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Monday 30 December 2013

The Allogeneic Bone Marrow Transplant

My Allogeneic Bone Marrow Transplant workup started on May (2012) when I had to be tested all around just to check that my body was in good shape for the chemotherapy, radiotherapy and finally the transplant.

All began with several doctors appointments and different tests: Blood Tests, TBI Planning, ECG,  Chest X-Ray, Gated Heart Pool Scan, Appointment with the Bone Marrow Transplant Coordinator, Dentist, Breathing Test, Gynaecologist, BMT Clinic Appointment, Social Worker Appointment, Skin Check, Overnight Urine Test, Allogeneic Bone Marrow Transplant Patient Education, and a Lumbar Puncture.

The protocol of my Transplant was a CY/TBI (Cyclosphosphamide/Total Body Irradiation) in I had to be admitted 6 days before the exact day of the transplant.

DAY -6: Commence anti nausea medication
DAY -5: Begin Ondansentron IV twice a day, Mesna IV over 30min, Mesna IV over 23.5hrs, Cyclophosphamide IV over an hour
DAY -4: Ondansentron, Begin Mesna Infusion, Cyclosphosphamide IV
DAY -3&-2: TBI Morning, TBI Afternoon
DAY -1: Commence Cyclosporin IV Infusion over 12 hrs, TBI Morning, TBI Afternoon
DAY 0: Cyclosporin (CSA) IV and 11:00am HAEMOPOIETIC PROGENITOR CELL INFUSION
DAY +1, +3, +6, +11: Methotrexate IV injection over 5 min
DAY +2, +4, +7, +12: Folinic Acid IV injection over 3 min

It was an exciting but quite scary process.

I definitely though it meant my cure but I learnt it was a very painful process.

Starting with a very high and strong dose of chemotherapy followed by total body irradiation (radiotherapy) was a very debilitating process although I never felt it right away but in the following days.

I didn't suffered the side effects I was so aware (not scared) of, didn't have the horrible nausea or the burns because of the radiation, so I thought that was the toughest part.

DAY 0 (7th June 2012) being the most important as I was to receive the New cells or the cell infusion I was very excited, but I couldn't see anything because I was sedated and blissfully sleeping. I didn't felt anything (good or bad) nothing at all.

When I woke up I was still the same, same feelings, skin and face... really nothing special happened.

The pain started a few days later and increased quickly I lost all the internal lining from the mouth (which swallowed a lot), trachea, stomach, guts, and all the rest. I had to be connected to a pump that constantly fed my with pain reliever, which made me hallucinate and I have a very few funny stories from that time.

I couldn't really eat it was a very painful exercise and I had to be fed trough IV but I tried to keep the stomach working a little bit by eating yogurt in the morning and ice cream the rest of the day.

With a lot of free time in my hands and not leaving the hospital room (because of the weakness) I started to do Sticky Mosaics (no one is paying me for this) and that kept me pretty entertained.

I believe this was the time I felt the loneliest and saddest of my whole treatment, because I was not regaining but loosing the little strength (and hair) that I had gained before this last process started. Before the transplant I have been in remission for quite a long time and the doctor stopped the chemotherapy for a bit so I could regain strength to face the transplant and I felt like ME again: strong, no more chemo brain, beautiful, hairy, and happy. I was home with my sister and husband and I could enjoy being alive again, so I believe that small amount of freedom before the transplant gave a sour taste when I was back in hospital.

I won't say it was a 'walk in the clouds' because loosing all your internal lining is pretty painful and being in a state in which is preferable not being among a lot of people is lonely. But I convinced myself this was the last time I was going to be admitted in a hospital and had to be content with it.

I completely decorated my room with my colourful mosaics and that helped me start conversations with my usual visitors: nurses, cleaners, doctors, anaesthesiologists, x-ray people, cleaners, food people, my sister and hubby.

By the end of the almost five weeks that this process lasted I made myself eat out of bed (almost) every time or at least in the morning (when I had more energy), walk to the toilet,  shower and get dressed by myself, I must confess it was easier to wait until someone (usually my sister) came to visit me and expect them to help me, but I had to follow a routine every day by myself otherwise if no one came in to visit I had really nothing to do.

allogeneic bone marrow transplant leukaemia ALL australia positive story
Myself the very first day hospitalised 

allogeneic bone marrow transplant leukaemia ALL australia positive story
Myself the very first day hospitalised
I couldn't really talk to my neighbour (next door room) because if I was awake he was Neutropenic or very sick and when he was up and about I was heavily sedated so that friendship never flourished.

Little by little I started to feel better, the pain was easing and I didn't feel I need to use so much pain killers, and I was told to pushed myself to eat a little bit more so I could be out of IV food. Eating only liquid at the beginning the Nutritionist kept an eye on me every day (energy levels, weight, and amour of food taken) and finally I could be disconnected of my pain killers pump and the IV food.

When I started swallowing pills again was very weird sensation but I felt really happy to be normal again, being able to swallow food and pills was like learning to walk for a baby. My lips and mouth were not that soared so I started to regain control of them and use them.

By making small steps I was feeling better more energised and ready to go home, when I got the news that I was free to leave the hospital I was so happy I cried (a lot).

Since that day I never been in a hospital room again, I am home... sleeping in my bed, creating my new routine, and finally regaining my strength to feel alive again!

Every day I thank (the universe, God, whatever you want to call it) that I am alive, that I had a second chance and I won't take my life for granted never again. I make a very long list every morning and every night about what I am thankful for, starting from every working piece of my body and ending with anything that is making a sound around my house. There is so much to be thankful for, and every day I will remember it and say it out loud.

Friday 23 August 2013

How to live with a Chemotherapy Portable Pump at Home

We got home. I felt mixed feelings... I was happy because I was going to sleep on my bed along with my husband and I was very scared because I had no longer the nurses to look after me and my health 24/7 and that was a big change at the beginning.

I went home with the Hickman's line on my chest and my sister was trained by the nurses to clean it every day. After every shower she had to lift the adhesive and clean underneath, it wasn't painful but at the beginning it feels weird.

We had to follow strict times for the medicines and keep checking my temperature in case of a fever as I was neutropenic most of the time. Being neutropenic all the time means no close contact to any human beings  or animals, have everything cleaned and disinfected to the maximum as one do not have any defences at all to fight a virus or any disease. So you have to change the bed sheets after 2 days, use towels just once, have all surfaces sterilised and clean methodically, at the end I assure you will be obsessed with cleanliness around you.

I had to go to daily check ups at the hospital and spent almost the whole day receiving treatment, between the blood test, chemotherapy and weekly change of buns of the Hickman's line, the days stroll. Sometimes I needed blood transfusion that meant: stay the whole day until 3 or 4 pm at the hospital. Which was very hard on my sister and husband who came with me every day for treatment and most of the time felt sleep on my side. I was probably on a comfy bed or a lazy chair and my heart fell for them.

Going to hospital every day was at times exhausting, getting out of bed very early, swallow breakfast in order to take a bunch of pills and then drive trough the streets of Brisbane to get in time. My husband had to skip work every single day a few hours just to drive us (my sister and I) to the hospital and the go back to work to finish the shift. Not easy at all. But I won an Easter Raffle and went home with a lot of chokies (chocolates), rabbits and a beautiful basket, I was so happy when I saw my name on the prize that I almost cried.
easter basket, prize, raffle, hospital, leukaemia, philadelphia positive
And the Winner is... Barbara Maffei

easter basket, prize, raffle, hospital, leukaemia, philadelphia positive
I was so happy! I totally saw myself winning when I bought the tickets

I don't remember any downside of having a pump any than having a shower with it. I could sleep comfortably (usually at 6 or 6.30pm I was out...sleeping), watch TV, do my nails. I saw it as something I needed to be alive not as a bad thing, most of like a little companion.

In the afternoons I watched a LOT of movies most of them animations, I really love them so I had time to catch up on old movies and comedies I never saw.

Actually I don't remember all I did quite clearly, my husband says I used to space out a lot and fall sleep all the time. I was just happy to be home with my family, eating home made food, watching funny things and doing my nails using only bright colours.
nails, bright colours, chemotherapy, chair, hands, leukaemia, philadelphia positive
My Sister's and my Nails, perfectly done by her :)

I kept eating my food as it was a medicine so that wasn't a big issue just another task I had to complete during the day. Although my sweet tooth helped me to keep indulging on Tim Tams and other things like yummy doughnuts.

I started to re-read the book You Can Heal Your Life (Louise Hays) and actually doing the affirmations gave so much strength and happiness. Before that I never realise how many things I had to be happy for or to be grateful of, that was a big eye opener for me at that time.

I kept all my affirmations from that time and read them from time to time and that gives me hope and a lot of happiness.

Experiencing a life threading illness is a tough reality and I found no use to think: Why me? Why us? On the contrary I just keep thinking about what tomorrow held for me and my family. What would I do when everything was over and dusted, like going for walks at the mall or meeting my friends. Always have faith and it doesn't matter which religion o God you adore but to have blind faith on getting better and be really strong to keep it together.

Enjoy the little things. Think of what really makes YOU happy and go and do it. I enjoy watching TV and movies that really makes me happy and it didn't require much energy and gave me really positive ideas and thoughts to concentrate on. Like all those Disney movies hold a message and I kept thinking on them when I was lying in bed or having dinner.
nails, bright colours, chemotherapy, chair, hands, leukaemia, philadelphia positive, friends
Having friends over is often very good for your soul, so you don't feel isolated
I know I already said in a previous post I didn't see drama movies or depressing documentaries, it might sound like taking it to an extreme but that worked for me, I never felt depressed or really sad during treatment at home. I didn't do the finances at home during difficult times, luckily my husband took care of everything. But I personally find that stressing so I didn't want to do anything with that. I concentrated on the good things happening to me at that precise moment (mainly daily events) and that is my little advise when your future is not that clear, concentrate on NOW, the future doesn't exists yet.

See you on the next post and remember to Love Yourself with All You Heart and Enjoy the Little Things!

Tuesday 2 July 2013

My life in Hospital: How I decided to have my head shaved

Even though I do not remember the exact date, after two weeks of having chemo I noticed that I was losing my hair, I found strains of hair on my pillow every morning and it wasn't that bad but before it became a nightmare I decided to let go of my hair. One morning I talked to a nurse about shaving my head, and she called Adam. He came in with scissors and a shaving machine, I took the decision by myself, and I told no one of my family or friends, that idea just snapped on my head one morning.

He started to cut my hair, and I remember the scissors couldn't do the job because I had so much, so it took a lot of time. He gave a pixie cut like Mia Farrow’s hair, but as I run my hands through my scalp I could feel the hair falling on my hands… so I decided to have it really short or ‘0’. He kept saying like: “It’s a big change… are you sure? Aren't you going to cry or get depressed?” And I was like: “Don't worry keep going I know where I'm going”. The truth is that I really didn't had an idea of what it felt to have NO HAIR, and personally I felt like being nude and cold all the time.

My Shaved Head Hair Nohair Cancer Leukaemia Barbara Maffei
My Shaved Head

The first days in the shower I usually forgot and several times tried to shampoo my (non existent) hair, and I also tried to touch it, comb it, it was like a phantom limb feeling, that’s how I can put it.

One big thing about not having hair was that I discovered that I had a really good looking scalp! I loved my head. Every night I put cream on my scalp and gave me massages, I enjoyed that part very much. And the cream helped me to loosen the few hairs I still had attached to the skin.

My Shaved Head Cancer Leukaemia Barbara Maffei
My Shaved Head
And I received one of the very big news in a long time, my little sister was heading to Brisbane to help me (and in the future she became my stem cell donor).

I was very happy on the countdown to see my sister, after two years of being on Australia I was desperate to see her. The day she came into my room was the first day I remember I cried a lot out of happiness and excitement.

My Shaved Head Cancer Leukaemia Rosagabriella Barbara Maffei
My Sister, Rosagabriella and I at the Patients Lounge

collage Cancer Leukaemia Barbara Maffei
A Collage... my first
In the meantime I distracted myself on the crafting group of the Hospital, every Wednesday I was there, sitting on the Patients Lounge waiting to have fun, talk to my fellow neighbors and create something different. I manage to do this beautiful collage on picture. It was done by a beautiful human being a volunteer, I don't remember his name (I will find out and update the post), but he helped us all doing the crafts, he used to carry all (paints, magazines, glue, beads, strings) with him 
and teach us how to create beautiful pieces of art. He used to also handover tea and cookies in the meanwhile. I remember him as an Angel. My crafty Angel.


morning afternoon tea menu food cancer leukaemia hospital
Morning and Afternoon Tea Menu at the Hospital
On regards of the food and my appetite. I decided to give it a chance to all the food on my weekly Menu, I simply choose to eat different foods every day, and make it as I was taking pills or having medicines in the shape of food. I made a commitment to myself to not lose my appetite and eat all I had on the plate, sometimes it was simply too much and I couldn't clean the plate but I did my best not to lose any weight. As I said on the beginning of the Blog I didn't focus on the side effects of the treatment, and I didn't get almost any nausea or vomiting as a result of the chemotherapy. I remember that when my friends used to visit me they bring me a bag of cookies from a French Patisserie: Le BoinChoix, I used to love them! Yam.

I used to order salads for dinner, always soup if they were available, and I couldn't miss the dessert for anything in the world, every afternoon tea was I little bit naughty with the sweets... I can't stop myself I have a sweet tooth. I enjoyed discovering Australian sweets and desserts, like scones and cream I will always remember that.

On late February commenced the second cycle of chemotherapy, this cycle was stronger and meaner than the previous one, this involved 2 separate lumbar punctures for administration of the intrathecal chemotherapy (the one that goes into the brain), and 4 days of chemotherapy infusing continuously. That's how I got the chemobrain! 

By the end of February I was free to go home with a big bag of medication, a long list of daily visits for more chemotherapy at the RBWH, a double Lumen Hickman's line on my right side of the chest, and a brain that wasn't on its best. I got home to St. Lucia (Brisbane) along with my sister and husband, it took them a great effort to take care of me 24x7 and they did it good, I can't complain, I am so thankful to them.

Friday 21 June 2013

The First Hospitalization and Chemotherapy Started

I was hospitalized on the room 27 of the 5th floor of the Royal Brisbane Women Hospital (RBWH) on the Oncology area, specifically on the 5C Ward. On and individual room that normally was used for patients who had received a (stem cell) transplant, so all my fellow neighbors (patients) asked me about my ‘transplant’ and how was it going. I never understood why they kept asking me these questions about my ongoing ‘transplant’ until a nurse explained to me what was happening.

rbwh brisbane leukaemia ward 5c all ph+ chemotherapy
Royal Brisbane and Women's Hospital - My second home for a long time

My Star
I really liked my room, my good friends bought me two beautiful balloons (a star and a smiley) and they kept me company. I had a beautiful view of a big, big tree which was really green and leafy, I wasn't feeling that bad so I never realized that I was ‘that’ sick and why was everyone so worried.

First thing in the morning the doctor ordered a Bone Marrow Aspiration (BMA) to establish the type and details of the disease.

That very same night I had a meeting with Doctor Kirk Morris (MBBS, FRACP, FRCPA Senior Medical Officer, Clinical and Laboratory Haematology from the RBWH) in charge of my case and his registrars, it was a really big bunch of people in my little room. He said after all the blood tests I was diagnosed with  Acute Lymphoblastic Leukaemia or ALL, that was an acute type of leukaemia and they had to act really fast or it will kill me, later I will be needing a stem cell transplant (from a sibling or a stranger), but at that point the doctor said it was pointless to discuss that matter, all I was thinking was: "All my siblings are in Venezuela – South America, what am I going to do?"
My Smiley

He brought to my room a few consentment pages for me to sign, he said that it was my choice to start the chemotherapy or I would probably die in three (03) days without it. I didn't ever thought about not taking the  chemo or other procedures, and sign immediately all that was given to me.
My doctor is a really sensible person, he always told me the truth from the beginning in a very good way and I felt from day 1 I was in good hands. We spoke about the side effects of the treatment, such as: hair loss (very scary for me), fertility (I lost it completely after all the treatments), amount of possible cycles of chemo, rounds of chemo, appetite loss (which I never suffered really bad), the vomiting, fatigue and having chemo brain (which is being confused and forget things all the time), those are the main side effect I remember. 

The nurses brought more paperwork to be signed: I needed a Hickman's line...ok I signed everything and was carried to radiology to install it. The procedure wasn't painful the first few days I felt it in my sleep but after a week it was part of me.

iv pump machine leukaemia all ph+ story positive
IV Pump Machine or Wall-e for me
I got hooked to an IV pump machine I used to call wall-e like the robot in the Disney movie, and from now on I will refer to it as wall-e (my perpetual companion). Since I could barely move being attached to wall-e 24 hours a day, I had the love of my beautiful, compassionate, good (and all the adjectives you can imagine) FRIENDS who helped me: bath, change, comb my hair, everything I couldn't do because of my new attachment. I will always be grateful to 
them and they will always have a special place in my heart.


One of my friends (Marilyn G.) took my PJ's everyday and wash them and bring me beautiful clean clothes every morning. She was my angel!

The 9th february the first cycle of chemotherapy started, the aim of treatment is to destroy leukaemic cells and induce a remission. This means that there is no evidence of leukaemic cells in the blood and bone marrow and that normal blood cell production and blood counts are restored. 

After further analysis of the Bone Marrow Test, Dr. Morris explained they had found another characteristic of the Leukaemia, a particular genetic abnormality found in my leukaemic cells, called the Philadelphia (Ph) chromosome, so I was not just Leukaemia ALL but ALL Ph+, so I started a new drug called: Glivec (imatinib mesylate).

All the days happened quickly, or that's what I remember, it is nowadays a mixture of memories and I'm writing all this with the help of another set of eyes (my husband's) because is not clear for me. 

The doctor explained the course of medicines, procedures, duration, side effects (again... I couldn't hear them, I ignored them all the time) I was going to receive and the chemotherapy started right away after he left the room.

I thought it was going to be painful (I was scared) or something like that... it wasn't, maybe a metallic aftertaste in your mouth but nothing more. Because, I personally believe chemotherapy was associated with pain, skinny persons, gray skin, pale faces and no hair (remember Philadelphia? the movie, I know it was about Aids but something like that... scary), so i immediately imagine myself ageing when the nurse injected me with the first cycle. None of that happened.

I was inundated with information, dates, values of blood cells, and a lot of books and booklets about the chemotherapy and Leukaemia and choose NOT to read a thing, nothing, I refused to read secondary effects, or anything related to the disease I preferred to listen to what the doctors had to say that was the best choice and follow their advice. Instead, my husband was reading everything he could and asking all the questions.

At that time, I decided to close all my social media networks, I couldn't deal with the fact of explaining everything infinite times. I even didn't want to talk on the phone and hear people (even my closest family) crying, now that I look back I think I was in denial, I never felt sick, yes, weakened but never gravely ill.

I firmly believe that helped me, I focus on the bright side of the walk, reading, watching TV, talking and enjoying my friends, making new friends on the patient lounge. I really convinced myself those were vacations, because I was in a perfectly clean and beautiful place, I had a room for myself (which is a very rare case in a public hospital), I was alive, I could: walk, talk, smile. And started to live being grateful of every little details I noticed around me, like the 'good morning' of the first nurse I talked in the morning until the 'good night' I received from the lady in charge of delivering the food (to my room, yes! I had room service with a Menu... by the way). So, I felt very grateful to be treated in a good health system, with beautiful doctors, lovely nurses and I even found a really good friend who spoke spanish like me: Maria (she was the cleaner of the ward). And I focused on not letting anything to take away that happiness I found around me.

I think my hubby, friends and family thought I was becoming crazy in a hospital, receiving chemotherapy, suffering a life threatening ill, and being happy (not all the time) but most of the times.

I used to talk to myself when I was becoming sad and felt like crying and used to say what my mom (Ingrid G.) says: "Tears don't solve anything" and that helped me to keep going.

I was going to the patients lounge every moment I could, I was feeling energetic and fine, I joked my friends who visited me every day and also took turns not to leave alone at anytime, God I am so blessed to found them here on the other side of the world. And not having any more family than my husband that was a big relief not feeling alone.

After a few weeks I started to notice that I was the only patient on the floor who had long (I mean really long hair). My fellow neighbors had really short o no hair at all. That made feel so guilty and ashamed, I really don't understand why… but that’s how I felt at the moment. It was so hard to wash my hair at the hospital, I was hooked to wall-e, and I didn't have any conditioner (just a liquid soap to wash yourself completely), combs or scrunchies, for me at that moment that was a BIG thing… my beautiful long HAIR. I was so superfluous at that time.


I started to colouring children's books when I was alone in the room to keep me distracted or to focus on something colorful, beautiful and different that the hospital environment and that helped me to construct a routine. I felt so happy when I finished every draw, I remember all the nurses used to joke with me about it, and that was good too... I had another reason to laugh and make them laugh. That was my personal happy time. I also use to carry them with me to the patients lounge and draw while watching tv or sipping a cup of tea, enjoying my 'vacation'.

All the personnel at the hospital (the nurses, doctors, registrars, cleaners and general staff) were so kind to me and also my friends, I could never complain about anything.

Monday 17 June 2013

Diagnosis: Leukaemia ALL Ph+ on 7 February 2012 and happy birthday to Barbara

Believing that I had a gallbladder issue, due to a continuous pain I have been suffering for more than a month, I ended on the emergency room (again).

For me it was a routine visit related to a gallbladder pain, I thought: maybe I will get some painkillers through the vein and then go back home... tomorrow I'll go to work, etc, etc... But this time the night before I had fever and the nurse explained to me that they needed a blood sample.

The results were back and the Doctor asked my husband to come and sit, I noticed he was really serious and stiff and told us the results were abnormal, that something in my blood was somewhat strange, I only had 7 platelets and almost no blood cells of any kind. I felt the doctor was really scared, more than me, but he always told us the truth from the beginning which was very different approach from what I was accustomed (being born and raised in Venezuela – South America).

venezuela south america leukaemia all ph+
Venezuela my country of origin
I was in a private hospital with no insurance, so the doctor suggested to be transferred to the Royal Women Brisbane Hospital, the biggest and advanced hospital of Brisbane and a cancer investigation centre. After a few minutes the paramedics arrived and took me to this hospital in an ambulance (I have never been in an ambulance before), we waited to be admitted at the emergency about two hours it was almost dawn by now.
In all this time my friends took turns with Oscar (my husband) to stay with me and keep me company, I never felt alone but I was really scared, I trembled like a leaf... they thought I was cold but I wasn't.

I was admitted… Oscar filled up a lot of paperwork by my bedside and he usually answered questions for me, I was just trembling and thinking.

On the emergency room I was seeing and observing everything around, you are in a bed on a ‘room’ made from curtains and all is clean, organized and you could say: pretty and sterile.

I remember the doctor that attended me had beautiful red hair and was a Canadian, always stayed with us and never left my side. She said more blood test will be needed but they were certain that I had some kind of cancer blood.

So, I had to have a blood transfusion, the first of my life, the doctor sat with us chatting and checking my vital signs all the time just in case I had some reaction to the blood. Nothing weird happened.

Of course she asked us why we decided to move permanently to Australia (I imagine getting us distracted from the whole thing) and she told us why she moved from Canada to Australia as well.

Nurses came in, they needed another blood sample, they keep doing tests, I had a platelets transfusion as well, for each process a bunch of doctors came in and I had to sign consent forms for everything, I really lost count about all the papers I signed since I came in that night.

The morning came, I certainly didn't sleep at all, and Oscar stood there with me in a really small and uncomfortable chair.

At one moment I remember I told my husband: "It's ok, all is going to be fine, don't worry"

Since that day the 7 of February of 2012, three days after mi 31th Birthday, I did not left the hospital until four and a half weeks later.

I am reciting every day

All is Good in my Life

I am beautiful

I am open to new and exciting experiences the Universe offers me