BMT: Day 0 (Transplant Day)

The transplant began at 11.30am today. I was very excited when the lab technician took out the packet of cord blood (total of 50ml) from the liquid nitrogen tank because I got to see what I call "smoke" coming out of the tank. We were a bit nervous watching the nurse spike up the $40,000 packet of cord blood ... it didn't drop or leak - phew. The transplant took 15 minutes (like a blood transfusion through Mr Hickman) and it went relatively smoothly (according to the nurses), although I was in great discomfort. The moment the blood was infused into my body, I felt very cold, had a terrible headache and stomachache. I had diarrhea and puked up simultaneously during the transplant. Both ended up on my lovely new Ralph Lauren jacket which JJ and Eunkyung so kindly sent over from the US (it was helping to keep me warm). My heart rate dropped from my baseline of 110 to 60+ and my blood pressure doubled. The increase in blood pressure was due to the preservative used to keep the stem cells in the cord blood alive. I was also exhaling some "sweet stuff", which was caused by the nutrients given to the stem cells in the cord blood. My pee also has blood in it (looks like Ribena drink) but this is expected to stop in 1-2 days. These reactions are apparently very common and to be expected. I will be monitored closely until my blood pressure & heart rate return to normal. I am no longer bothered by all the wires they have hooked up to me. I have greater concerns.

I still have bad nausea. I refuse to eat and drink, which is a real worry for everyone because it has been 3 days since I stopped eating and that is not good for my gut. I hope my appetite comes back really soon. The doctors have ordered the nutrition bag (through IV) for me starting tomorrow, but I am still supposed to eat and drink to keep my stomach working properly. Otherwise, they will need to give me the feeding tube (through my nose), which I would like to avoid. But I just can't hold anything down despite all the anti-vomitting medicine. Hopefully, tomorrow.

Though the physical transplant procedure was a success, this is only the first step. My next target is to achieve engraftment (when the transplanted stem cells find their way into my empty bone marrow and start producing new healthy blood cells of all types). This usually takes three or more weeks. Meanwhile, my counts will be zero (or close to it), and so I am extremely vulnerable to infections. To help along the way, I will be given a number of prophylatic medications. I will also have to stay put in my special BMT hospital room for protective isolation.