Some Starters on Team Janna

Today is Day -1 and Andy Rasmussen, Janna's oldest brother, being the lucky match for Janna's transplant, is in the hospital today to start the marrow transplant process.  It started for Andy this Sunday with daily shots in the stomach, and he had endured quite a bit of pain throughout the week as the shot concoction forced his marrow to go into overdrive and produce stem cells.  Andy is now in the hospital hooked up to a fancy machine that will filter out the stem cells from his blood and put everything else back in to his bloodstream.

They say that at times, the recipient can take on traits of the donor (hair color, blood type, etc.).  It could very well be that in a few months, Janna becomes an avid BYU football fan and has multiple strong opinions on politics.  :)

Thanks Andy!

A Good Day

I want it on record that today was a good day. Cory spent the night with me last night, my sister brought my kids to see me, my appetite was good and I kept all my food down, my other sister came to visit, a dear, longtime friend I haven't seen since we moved to Virginia came to visit, my spirits are good today, no chemo or radiation...a good day, friends. In fact, I'm feeling overwhelmingly loved, supported, and blessed. The blessings of all this outweigh the trial. And I will look back on this post in the tough days ahead when I don't feel that way. :) But, for today, I feel very blessed and very grateful.

Last Radiation Treatment - EVER!

As of this afternoon around 5:10pm, Janna is forever finished with her radiation treatments!  All she has left is one chemo treatment tomorrow, then the transplant will take place this Friday.  Every day gets us a little closer to putting this all behind us.

The radiation treatments were pretty tough.  They have started to sap her energy and keeping food down isn't easy.  But, the docs chose this treatment because of her type of AML.  We noticed that everyone's treatment seems to be a little different and we asked why some AML patients get mainly chemo and others get radiation.  The doc explained that because of the tumor that Janna had, and because of where it was (outside of the bone and near her optical nerve), they chose to give her radiation since it can penetrate every bone in her body, including bones and areas in the central nervous system.  Apparently some chemo treatments can never enter the nervous system, and if the tumor was close to the nervous system, they don't want to take any chances.  They want to make sure they get all of it, and radiation is the only way to ensure that.  These doses of radiation would be fatal without a transplant, which is scary to think about, but it has to be done.

Stole this from Janna's sister Ali - Janna, Clara and Gabriel, at the hospital today visiting together in the lobby.

She is doing relatively well, all things considered.  She is tired, often nauseous, but is walking regularly and riding her stationary bike in her room.  She is also not yet hooked up to an IV, which is unusual, but welcome since she doesn't want to be tied down.  She can be off of the IV for now because she drinks a LOT of water every day, so staying hydrated has been easy for her to do so far.  When she receives her chemo treatment tomorrow (Tuesday), she'll have to be hooked up, since it does a number on the kidneys.  Speaking of her chemo treatment - tomorrow is the LAST day she'll ever have to receive chemo (at least that's the plan), so we're planning on celebrating somehow.

Thanks again for all the prayers and well wishes - they are much appreciated!

Day -7

Janna was admitted to the hospital today.  She started the day off with full body irradiation this morning around 8:30am and then got to decorate her room! 

Last April, a friend of Janna's organized a service project and sent Janna over 1000 paper cranes - we decided to bring some with us to help improve the room's ambiance.

Overall it's been a pretty good day.  Having to say goodbye to the kids this morning was tough, and we understand that there are many tough days ahead, but we'll get through it.  The boys (and Clara) can come and visit until her immune system disappears, which should happen in the next few days.  And skype/facetime seems to work OK, so she won't be completely separate from the world.  

Today is Day minus 7, next Friday will be Day 0, and hopefully she'll be released from the hospital somewhere around Day 19 or 20.

BMT 101

My survivor jewelry!  My nephew Alex (a cancer survivor himself) made me the braided bracelet, and my mom (with Lucas's input) ordered the "Team Janna" bracelets.  Makes a girl feel loved. 

 A lot of you have asked or may be wondering what this whole bone marrow transplant process entails.  This is how we understand it...

I will officially begin this process this Friday (August 9).  I arrive at the hospital at 8:00 for my first total body radiation treatment.  Friday is day -7.  I will have four days of total body radiation twice a day, a day of chemo, two days of rest, then the infusion of my brother's stem cells on Day 0 (August 16).  Andy will begin his shots on Day -5 (Sunday) to spur his bone marrow production.  They will start collection next Thursday, in which his blood will be drawn, the stem cells that were created in his bone marrow and spilled over into his blood will be filtered out, then the remaining blood will go back to him.  This may take 2 days to get all that they need.  Those stem cells are then given to me through my central line just like a blood transfusion.  

The amount of radiation and chemo I will be given are to (1) destroy any remaining leukemia cells, and (2) destroy my bone marrow to make room for Andy's.  Without a transplant, my bone marrow wouldn't recover and I wouldn't survive.  

After the stem cells are infused, we wait.  While I am treated for and recover from the side effects of chemo and radiation, I'll receive blood transfusions as we wait for Andy's cells to make their way into my marrow and start making new blood cells.  I'll be neutropenic at this point, as my white blood cells (and red blood cells and platelets) will be completely wiped out, leaving me without an immune system. They will know engraftment (Andy's cells have begun producing new blood cells in my marrow) has happened once my white blood cell count reaches a certain level, usually 2-4 weeks after infusion.  I'll be able to go home when my white blood cell count stays stable for 3 days, and I meet several other stipulations (no infections, eating 1/3 of my daily caloric needs, etc.).  I will continue to be closely monitored for the first 100 days, which are the most critical. During this period, I will be on immunosuppressive drugs to prevent GVHD (graft versus host disease).  Because we are replacing my immune system with my brother's, there is the possibility that Andy's cells (graft) could recognize my body as foreign (host) and attack.  It is necessary, then, to suppress my immune system to avoid this as much as possible.  There is always a risk of GVHD...but it is a  necessary risk, as the benefit of the GVL (graft versus leukemia) effect outweighs the risk.  So, while Andy's immune system may fight my body, it will also fight the leukemia.  Hopefully I can experience minimal GVHD symptoms.  

Even when I'm out of the hospital, then, I will still have to take many precautions to avoid getting an infection my body can't fight.  I also have to stay within 30 minutes of the transplant center for the first 100 days.  Cory and the older boys will return to Virginia for work and school at the end of this month, while me and the babies stay here at least through Day 100 (November 22).  At that point, I will continue to be monitored by my oncologist in DC, and will wean off the immunosuppressive drugs over 6 months.

Those are the basic facts.  As far as our feelings about all this?  That's for another post. :)

Thank you for your love, support, and prayers.  

Quick Update

Just a quick update to Janna's short post last Friday - we're still planning on her being admitted this Thursday and she will start a seven-day regiment of radiation and chemo treatments.  Full body radiation will be for four days, twice a day, then she'll have one day of chemo, then a day break, then the seventh day will be "Day Zero".  She will be in the hospital between 25 and 35 days (most likely), although what they consider to be Day Zero will be on the 7th day of her being in the hospital.  It's around Day 19-25 that she will be able to leave the hospital and begin the ~75 day waiting period.  Around Day 100, she will be able to return to VA (at least we assume this is the case right now).

I Guess We're Really Doing This

I started my final pre-transplant work-ups today, and will continue them into early next week.  I will most likely be admitted to the hospital next Thursday, August 8, to begin the process.  So, we're going to enjoy a really great weekend.