silveryscrape (silveryscrape) wrote,
silveryscrape
silveryscrape

Martin Klimas. Brilliant.




(ps. I <3 Warren Ellis.)





Also art.







Lots to say about Manband, but not enough caffeine in my system. Love Chris, L.O.V.E. Rich Cronin, believe there will be a season 2, based on how truncated this bunch of eps felt.

Holy crap, I did not realize Rich was only 200 or so days out from a match unrelated transplant when he did this show. That's like... he is so amazing. Okay, let me turn on the coffee maker. I want to talk about Rich.

Here's the thing. I was all prepared to be sad for him, because Acute Myelogenous Leukemia is one of the scariest diagnoses you can face. Depending on cytogenetics and subtypes and response to treatment and all that kind of stuff, most people die within two or three years of diagnosis, and it's not an easy road.

You get the phone call; you go to the hospital IMMEDIATELY, because most likely like Rich you have 1/3rd the blood you need, or else you have so many fucked up white blood cells that you might have a stroke at any moment. Xrays, CT scans, MRIs. Bone marrow biopsy, which is a test in which the doc bores into your hip bone from the back or your sternum in order to suck out some bone marrow, to check the status of your leukemia. Lumbar puncture, in which you lean over a table while the doc pokes into the space around your spinal cord to suck out some CSF, to see if the leukemia is in your central nervous system. You will get a central line, an IV catheter which terminates right outside your heart. Chemo for a week straight, a 24/7 continuous drip of poison into your body, with the hopes that the poison will kill the cancer faster than it kills you.

Your hair falls out, your blood counts plummet. Transfusions of blood and platelets. Your heart may be damaged. Nausea, mouth sores, diarrhea. Possible neurological toxicities, which show up as confusion, loss of balance, tremors. Fevers, rashes, dizziness. Shortness of breath. Bleeding. EXTREME boredom, stuck in the hospital for weeks on end. Insomnia from the round-the-clock medications, blood draws, tests. Fear, uncertainty. Grief.

Then two weeks later, you get another bone marrow biopsy, to see if the chemo worked. If not, you start the whole thing again.

If it worked, or mostly worked, and you are relatively ok, no extreme side effects from the chemo, no infections, and your blood counts are good enough that you won't get too many infections outside the hospital, you go home. There, you can look at your bills and call your job, if you still have one, because it's probably been 6 weeks. You won't be able to work, most likely, depending on what your job is - you'll be too exhausted, and you really shouldn't be around people too much. Hopefully, you have someone who can help you live, like clean and cook for you and help you get around. You'll have to go to clinic pretty often, to get your blood drawn for tests and get your line cared for and to get checked out. Lots of pills to take, antibiotics, anti-nausea meds. Pepcid. Maybe opiates, for pain.

After that you'll get more chemo every month, probably for at least four months. Most likely you'll be in the hospital on other occasions during this time, for infections, which can kill you outright, or for other symptoms, depending on your response to the chemo and the nature of your original disease. Also during this time, you will have a consult with a bone marrow transplant center, because your only chance for a durable cure, depending on the cytogenetics, subtypes, etc., is transplant. They will want to type your family members, even the lost ones or the ones you don't speak to. If none of your family matches you, they will turn to the National Marrow Donor Program. Hopefully someone out there in the world is a match. Hopefully you stay in remission long enough to find out. 70% of people with AML relapse. You will never be able to stop thinking about this.

If you find a donor, if this person meets criteria and agrees to donate, you get to check back into the hospital for a month, maybe more. You'll say hi to all the nurses you remember from last time, and maybe to some fellow patients or family members you know from clinic. You know to bring books and movies, your music, your own pillow, an egg crate mattress. Your caregiver brings a cot. You're getting pretty good at this.

You might be enrolled in a research study, but that's okay - you probably were for your induction and consolidation chemos in the first place. We're very big on studies in oncology. Depending on the study, you will start your chemo immediately. You will learn to count the days from your admission down to Day 0. You will learn that Day 0 is your new birthday. You get your new stem cells on Day 0. You might cry.

After that you count up. Day +1, Day +2. Because you're an "allo," meaning you received an allogeneic transplant from someone else, rather than your own autologous cells, you are monitored very closely. Temps and blood pressures every four hours. People asking you the same questions over and over. Any diarrhea yet? Any spots on your skin? Chills, tremors, dizziness? Anything at all? You know what the big questions are, which no one can answer right away. Will the stem cells engraft? Will they work? You also know the other questions, the scary ones. Will they fight my leukemia? Will they fight me?

You are on immune suppressants, just like someone who has a kidney transplant. But in this case, it's not because your body might reject the new part; it's because the new part might reject your body. If that happens, your skin might slough off, or your guts fill with lesions. Your liver might stop functioning correctly. And because you got a donation from someone you're not related to, the chance of these things happening is high. You will be watched closely for clues and signs. You will be watching, too. You've learned to wonder about every twitch, every twinge. The least little thing can mean devastation. You know that now.

By Day +200, you're long out of the hospital, but you're probably still on immune suppressants, maybe tapering down off them by now. Still, your immune system is like that of a baby and you get sick easily. You're tired a lot. You still have to check in with the doc pretty often, and no doubt you get yelled at for the lifestyle, for the new project. It's okay; you know what's important now. Never going to forget.

You still have a pretty high chance of relapsing.



And that's... you know, Rich Cronin seems like the most loving, grounded person. Watching the show yesterday, I was so impressed with his sense of humor, his willingness to support the other guys, his dedication to the project. Did you see in the finale how Dr. E said, "We finally got you into clinic"? Yeah, Dr. E was cool about it, as he always is, but I heard the message, and I know Rich did too. Holy CRAP man, you had your transplant when?? And you're hanging around a shmillion strangers all breathing on you and touching you, in a strange place with strange bacteria and fungi, doing a job where sleep is considered a luxury? You crazy. And yet, he has every right reason in the world to do what he's doing, and no bitterness over his lot, only gratitude for the chance to live. Omg I love him so much. Plus, fucker is funny.

So, uh. Wow! I wrote you a book. Sry. Just, yeah, that was my old Medical Director in the finale, and my friend Erin drawing Rich's blood and going over his counts with him. Yay, Dr. E! Yay, Erin! And I really meant this entry to be an ode to CK's REALLY ANNOYING passive aggressive sarcasm, which gave me like 968039 trickC bunnies, and also his ass, which is, indeed, fine. But I guess that'll have to wait. It's 3:30 and I'd better eat breakfast. :P
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