we find out all about that next year.

I am going to give you a breakdown of what is happening when but at this stage I am not too sure of what it all entails.  We have an appointment with Prof on Monday evening and I will be taking my shorthand notebook with :)

On Monday the 1st we have to go through to the chemo clinic where they will do his safety bloods and a cardio assessment.  The schedule also says that he has to have a bone marrow biopsy but I don't think this will be done as Jimmy has had one within the last month so I am sure they will use these results.
If there is a need for another bone marrow biopsy then this will be done on Tuesday the 2nd.
On Wednesday the 3rd Jimmy will have a lung function test and then be admitted for pre-hydration. 
He will remain in hospital for Thursday the 4th and Friday the 5th so that they can administer the heavy dose of chemo twice a day for two days.
Then on Wednesday the 10th I start giving him Neupogen injections daily for 10 days to stimulate stem cell production.
On Wednesday the 17th we has to go back to the clinic for full blood counts.
And on Thursday the 18th they start the collection of stem cells by aphaeresis.  This could take anything from 1 to 4 days.

We will obviously know more on Monday after our appointment with Prof about what will effect him how and when and whether or not his immunity will be compromised around Christmas.  I will try and update again on Monday evening to keep you all in the loop.

On the left hand side under pages you will find a link called 'Stem Cell Transplant'.  Here I have explained in detail what a stem cell transplant is all about.

Thursday, 20th November

This has been such a roller coaster week for us....

At the time of my last blog we were floating in the clouds because we had heard that the decision made by the panel of professionals was to go ahead with SCT (stem cell transplant) and then continue with chemo after.  We were hoping to get some news last Friday as to when the whole SCT process would begin.

I had resigned myself to the fact that we weren't really going to have a Christmas this year as Jimmy would be in isolation where only I can visit him and this would be every day for a minimum of 4 weeks.  This time period obviously depending on how he copes with the treatment.  We didn't hear anything on Friday so we were anxiously awaiting some news on Monday.  On Monday Jimmy phoned Ilhaam but she was on a course for the day so he tried again on Tuesday when he was told it was a 2 day course.  Of course he was eager to get hold of her on Wednesday morning for some news.  I told him that she would probably be catching up with work on Wednesday so hopefully we would get some news on Thursday.  He did speak to her on Wednesday and she said that she had forwarded the official approval from the medical aid to Prof but had not received any correspondence from him yet. 

On Thursday (this being yesterday) morning Jimmy phoned her again and she told him that she was still waiting for the 6 week plan from Prof but that he had discussed Jimmy's case with her very briefly last Friday and thought that it would be best to postpone the SCT to January due to all the holidays.  This was devastating news to both of us.  I can't even explain to you in words how this made me feel.  Jimmy finished his last cycle of chemo on the 20th of October so it is already just over a month of no treatment apart from his monthly Zobone (calcium) infusion.  If we wait till the beginning of January for SCT this means sitting at home for two and half months waiting and in the meantime no chemotherapy so what is happening to his cancer counts? Jimmy is desperate to get this behind him and return to work as soon as possible.  I tried to be strong but this was a huge blow.  It's very hard to be strong, stay positive and keep fighting this terrible disease when we feel like we are just puppets and have to go along with whichever string is being pulled.  I was completely devastated.

I decided that I would phone Ilhaam but wasn't sure of which course of action to take.  Jimmy and I both feel that we have not rocked the boat and not even once demanded to speak to Prof about anything.  So I decided to first phone the medical aid to find out what the norm for this sort of thing is over December.  My plan was that if it is possible to have SCT over December but not the norm that I would play the emotional part and beg that a plan be made.  If it is normal to have SCT treatment over December then I was going to go the whole 'this is unacceptable' route.  The information I was given is that it depends from hospital to hospital and the doctors make the decision.  I then phoned a dear friend who has good ties with these kind of procedures to ask her what she thought of this whole situation.  She explained that Prof is a very respected Oncologist and didn't think it would be a decision he would make lightly.  She explained that SCT is not a mickey mouse procedure and that hospitals do not work on a skeleton staff over the Christmas period but because so many staff are on leave they make use of agencies for temp staff.  There is the possibility that you could have one doctor doing the morning round and another one doing the afternoon round and she is sure that Prof would prefer to do the SCT when he feels confident that his own staff are there and available.  I did see the whole picture in a different light after this but still felt angry because they do SCT all the time and must have known some time ago that due the delay with the medical aid asking for another bone marrow biopsy it was pushing the procedure closer to Christmas and it would have been nice to have some communication from their side explaining that time is running out for this year and the reasons, instead of dropping this information that wasn't explained at all, like a bomb shell on us.

Jimmy and I both spent the rest of yesterday trying to get hold of Ilhaam or Dr Fine to get some answers.  Eventually Jimmy decided to send Ilhaam an email explaining his concerns at the delay from a medical point of view as well as from a work point of view.  He got hold of her later in the day and she said that she had forwarded his email to Dr Fine who would discuss it with Prof and they would come back to us.  Oh boy.....this waiting game is a killer.  I definitely have come to understand the term "when something eats at you like a cancer" !

Last night at about 11:30 we received an email personally written to us by Prof.  He explained that he understands our concern and Jimmy's need to end the period of 'sick leave' with regards to his work.  However, because the procedure requires first to harvest stem cells, which in itself takes 2-3 weeks, they would not be able to complete everything this year.  He explained that a SCT is a routine and effective treatment for patients with Multiple Myeloma. But it is also a heavy treatment which can lead to organ failure, eg kidneys or heart, that requires the assistance from other disciplines.  He has learned through experience that Christmas and New Year are a bad time for such therapies as if there were to be complications, most the people they rely on are on leave and then they all close for 2 weeks in January.  He said that he is happy that we harvest stem cells this year, but will have to postpone the transplant to mid January.

We are both happy with this decision, in light of the fact that there is nothing else than can be done.  Prof has basically met us half way by splitting the procedure in half, time-wise.  This means that Jimmy will go back to work a bit later that he anticipated next year (although it does still fall into the time frame that Prof advised in the medical report that was sent to Komatsu) but not as late as should the entire procedure have been postponed till mid January.  Another positive is that to stimulate stem cell growth prior to harvesting them, Jimmy will have to have a course of Neupogen injections for close on a week.  This is the same injections that I have been giving him to bring up his white blood cell count after each heavy dose of chemo.  In my opinion this would mean that his immunity would not be as compromised as it is now and we would possibly be able to do a few outings with the kids over the Christmas period.  Obviously everything would have to be in moderation as he does tire extremely quickly.

So....once again we have a plan in place and we can move forward.  Thanks again for all you messages of support yesterday.  Thanks to Mike, Kathy, Patsy and Maureen for lending me you ear, for the hugs and the much needed cup of coffee.  I bumped into Mike and burst into tears....for a man
you handled this very well Mike :) 

On a lighter note; Brad wrote his last matric exam on Tuesday, woohoo, and passed his learners licence yesterday.  Well done my boy.  The girls have 2 more exams each to write and then we are home free.

Wednesday, 19th November 2014

Isn't it weird how things work out?

Last night, sometime after our good news I told Jimmy, and Rohan and Patsy who had come to visit, that my throat was extremely sore.  I have been sneezing for the last few days and this is normally a good sign for me that something is brewing but I put it down to this awful south easterly wind that has been blowing a gale for days on end now.  And I did what I have been doing since Jimmy's diagnoses and took regular doses of Vitamin C powder.

This morning I woke up with my throat on fire and clammy skin.  I phoned straight away for a doctors appointment and have just come back from the chemist with a shopping bag full of medicine.  I have acute pharyngitis and a fever.  I can't believe it!  I haven't even had as much as a cold in the last almost 5 years.  And now, when it's the last thing I need, I get sick.  I told Dr Bell he needs to wave a magic wand as I cannot afford to get sick now.  Apart from infecting Jimmy, it means I can't take him to the clinic as I will put all the other cancer patients at risk and there is no way I can go anywhere near F4 isolation ward with a contagious ailment. He has given me Penicillin and I need to get an extra dose in during today and he said to sleep in a different room tonight and in 24 hours I shouldn't be contagious anymore.

I have given my body a good talking to.  I said "you have been fighting so hard at staying positive and getting through the hard days, been strong and not gotten sick up until now and this is not on!  You cannot let me down now, just before stem cell transplant". 

This actually sucks big time because all I want to do is give Jimmy hugs and kisses in light of our wonderful stem cell transplant news. 

You would not believe how big the smile on his face was yesterday when he came into our room to tell me that Mrs Viljoen has just phoned.  It is a memory I will never forget.

Thanks to each and everyone of you for all lovely messages, emails and phone calls.  We truly would never be able to walk this road without you. 

Your love and support has been our pillar of strength.

Tuesday, 18th November 2014

As you know Jimmy's motivation for stem cell transplant went in front of the committee today between 2pm and 4pm.  At 4pm Jimmy asked me if he should phone and find out if there is any news.  I told him I didn't think he would get through as I was sure they closed at 4pm.  Anyway, he tried and got no answer.

Not 5 minutes ago his cell phone rang and it was Mrs Viljoen from the medical aid to say that she thought she would phone and let us know that they had just got out the meeting and stem cell transplant has been approved.

STEM CELL TRANSPLANT HAS BEEN APPROVED

 

 

 

 

This is the same lady who organised the injections for us through the pharmacy at Panorama Hospital.  Nice to know that there are people who really care and not just doing their job.

 

She is going to let Ilhaam/ Prof Novitzky know in the morning and I will update again once we know more and when the whole 6 week process starts.

 

Thank you so much for all your prayers and positive thoughts.

 

 

And last but not least, wishing my Mom and Dad a happy 47th wedding anniversary today.

Monday, 17th November

The days and weeks have really been dragging....I constantly feel like we are living in limbo.

Since last I updated, the stem cell transplant motivation with Jimmy's bone marrow biopsy results have been re-submitted to the medical aid.  I had one of those gut feels on Friday and thought we were going to get some news but nothing.  Last night I got into bed and was thinking about the week ahead and it's as if a calm has come over me.  I know we will be getting an answer this week and a plan will be laid out for Jimmy.  I believe that the best decision will be made and we will be able to move forward and have some positive results.

While I am typing Jimmy phoned through to the medical aid and the motivation is going in front of the panel tomorrow afternoon from 2pm to 4pm.  Hopefully well have an answer on Wednesday morning.

The kids are all still busy with final exams so they were studying this weekend.  It was Shannon's 18th birthday on Saturday.  It makes it very difficult with Jimmy's blood counts being so low and the fact that we can't go out.  So Shan spent the day with her mom on Saturday and then on Saturday evening we booked a table at the Toad for the girls to go out for dinner and Shan had her first legal drink.  They ended up getting a group of friends together so I think it turned out alright and a good time was had.  We didn't end up seeing much of Shannon on her birthday and only had birthday cake on Sunday but we will have to make it up to all the kids next year on their birthdays when we can enjoy the outing together.

Technology is so amazing.  I have been following a blog called Julie's Myeloma and after months of just following I decided to comment on her post.  If you noticed the comment at the bottom of my blog last Monday you will see it is from Julie.  Amazing to think that we can become friends from two different ends of the world, have something so devastating in common and even more strange is that her husband's name is Jim.  Julie had her stem cell transplant in 2010.

Well, hopefully I will be back blogging on Wednesday with some important news...

Monday, 10th November

I'm just popping in for a quick visit....that's what it feels like when I am 'talking' to you all.

We heard from Ilhaam this morning that the medical aid have already come back and asked for a schedule of the costs involved for stem cell transplant.  She feels that this is a positive step as they haven't written off the idea completely and recommended another treatment yet.  She is busy with the paperwork now and is hoping to get a final answer from them by the end of the week.

It is amazing how you learn to live with and accept the daily stresses.  I know what I want the answer to be but it is almost like I am at peace this week and know that whatever decision is made, is being made by a panel of professional people and I need to trust them.

Today is my sister Debbie's birthday.  Sisters like you are only made for those who are lucky, fortunate and blessed like me.  On your special day, I wish that your life ahead brings as much joy as you have brought in my life until now.

Thursday, 6th November

The dreaded blog.....I have started this one quite a few times and given up.  I really look forward to the day that I have some supadupa news to share with you all.

We went through to the chemo clinic for Jimmy to have in monthly Zobone infusion (calcium to strengthen his bones) on Monday so that should he have a fall hopefully his bones have been strengthened enough that he won't experience a break.

I am very glad that the sun is out and the last few days have been warmer as Jimmy went for another walk around the block this morning.  He has been through a very down patch and with what took a lot of encouragement from my side he has been much better over the last 5 days or so.  He has been more talkative and made the odd cup of tea, just more in touch with me and what's going on around the house and it has been awesome.  It is so easy to just sit in the chair and do work and watch TV and not comment on much.

We got the results of the bone marrow biopsy and at long last the medical report from Prof Novistzky, which is needed by Komatsu.  It is not as good as we thought it would be.  His tumour burden has increased by a few percentages. From the results I can see, compared to the original readings in April, that it came down in July and has now increased to slightly more than it was when he was first diagnosed.  This is proof again that he has definitely hit a plateau, as is reported as failing to achieve VGPR which is 'very good partial remission'.  Prof has once again sent a motivation off to the medical aid as in his opinion Jimmy should have a stem cell transplant now and then some vigorous chemo post stem cell transplant and he is sure that his body will react better to the chemo post stem cell transplant.  The report basically says that he feels that we have a good chance that if the stem cell transplant is a success and he reacts well to the intensification of this treatment post stem cell transplant he will be able to resume some or all of his activities, depending on his rate of recovery, in about 6 months.

Now that I have become more familiar with all this cancer terminology I am quite astounded at just how bad Jimmy originally presented in April at the time of diagnosis. "Mr Smith presented with quite extensive features of multiple myeloma with advanced clinical manifestations including lytic lesions (these are the cancer tumours which were found in his skull, arms, legs, and ribs), anaemia, renal failure (he was admitted to hospital as kidney failure is life threatening) and hypercalcaemia (this is also life threatening due to unusually high doses of calcium found in the blood as a result of the cancer cells in the bone marrow)".

In just a little over a week we will be 7 months into this journey.  On reading the report yesterday my first reaction was that we have come no where in 7 months but when I go back and read his original diagnoses I realise how blessed we are.  It also reminds me how far Jimmy has actually come; from using a wheel chair to using a walking frame to going for a walk around the block.

Yesterday was very emotional for Jimmy and myself (although he doesn't like to show it) and I refuse to show it in front of him.  I felt that this cancer was winning the battle but this morning I feel blessed for how far he has come.  I feel positive that the decisions that will be made by Prof and the panel at the medical aid will be the right one and I look forward to moving onwards and upwards when we get an answer in about a week.

And I almost forgot.....Well done Loren on passing your drivers licence first time.  It was quite weird waving goodbye to Loren and Emma this morning in the driveway as they left for school together with Loren at the wheel. <3

Tuesday, 28th October

This morning the hospital phoned to say that the medical aid has requested that Jimmy have another bone marrow biopsy before they will consider the stem cell transplant.

A bone marrow biopsy is not sooooooo bad if you can prepare yourself for it and the pain.  This was quite unexpected so we dashed through for his 11:30 appointment.  They always give Jimmy Pethidine about 30 minutes before which definitely helps.  Shame, I think today was an eina one because I heard Jimmy moaning during the procedure.  Jimmy has been having Zobone infusions monthly for the last few months and Prof reckons they must be doing a good job at strengthening his bones.  Yay....a positive!

We should get the results of the bone marrow biopsy in about 10 working days after which Prof will submit his motivation for stem cell transplant again, with the bone marrow biopsy results.  I also asked today if Jimmy's last M protein results were back but they are also still waiting for these, so I will phone tomorrow at which time they can also give me the results of his full blood count today so that we have got an idea of where we stand with regard to his white and red blood counts.

Naturally my mind went into over analysing mode;  Is the fact that the medical aid requested a bone marrow biopsy a good thing or a bad thing?  It is a good thing because this and the M protein reading are both good markers as to how he is reacting to chemotherapy.  Better to rely on both than just one. But it also means that instead of going ahead with stem cell transplant things are now delayed for a minimum of 14 days.  The fact that the medical aid are asking for this means that a specialist at the medical aid is looking at Jimmy's results...I think this is a good thing because we are now not only relying on Prof Novitzky's opinion.  If there is no change in the cancer burden (bone marrow biopsy results) will they say he has to try another chemo first to see if it can bring down the numbers before he has stem cell transplant? And to be honest I could go on and on.....but why stress myself out about this when it is not in our control.

And in case you are wondering......yes, I did look at the calendar again and this does mean that if the medical aid give us the go ahead for stem cell transplant then Jimmy will be in F4 Isolation Ward over Christmas.  I hope UCTPAH has a chimney!

I thought I would add some photos to give you an idea of what a bone marrow biopsy entails.

Monday, 27th October

Another week has flown by...

We spent another weekend away camping, this time we stayed at Gaansbaai.  A lovely, no frills caravan park right on the beach front with nice grassed sites and lovely clean ablutions.  The wind was a bit hectic but from what I have heard it was just as bad at home.  My Mom and Dad joined us for the whole weekend and I can honestly say we came home feeling very rested and relaxed.  Thanks to my parents for a lovely weekend and to my darling husband for great company.

Our site right on the beach front at sunset



Jimmy and I were chatting over the weekend and I brought up how sometimes things are done for no real reason and then they make sense later on.  We went on holiday with Stan and Michelle at the beginning of January when we camped at Camdeboo National Park and Karroo National Park.  While we were there, Jimmy got a bee in his bonnet and decided that we wanted to sell our Bushwakka trailer and buy a 4x4 caravan.  We walked around the park and saw a really nice one, asked the owners if we could have a look at the layout etc and how they found it.  We got back from holiday and advertised the trailer which we sold and bought the caravan.  The strange thing is that if we hadn't sold the Bushwakka we would never be able to go camping now like we are with Jimmy being sick as there is no way I could set up camp by myself.  Jimmy would also not manage climbing up the ladder to where our bed was above the trailer.  I would never have been able to hitch up or unhitch the trailer by myself either.  And the nice thing about camping is that even though Jimmy's counts are low and his immunity is compromised we can go away for a few days and we are never near a crowd of people.  Even having breakfast in a B&B would be a problem if someone else in the dinning room is sick.  Unfortunately I think this will be the last time we can go away until next year as once the whole stem cell transplant process starts Jimmy will either be confined to home or in hospital.  But you never know.....maybe we are lucky and can just pop down to Imhoff Caravan Park in Kommetjie for a weekend at some stage.

We had quite a busy week at home having the alarm system seen to, the irrigation system repaired and all our trees trimmed.  I also spent some more time in the garden.  I've got my work cut out for me this week as there are 2 bakkie loads of wood chips in the driveway waiting to be spread in the garden beds.

We had some distressing news on Friday.  As you know Ilhaam sent off Prof Novitzky's motivation for Jimmy's stem cell transplant on Monday last week.  Well, on Friday she phoned to say that it had been turned down.  This was a huge shock and when I asked her if this was out of the ordinary she said that it was the first case of one being turned down since she has been Prof's PA. She re-assured me and said we must not panic.  The reason given was very medical and she did not know what it meant but has passed it on to Prof.  She says that Prof would never have motivated for stem cell transplant if he thought there was the slightest possibility that it would be turned down and that he will deal with it.  She seems to think that it is something that Prof would have to explain and further motivate.  So now we sit and wait again.  We don't know when he will be finished so that Ilhaam can re-submit and whenever this is we will probably have to wait a week for an answer.  It really is cutting things fine for having Jimmy home for Christmas.

We should, sometime this week, get Jimmy's last M protein reading back and I am keeping everything crossed that these have come down, even if just by a teeny weeny bit.

Monday, 20th October

I really have been slacking at keeping this blog up to date but waiting around for results and answers about what happens next and when doesn't leave much news to update on.

I have spent a couple of days over the last  2 weeks working in the garden and have also started a vegetable and herb garden.  I can't believe how my lettuce and tomatoes have grown in a week.

Jimmy had chemo on Thursday and his white blood counts had come up nicely after the Neupogen injections.  The chemo clinic has been very busy lately and it was the fourth time in a row that I waited in the lounge instead of sitting next to Jimmy.  They were so busy on Thursday that he actually lay down on one of the beds to have his chemo.  We discussed going away for the weekend as we have been itching to go camping with the warmer days that we have been having in Cape Town.  Funny how you definitely know when summer has arrived because the South Easter is blowing a gale.  We got home at 3pm and made the decision that we would go away for 2 or 3 days.  I packed the fridge and our clothes and we pulled out the driveway at 4.10pm.

We had a lovely chilled weekend at Onrus Caravan Park.  We got there quite late on Thursday so I just put of the awning and did the rest in the morning.  We had a good laugh because Jimmy can't really do much more that hold the tent poles while I hammered in the pegs and attached the guide ropes.  I also had to unhitch the van and do all the things that men normally do and we were convinced our neighbours thought that Jimmy had it totally waxed.  All that was missing was a beer in his hand while I set up camp! My Mom and Dad came through from Bredasdorp for the day on Saturday and it was so nice to see them again.  They have both had bad flu and bronchitis so it really has been a while since we have seen them.

Jimmy had his last session on chemo today.  And boy is this a nice feeling.  Unfortunately not for all the right reasons but it still feels good to know that going through twice a week will be a thing of the past for a while anyway.  I had got myself all ready to go and find out what is happening next and when.  We were a bit frustrated that they had gone ahead with the last cycle of chemo after Prof had said he was stopping chemo.  And then on course we didn't know if they would only start the motivation for stem cell transplant after this cycle or only once the next cancer count results come back.  I had my little speech all planned but we received some wonderful news instead.  Prof has in fact already done the motivation and Ilhaam was going to send it off to the medical aid today.  She said it has to go to the board and then in front of a panel and can take up to 2 weeks to get confirmation but she didn't think it would take this long for us because our medical aid works quite quickly with authorisations compared to most.  So we should hear in the next week or so.  Prof then gives us a typed up 6 week plan laying out exactly what happens when for stem cell transplant.  Ilhaam actually showed me what it looks like and on there is listed when the Neupogen injections are to be given to stimulate stem cell production and it also explains which days and for how long Jimmy will be in hospital before he actually goes into F4 (isolation) for the transplant.  This is basically the only period that they cannot predict as it is different for each patient.  It depends on how sick he is, the level of nausea, the level of diarrhoea and if he can stomach food etc etc

The clinic was very quiet today, only us and one other person so we were asking all the questions we could think about with regards to stem cell transplant.  Jimmy's white blood counts have dropped off a bit again but because he will not have any more chemo for now, Prof did not give us a script for any more Neupogen injections as without chemo his white blood counts should come up nicely on their own again.

So now we are looking at the calendar and if things start moving forward for stem cell transplant we really will be housebound from next weekend and are hoping Jimmy should come out of isolation around the 15th of December and be home for Christmas.  Of course we won't hold our breaths as there are endless possibilities for delays along the way.

Today is the start of matric final exams and Brad wrote CAT.  We wish him and all our friends whose children are writing matric everything of the best.  I think the month or so ahead is going to be a bit stressful for learners and parents alike.

Sunday, 12th October

Today's blog is long overdue as I know many of you must be wondering about Jimmy's M protein results.  I must apologise for this but my head has just not been in the right space.

Monday was rest day between chemo cycles and we were supposed to receive the results of the M proteins too.  I phoned a couple of times only to be told that some results had come through but not Jimmy's.  We woke up with knots in our stomachs and spent the whole day anxiously waiting for the results.  We went to bed saying that we couldn't believe we would have to wake up on Tuesday morning with the same feeling all over again.  And this is exactly what happened.  I phoned through to the clinic a couple of times but the results were still not in.  I eventually asked Olivia if she wouldn't mind please phoning us once the results are through as I know how busy they are and I hate phoning and interrupting them while they are giving chemo and bone marrow biopsies etc are being done.  By Tuesday night we still didn't have any results. I did not fall asleep for hours and the last time I looked at the time it was 4:23 am....just too much stuff going on in my head.

We finally got the results on Wednesday.  In spite of knowing there was the possibility that the cancer cell count will not have dropped it was still a huge shock.  It's hard to believe that after 3 cycles of the new chemo there was absolutely no change.

On Thursday morning I phoned the clinic just to make sure that we were not having chemo only to be told that Jimmy does have to do the last cycle.  Of course we were not expecting this and completely forgot that it was first treatment of the next cycle and he would be having Doxorubicin too so with us getting though later than normal it ended up being a long day.  We were a bit disappointed about doing the last cycle as Jimmy's white bloods had come up nicely after having a rest day on Monday and I knew that after the Doxorubicin on Thursday his blood counts would be going one way.  We have had the children here for the school holidays and feel bad that we have not been able to go out or do anything with them.  We were hoping to at least go out for a family dinner over this weekend but the red devil definitely put an end to any of these plans. 

I was talking to a friend about Jimmy having to do last cycle of chemo when Prof had said that if there was no change we would stop chemo and start the process for stem cell transplant.  She said that maybe be wants to do the last cycle because after 3 there has been no change and by doing the last cycle while all the paperwork gets done for stem cell transplant might mean that they are actually stopping the cancer cell count from going up and this does make sense.  The only problem now is that we don't know if he is starting the process now or if it will be after this last cycle.  The difference of course is that Jimmy will or will not be in isolation over Christmas. 

I have very mixed feelings over the results.  If there had been a decrease in the cancer cell count then Jimmy would have completed the 4th cycle of chemo and Prof was going to motivate for another 2 and then do stem cell transplant.  Remembering that the most important thing was to get the cancer cell reading as low as possible as this would mean a longer remission.  But because there has been no change we will be going ahead with stem cell transplant with a higher cancer cell reading. Jimmy will now more than likely have to continue with chemo after the transplant but there is a good chance that his body will react better to the chemo after stem cell transplant.  Unfortunately once he goes into remission this period will now be shorter.  I do know that the one thing Jimmy is feeling happy about is that he will probably be able to return to work in the new year.

Tomorrow the 4th term starts and this is always a hectic one.  Very little school time before the kids start preparing for final exams. And before we know it the term will be over and Christmas will be here.  What a year it has been.