Once More unto the Breach, Dear Friends...

Dr. Saad Jamshed. If anyone ever tells you that you need to give a marrow sample, tell them, "I want it done by Dr. Saad Jamshed!"

The whole experience today was positive; every single Georgetown Hospital employee with whom I had contact was professional and very friendly, including Maurice, an orderly on his lunch break who took the time to lead me through a maze of passageways to make sure I ended up at the right check-in counter. I could even forgive him for being a Cowboys fan.

I had three procedures done today in preparation for next week's kick-off of my trial participation: a bone marrow aspiration, an EKG, and a CAT scan. These were all courtesy of the trial. There's a lot I want to cover, so I may break it out in a couple of different blog entries.

Back to Dr. Jamshed. Dr. Jamshed is the principal investigator on the clinical trial of which I am now an official member, and the guy that did a great job with my marrow draw today. My first meeting today was with him and Damiet Smit, the trial coordinator we met on our last visit to Lombardi.

I will admit to a great deal of anxiety heading into the appointment. I was telling my "inner child" all the things that I imagined I would be telling Robbie in a similar situation. I was focusing on the fact that this momentary pain was worth the information it would provide. That it would only hurt for a few minutes. That it wouldn't hurt that bad. That if I was brave, I could get a toy afterwards. My inner child wasn't buying any of it.

I was brought back to a procedure room, where I got the chance to snoop a little before the Dr. Saad and Damiet showed up. There on the counter was my old friend, the Charles Manson Autograph Model XXL Marrow Extraction Bayonet with its attractive blue T-handle (see actual photo above). Scarier, there--lying next to the bayonet--was a sharpened length of pipe in a plastic bag labled "Spinal Needle". Fabulous! A SPINAL needle. Sweat begins to bead on my brow.

Dr. Saad and Damiet made their entrance. Before we did anything else, I initialed the 19 pages of the clinical trial consent form (which I must get around to reading one of these days) and signed a couple of more places. It was more like signing for a mortgage than a medical release, but at least it delayed my impending impalement.

The marrow extraction couldn't have gone more smoothly--even the lidocaine shots were less painful than my first experience. After I'd stripped down, donned the attractive hospital gown, and assumed a face down position on the table provided, Dr. Saad proceeded with the procedure, explaining what he was doing all along. He numbed the skin, then after a short wait numbed the bone. He made a small incision with a scapel at the point of entry, the better to reduce bruising and swelling. Dr. Saad is not a big guy, and apparently I have very healthy bones (his comment), because he had a bit a struggle to penetrate my pelvis--I think he was using a rubber mallet to drive the needle into my bone. But penetrate he did, and carried away a couple of vials of marrow, along with a chunk of bone needed for analysis. All this was done with little to no discomfort. Afterwards, I was given an ice pack to lie on and left alone with my thoughts for about 15 minutes.

The spinal needle? Turns out that's for people "over 400 pounds"--glad I lost the weight.

Damiet and Dr. Saad came back and started handing me perscriptions for drugs, procedures, and more tests--I came away with seven different perscription sheets. I start Chemo on Monday, and the first session apparently can take up to twelve hours, as they watch to see how your body handles the drugs. These are powerful drugs that start killing cancer cells immediately and in great number. These dead and dying cancer cells then leave in their wake toxins that the body has to handle. Different people handle them different ways: some people get the shakes, get itchy reactions, and other exciting side effects (besides the usual nausea and fatigue). Given the extent of my involvement, I'm also a candidate for something called "Tumor Lysis Syndrome", and as such will be taking the drug Allopurinol starting on Saturday and continuing for 14 days. I'll also be taking anti-viral (Acyclovir) and antibiotic (Bactrim) for the duration of my Chemo. I also have a script for an anti-nausea drug, should that be needed. Whew. Enough for now.

I'll tell you about the rest of the visit over the next couple of days, including the surprise I got at the CAT scan station, but it was all fairly anti-climatic after the marrow draw.

One last thought--as I wandered through the labyrinth that is Georgetown University Hospital, I was struck again and again just how lucky I really am. I saw people with real problems. I learned that the scariest word in a hospital is "pediatric", as in "pediatric oncology" and "pediatric sedation" and "pediatric haemotology". I wandered past the Major Trauma department, where I caught glimpses through swinging doors of paramedics and nurses trying to save an accident victim. I saw families sleeping in chairs, waiting for loved ones to come out of surgery. I talked to a lady whose 11-year-old son (he looked a lot like what I think Robbie will look like in six years) was going in for yet another CAT scan. In the grand scheme of things, I don't have it bad at all.

Enough pathos for now. More tomorrow on the today's trip. Monday starts the real fun.

Also, a big "hello and welcome" to my brother-in-law, Sean. He's the devilishly handsome guy whose picture now graces the "Friends" section. Hey, Sean! Don't know if I'll make the family reunion this year, but next year for sure.