Friday, August 14, 2009

Karmanos Cancer Center Evaluation

The photos you're seeing above are images of a place and a person we will be seeing a lot of in the next few months.

The first is of the Barbara Ann Karmanos Cancer Center in downtown Detroit where Gil will go for the transplant. The second is of Dr. Joseph Uberti, MD, PhD who is the Co-Director of the Bone Marrow Stem Cell Transplant Program at Karmanos and will be in charge of Gil's care.

The evaluation session today went smoothly and was pretty much what we had been led to expect. Everyone on the team is in agreement. Gil's leukemia requires a transplant to obtain a cure. The Karmanos team is recommending it as the preferred treatment and is proceeding on that basis.

A letter in support of a transplant as soon as possible will be sent by the physician team to the insurance company on Monday. Hoping that the bureaucratic red tape is kept to a minimum, it's "conceivable" that the transplant procedure could be scheduled in as soon as two weeks. The team wants to perform the transplant as soon as our insurance can approve it and before there is any chance for relapse back to the active disease.

The HLA typing results came back and Gil's sister, Genie (in California), is as perfect a match as could be hoped for. Apparently there is no such thing as a "perfect match" and there will be factors in her stem cells that will inevitably lead to host vs. graft (HVG) rejection issues. The team is hoping to keep them at a minimum with steroids and immunosuppressive drugs.

Apparently, there are 19 inpatient beds at the hospital for bone marrow patients. There is a track (?) that patients can use to walk on to stay conditioned and in shape as they undergo treatment and recovery. In-room refrigerators. Family members can stay with the patient for the entire stay if desired. I will stay with Gil at the hospital for the entire treatment period.

Once admitted, we've been told it will take up to ten days for the chemo to eliminate Gil's cancerous bone marrow cells. He will be allowed to recover for a few days and then receive an infusion of Genie's cells. Genie's cells should become productive within Gil's system within a week or so.

The attention from that time forward will be focused on keeping the rejection issues in check. That could mean an easy course of recovery or it could become life-threatening. We were told to be prepared for all possibilities from the best to the worst results. This is not a walk in the park.

The nurse coordinator who spent most of the day with us encouraged Gil to gain as much weight back and to be in the best physical shape possible before he comes back for the transplant.

Next steps:

We will hear from our nurse coordinator when the letter is sent to the insurance company. She will contact Genie to get the required test (CXR, EKG and blood work) results sent to Karmanos. Gil will need further testing to assure his underlying good health.

P.S. We are very carefully following the health care debate these days. Our lives are intricately tied to current coverage issues and we are so sympathetic to persons who are ill and who don't have insurance coverage.

P.P.S. Going off the air again until next Friday. In the meantime, it's calories in and lots of time spent working out for Gil.


Insurance pending
Could they possibly deny deserving?

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