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.

Myself the very first day hospitalised 

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.

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.

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 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.