Simple blessings...

As I sit at home this afternoon, I'm thankful for so many simple things, simple gifts that God has graciously provided. My family is currently making a bit of a commute each Sunday for worship, but we're finding we enjoy the time together in the car, as well as a lovely drive through the countryside. And we're certainly thankful for the opportunity to fellowship with friends old and new before and after such a God-exalting worship service. All of these things are simple, yet precious.

I'm linking up to

 

Tim and Michele's story {a video}

As I mentioned in this post, part of Michele's day at the Fisher house last Saturday included an interview. Today, which happens to be her birthday, her mom received a copy of the final video. Tony did a great job of editing a day's worth of video and interviews into a wonderful, but brief, story.




It was such a special day -- so glad we were there to share it!

Bone Marrow Transplant FAQs {or, I'm married to a stem cell stud}

My stem cell stud!

As we've approached the time for Jeff to donate bone marrow for Michele's transplant, many folks have asked what would be involved. Will Jeff be put to sleep? How do they extract the marrow? How will this affect Jeff? Jeff and I are the type of people who take a "less is more" approach to medical knowledge, but we've found this process to be really interesting. Of course, it's all personal with us, too, as we stand in awe that something as elemental to the body as stem cells can be removed from Jeff and placed in his sister in hopes of rebuilding her immune system.

Here are some answers to some of the questions we've been asked. I'll try not to get too graphic (mainly because I might get lightheaded, causing my laptop to fall onto the hard hospital linoleum) while giving as much info as I can.

Why does Michele need a bone marrow transplant?

Michele & Jeff pre-transplant

About a year ago, Michele was diagnosed with aplastic anemia. In itself, this compromises the immune system; combined with other conditions Michele has, it presented major challenges for her immune system. Earlier this year, doctors found that the aplastic anemia had progressed to MDS, which would most likely lead to leukemia. Essentially, Michele is no longer producing white blood cells. Her immune system is basically non-existent, but doctors are hopeful that a successful stem cell transplant will provide her the ability to produce new, healthy bone marrow, as well as providing a brand new immune system. 

How was Jeff selected as the donor?

Michele's two brothers both went through two rounds of blood testing to determine whether or not they were a match. Amazingly, both Jeff and Kevin were identified as 100% matches. The doctors ultimately selected Jeff.

Where will the transplant process take place?

Michele has been so blessed to be accepted into a protocol at the National Institutes of Health in Bethesda, Maryland. NIH offers her a team of specialists working together to help with each of her issues as they prepare her for the transplant process. Because of Michele's compromised immune system, she was already dealing with infection issues when she arrived. She was immediately admitted, with the team working around the clock to identify and treat each infection. Michele is not only the beneficiary of years of research done here at NIH, but other patients will benefit from the research protocol that Michele is a part of. And all
of this care has been provided at no charge to Michele.

As part of the donor process, Jeff has traveled to NIH twice: once for more screening and testing, and again for the actual donation. Again, this is done at no charge to Jeff or Michele, with some of the travel expenses even reimbursed.

How has Jeff prepared for the donation process?

First of all, he has tried to stay well. Michele's husband, Tim, consistently reminded Jeff to "Keep that blood healthy!" Second, for five days up to and including donation day, Jeff has taken injections of Neupogen to stimulate bone marrow and stem cell production. He had the option of going to the hospital to receive the injections (two shots once each day), or we could learn how to give them ourselves. Because it's quite a commute to NIH from where we are staying, we bit the bullet and learned how to do it. Additionally, he's tried to stay very hydrated.

How is the bone marrow obtained for transplant?

The apheresis machine.

This is one of the best things about being at NIH. Rather than being put to sleep and extracting the marrow by needle directly from the hip bone, Jeff went through apheresis. This is a process of filtering the blood; blood is removed from one arm (similar to a simple blood donation), run through a machine to remove the stem cells, with the remaining blood products returned to his other arm. As they return the blood, they also give the donor citrate (to lessen clotting) and calcium (to counter the effects of the citrate), as well as saline (for hydration). Quite a little cocktail flowing in!

Color matching during filtering process

After 45 minutes to an hour of prep, the actual apheresis process can take up to six hours, with the possibility of going through it all again the next day if the minimum amount is not collected. The doctor stopped by after only two hours and said that Jeff had produced about twice the normal amount of bone marrow. In fact, he said that we could actually stop apheresis then and have enough, but he wanted to keep the process going for a couple more hours to have enough for multiple transplants, if needed. The doctor originally calculated that 25 liters of  blood would need to be filtered in order to obtain the required amount of stem cells; only 15 liters were actually filtered. All of this is an amazing answer to prayer!

A nurse told Jeff he had very pretty cells!

At the end of the process, Jeff lost the equivalent of a pint of blood, and all of his blood products are naturally replenished within 24-48 hours. The side effects from the Neupogen shot begin diminishing within that time period and should be gone within two weeks.

How will Michele receive the transplant?

Michele will undergo chemotherapy and radiation for seven days beginning Memorial Day. She'll have a day to rest on June 4, and will receive the transplant on June 5, right in her hospital room. Following the transplant, she'll still need to receive transfusions for several weeks until her bone marrow begins producing. At some point within the first two weeks following the transplant, Jeff will come back to NIH to go through apheresis again, this time to donate granulocytes, a type of white blood cell that is integral to the immune system.

It's been amazing to be cheering from the sidelines through this process. We have confidence in God's sovereignty in all things; we are so blessed to, in this instance, see how His hand has orchestrated so many things to bring all of this together at the right time. He has been gracious to provide so many blessings along the way -- even Christian nurses (which, we've been told, can be rare at NIH).

We are so thankful that the Lord has answered so many prayers. Thank you to those of you who have been praying for Tim and Michele. Please continue to pray that Michele's new immune system will grow strong within her body, but not so strong that it will recognize her organs as foreign... it's a fine line. And may God receive glory in all that happens.

Washington DC, the sequel

Our second trip to Washington DC (for Jeff to donate stem cells for his sister) has been full of surprises. The first surprise presented itself even before we arrived in DC. If you know me at all, you know that I love Mexican food. Imagine my surprise at finding one of my favorite restaurants from out West -- Abuelo's -- in Roanoke, Virginia, and right at dinner time! Just a little thing, but nice!

 On Tuesday afternoon, we headed downtown to try to visit one of the many free museums. I use the term free loosely here; the high price of parking definitely offsets free admission. Thankfully, the Air and Space Museum was open longer that day, and we stayed through closing. Jeff and Jared were especially excited to be just a few feet from vintage aircraft they had only read about.

After the museum (and after dark), we wandered down to the Washington Monument...

and the Vietnam War Memorial Wall...

and the Lincoln Memorial.

We wrapped up the evening with food from the best Five Guys Burgers and Fries we've ever enjoyed.

Wednesday was spent up at NIH, as Jeff signed his consent forms and we took the kids up to visit with their Uncle Tim and Aunt Michele. Michele was up for a walk about then, so we did a couple of laps around the floor before finding a place to sit and visit.

Thursday was the beginning of the donor process for Jeff, as we reported to Apheresis at NIH to donate leukocytes (white blood cells). These will be held for Michele in case they are needed after the bone marrow transplant. After prep, the process took about three hours and required Jeff to keep his left arm still and straight the whole time. I thought Jeff did really well, and the Lord was so good to provide us with a Christian nurse. Once he was released from apheresis, we reported to the clinic to broaden our horizons. A sweet Bulgarian nurse taught us how to give Jeff injections of neupogen. This is the medicine they call "The G"; it stimulates Jeff's bone marrow production to provide more stem cells for donation. Once the injection process was explained, we decided it would be simpler for me to give Jeff the injections than for him to inject himself. Because the dose is so large, I'm actually giving him two shots each morning. Talk about a stretch! It takes both of us to get through all of the steps and keep things sterile (and we're both the types to basically pass out at the sight of blood and/or needles), but we're getting it done. (Aren't you glad I didn't include any pictures here?)

We were pleasantly surprised to learn that the Andrews AFB Air Show was scheduled for this weekend, with a special day for military families on Friday. Mom and Dad took us to the flight line where we enjoyed seeing more vintage and modern aircraft, as well as watching some amazing aerial feats. The highlight of the day had to be Blue Angels demonstration -- absolutely amazing!

The best surprise of the week was learning that Michele would have an eight-hour pass to leave NIH and come to the Fisher House on Saturday. A couple of military journalists scheduled a video interview with Tim and Michele (and a brief cameo appearance by Jeff). Tony and Stacy were very kind and spent most of the day with us as we shared a family cookout and watched the Blue Angels again, this time from the front porch of the Fisher House. However, before lunch, Colonel Rizer (Wing Commander for Andrews AFB) came by the pick up Tim, Michele, and Jeff to visit the Fisher House airplane which had just arrived for the air show. After introductions, he invited the rest of us to come along, too. Jared joined the others in "the white top", while AnnaKate and I followed along in our little CRV. It was fun to follow along as the Colonel drove with sirens wailing -- all traffic stopped to let us pass, and we saw some very snappy salutes. He drove us right out to the flight line, right in the middle of the crowd, right up to the airplane. The base photographers were waiting for us and began snapping pictures immediately. Passersby took note and began taking pictures, as well! Afterward, when Colonel Rizer returned us to the Fisher House, he presented both Michele and Jeff with his Commander's Coin.

It was a very special day, and we are so thankful to have spent it with Michele. but the days ahead are full of challenges. Michele still has hurdles to overcome as she prepares for the transplant process. Tim faces the daily challenges of faithfully caring for Michele and working with the doctors to manage her care. Jeff faces challenges over the next several days of injections, side effects, and the five to eight hour stem cell donation process. And Mom and Dad have the challenge of walking alongside Tim in caring for Michele while facing health issues of their own. I hope you'll join me in praying for them all in this process. As Michele's doctor so wisely put it, we can do everything right in the transplant process, but in the end it's up to God. Amen.

Washington DC and a reminder...

Jeff and I have enjoyed a whirlwind trip to Washington DC the last few days... probably me more than him. (After all, this trip has really been all about him being poked and prodded to be sure he can donate stem cells to his sister.)

 After arriving in the wee hours Sunday morning, we did a trial run to NIH, just to be sure we could find it before we had to fight our way there through rush hour traffic on Monday morning. Later that afternoon, we enjoyed a driving tour through downtown Washington (that's what we're calling our search for a parking spot). I saw some amazing architecture and was able to snap a few shots from the car window.

We finally found the perfect place to park on the mall, and the Washington Monument was happy to serve as our marker to help us find our way back. You can see that beauty from just about anywhere! The Secret Service officers were very friendly and helpful, answering our questions which ranged from "Can we park here?" (the answer was "no") to "Are there any public bathrooms around here?" (another "no") to "Has that woman really camped across the street from the White House for the past thirty years?" (unbelievably, it was "yes" to that one, but she still has not achieved world peace).

After parking, we wandered around by foot, just enjoying the lovely spring day. Just people watching in DC is a cultural experience. We didn't try any of the local food (read that "street cart") this trip.

I figured  Jeff should get a picture of me in front of the White House... after all, I've been helping to pay the mortgage on it for years!

The bank that holds our money that makes those mortgage payments is conveniently (and attractively) located just around the corner...

This is the closest we got to the Capitol building.

We spent all day yesterday and much of today at NIH, getting clearance for Jeff to donate stem cells for his sister's transplant. When we finished up today, we visited with Tim and Michele in her hospital room for a bit. Michele's medical team is working hard to determine the cause of her fever and the swelling under her eye -- they really are the best. Then we headed back to the Fisher House at Andrews AFB, our home away from home, to rest and get ready for the long trip back tomorrow. We can't wait for our next trip -- we'll be able to share the city with the kids and complete the transplant donation!

To learn more about Michele's transplant and how you can help, please read my post about Shopping for Shelly. And please spread the word by sharing the link via Facebook, Twitter, email -- however you communicate with your friends and family! Bloggers, my sweet daughter even helped me make a blog button that you can share on your blog. (Just cut and paste the code.) Thanks!