Stem Cell Collection

I am proud to say that along with my cancer co-pilots Craig, Mom and Dad, I made it through the first Smilow Cancer Hospital adventure. We found the right parking garage, navigated the elevators, the infusion check-in area, the lobby, the surgical floor of the main hospital and most importantly, I found where they sell Starbucks coffee. Over the past three days we got quite a tour of the place and became very familiar with it after a run of long days there. The great part is that we didn't have to navigate it alone. I have my own personal nurse/tour guide/organizer/personal assistant/appointment booker/patient advocate named Kathryn. I know already that she will be a God send throughout this process. She is Smilow's Autologous Stem Cell Transplant coordinator and wow, does she have it together. She whisked us around, explained everything and kept me on tract.

I have to say that the facility is beautiful. The main lobby boasts comfy black leather furniture, a water wall, beautiful contemporary artwork and even a piano that plays itself (and I understand they also feature guest pianists). Everything is open, airy and bright.

The medical oncology area is broken up into different pods. Each pod has four patient areas within it that are separated by half-walls with fogged glass and curtains that you can pull closed to separate yourself from the patient across from you if you choose. The rooms have huge windows so – I imagine anyway – that there is lots of natural light when it's not as gray and rainy as it had been during my time there, though it was calming to watch the rain drops stream down the windows. Each patient area has it's own moveable flat-screen TV, chairs for visitors and a recliner that even has a heating option to keep patient's buns warm, plus an overhead radiant heat option. The room's color pallete is pale yellows and spring greens and the floors are wood laminate so overall, you don't feel like you're at a hospital. And, they even offer you warm terry cloth blankets that come directly out of a heater. Volunteers come around to see if you want a drink or snacks and the IV poles are sleek and slim. It is very evident that this is a brand new facility. In fact, they've only been on the floor for five weeks so the nurses are still getting used to the space. The apheresis unit where I was on Tuesday had only been open for a week.

My mom, Craig and I arrived on Monday morning eager to start the stem cell collection process. After morning blood work came back it was determined that I needed some blood transfusions before I could start the collection. My platelets had dipped too low and with a deficiency there is worry for excessive bleeding as without enough platelets, my blood could not clot efficiently. My red blood cells and hematocrit were also very low - they dipped lower than they ever have. This left me very anemic, weak and lethargic. It explained the naps that I had needed in the days previous. The drop in counts wasn't at all unexpected - this is what happens after the ICE chemo (and what is also hopefully happening to the cancer cells).

I have never received a blood transfusion in my life and had no idea what to expect. Let me tell you, I never would have thought that platelets are yellow or that I could have an allergic reaction to the blood cells because of something the donor ate that day. I had several nurses throughout the day, and luckily each were very happy to answer all of our questions and were able to put me at ease about the whole process. It was mostly Sunshine, a young nurse with a cute Victoria Beckham haircut, blue fingernails, a quick wit and blunt nature who took care of me. She was straightforward and funny – and liked to pick on Craig. We hit it off immediately.

I received the platelet transfusion first. The bag was hung and the blood cells were sent in through my port. They gave me pre-meds of Tylenol and Benadryl anticipating any kind of reaction I might have. I didn't feel anything as it entered my body - just woozy from the Benadryl, which I don't do very well with, especially on an empty stomach. I hadn't eaten since the night before and wasn't allowed to until it was determined whether I would need to go through a catheter placement procedure. The transfusion took close to two hours. During that time I also received another Neupogen shot. The nurse (not Sunshine) sent the meds into my arm painfully slowly trying to avoid it burning but it made it a lot worse and I was left with a big 'ol bruise.

The PCA, Wade, kept us entertained through much of the day. He is a spunky little guy, always cracking jokes and has a very obvious passion for his job. For example, yesterday he told me that I have the "vital signs of a pimply faced teenager." The day before he brought over a deck of cards and performed a trick for me. On day one he brought us over a list of their DVD collection and would pop over to check where we were in The Truman Show. I drifted in and out of sleep in the heated recliner under my cozy blanket until the last yellow cell dripped in.

Then it was down to the apheresis floor where I would get my stem cells collected. At this point, we had gotten the results back from the lab saying that my CD-34 indicator was 20, meaning that I had plenty of stem cells to be able to collect - great news. We'd first have to have the apheresis nurses look at my veins to determine if they were useable. Otherwise, I'd have to get a catheter placed in addition to the red blood cell transfusion.

The nurse, Winsome ("You Winsome you lose some" she said as she introduced herself) gave me a stress ball and started examining the action. I squeezed that sucker with all my might, but to no avail. She needed a big vein to work with as the apheresis machine pulls and inserts blood at a great velocity and a skinny vein wouldn't be able to handle it – never mind one that was full of scar tissue.

"Sorry hun," she said. "Great white blood cell count, but not so great veins."

She assured me that it would be better in the long run because with the Quinton catheter would allow me to have my arms free during the process and I wouldn't have to worry about holding still for four hours at a clip. Whatever, all I could think was that this meant yet another surgery, yet another scar. And, more time without eating. I don't do well when my blood sugar is low - ask my husband.

It was off to surgery in the Interventional Radiology area of Yale New Haven Hospital. At this point it was already nearly 2pm and chances of actually being able to collect stem cells that day were slim to none. Oh, and did I mention that my stomach was still grumbling? I forced Craig to give me a piece of gum even though I wasn't even supposed to drink anything because I was so dehydrated and weak I couldn't take it. I sucked all the sugar and the one calorie out of that watermelon mint Trident like it was my job.

I had to change into a familiar hospital johnny but was allowed to keep my pants on – always a plus! Suddenly I got very itchy and noticed hives starting to creep up. This was something that I was told to immediately alert a nurse about as it could be a reaction to the platelets. One on my arm ... one on my chin ... one on my forehead ... the back of my neck. The pre-op nurses were concerned and had to call back over to Smilow. More and more time passed before I got clearance to proceed as the hives faded.

I was extremely wary about the idea of having a cathether inserted into my neck and turns out, my nerves were justified. It was right up there with my first bone marrow biopsy as one of the most unpleasant experiences of this entire bout with cancer. It was just plain awful.

I was told that 90% of people do it without sedation so I thought, what the hell? If old people and little kids can get through it, so can I. Well, it wasn't easy. I was laid out on the surgery table and they placed draping over my head so that I had about a six inch window of light and fresh air.

"Are you claustrophobic?" They asked. "No, thank God," I thought, as this would be a claustrophobic's nightmare.

While under my tent of sterile draping they cleaned and sanitized a huge area at the right base of my neck prepping it to be sliced open. I kept my iPod playing in my left ear hoping that it would calm me and that it would drown out some of the sounds of what was happening. However, that didn't really work as everything took place so close to my right ear.

The surgery fellow who performed the procedure was extremely kind and friendly though he kept calling me "Ma'am," which I know is supposed to be respectful, but it made me feel old. I didn't have the energy to request another salutation. He stuck a needle into my skin several times in several areas to numb it all up. Similar to when a dentist slides a needle into your gum before a tooth extraction – and equally as pleasant. Then, once my neck was numb, he would talk me through what was going to happen so that I'd know when to expect a "pinch" or "pressure". The "pinches" came when he sliced open my skin over the vein, then again when he stuck in yet another needle in two different places to sew in the sutures. Even though it was numb, I could feel my skin being pulled along with the fiber as if it were a torn shirt being mended. The "pressure" came when he was jamming the plastic cathether down into my right interior jugular vein. It was kind of like sticking two straws into your vein. Sick, I tell you. I could hear the length of the cathether tubing being pushed down into my vein as it ran alongside my right ear. A quick whipping noise akin to reeling in a fishing line, but thicker.

"We've just got to widen up your vein here," he said as the second tube went down beside the first.

It took everything in my being to remain calm, to keep my head turned to the left, to keep breathing and not freak out. I knew that if I moved I'd risk him slicing my jugular – you know, what Jack Bauer does to torture people with a slow, painful, blood oozing death. I gripped my mala beads and moved around the circle: "one bead, one breath," as my boss, Garret, told me to do. It relaxed me immensely and I would focus on my tense neck and try to release the muscles as best I could while Jack Johnson island tunes played in my ear and I visualized myself being anywhere but on that cold, steel table.

Luckily, the whole crew who performed the procedure were very cool and very laid back. All men - so there was a lot of talk about funny, raunchy movies. We talked a lot about Rocky - well, as much as I could through my little tent, about music, about Reggae. This helped to keep me at least mildly sane.

After about an hour it was all over. All I could think about was getting something to eat. At this point I was seeing stars as all I had in me were drugs and I was loopy from the strength it took to make it through that placement.

Now after 3 p.m., I was wheeled into post-op where Craig was waiting. When he asked me how it went, all I could muster was "I got through it and that's all I can say right now." I got teary even thinking about trying to explain it and had no desire to even know what this new outgrowth of my neck looked like.

The nurse brought over a boxed lunch and it might as well have been foie gras tossed in caviar with a truffle sprinkle. I devoured that chicken salad croissant sandwich with abandon. It was the most delicious thing I had ever tasted, though at that point, even elementary school cafeteria brand meatloaf would have been melt-in-my-mouth luxurious. My headache faded and my shakes stopped.

Half-way through my sandwich Kathryn was back to get me for the red blood cell transfusion. I had to ask her for some time. I needed to get dressed, to eat, to breathe. It had been such a long day. We'd been at Smilow since 7 a.m. She gave me 20 minutes before I had to be back up on the medical oncology unit. I chewed and breathed and got my bearings back.

We reconnected with my mom who had been waiting patiently in the lobby and were back to the heated recliner in a different pod this time. These nurses were not happy to see that I was there for a transfusion that late in the day. They certainly did not want to stay past their shift. I was so tired that I had no strength to feel offended. But my mom and Kathryn took care of that, ensuring that no, my blood bag would not be taken down at 5 p.m. and that there would be a late nurse there to care for me.

It was more Tylenol and more Benadryl then one unit of red blood cells. Kathryn told me that after the effects of these transfusions set in I would feel like a demi-God the next day and then a super hero when I received another unit the following day. I did not believe it at the time that's for sure as I felt like a slug that had been shriveled on concrete after a punky kid dumped salt on me.

It was 5:45 p.m. and finally the IV beeped that the transfusion was over. Sunshine came and took my temp - 100.2. She was just as upset as I was knowing that this was not good. I begged that they didn't have to keep me. Luckily, it was cleared that I could go home with instructions to take my temp that night again before bed. If I spiked a fever I had to call the on-call fellow and would likely have to come back to Yale.

On the more than one-hour drive home in the rain all I wanted was pepperoni pizza. I have not eaten pepperoni in years. My dad obliged when we called him from the car and by the time we arrived home, there he was at my house with a piping hot one from Little City.

As tired as I was, it was hard to sleep with the two prongs sticking out of my neck and the worry that if I turned the wrong way, the whole catheter would yank out. I think both Craig and I slept with one eye open. But good news was that I was fever-less.

On Tuesday it was back to Yale and with all the pre-work that was done on Monday, it was finally time to actually collect my stem cells (after a transfusion of one more unit of red blood cells). On this day, morning blood work showed that my CD-34 indicator had risen from 20 to 103 overnight. This was a great sign and showed promise that I would easily have enough to collect in likely just one day on the machine.

My nurse was Winsome, the same woman who had examined my veins the day before, a wickedly smart woman with an easy and contagious laugh and a musical Caribbean accent. She answered myriad questions that Craig and I asked with well explained answers and gave us a much greater understanding of how the whole process worked. She also had fun teasing Craig (it seems all the nurses do), worried that he wouldn't be able to handle all the blood and the set-up as he kept getting all smily and giggling. She jokingly threatened to kick him out for fear of him making me nervous. But she quickly learned that Craig is always smiling and laughing – that's just how he rolls. And that he has a deep fascination of all the gadgets, needles, tubes, dressings, drugs involved in all of this.

After she got me all hooked up to the apheresis machine, she said from that point on it would be like watching paint dry. To us, it was fascinating. And, I got two blankets out of the warming oven, plus another delicious boxed lunch on the house. Just as Kathryn said, I did feel like a demi-God with so much more energy from the transfusions.

Turns out, the CD-34 predictor was right. In just four hours, they were able to collect from me 12 million stem cells to be frozen for my later use. This is much more than I'll even need, which is 7.5-10 million, to have enough to recover from the chemo. I was so relieved and feel confident that this is a sign of more good things to come from this whole stem cell transplant process.

Yesterday, it was back to Yale, but this time I was excited because I was going there to get the Quinton catheter taken out. The doctor took me into a private room and with lots of disinfecting ointment, a clip of the sutures, and a swift yank while I had to "hold my breath and bear down like I was having a bowel movement," my jugular was once again free. The doc immediately jammed gauze backed by his two strong fingers into the hole in my neck and held the pressure for a solid five minutes to stop the bleeding then dressed it in more thick gauze and clear covering. Being able to sleep on my right side again without the worry of waking up in a pool of my own blood last night was heaven.

Step one is over and I couldn't be happier with the results.

Craig videotaped me explaining the whole stem cell collection process in the embedded You Tube video. It is much easier to describe with a visual as the whole collection is not necessarily an intuitive process or one that's easy to wrap your brain around. Hopefully this is mildly helpful:

Entering the Unknown ... Again

To say that I'm not a little anxious about the start of this stem cell transplant procedure tomorrow would be a lie. The hardest part of preparing myself for it is that I really can't prepare, at least not mentally.

I'm having trouble wrapping my brain around it all and there are still so many unknowns and so many variables. I am a planner by nature and am also a very visual person. I like to know what I've got coming at me. But tomorrow, we'll be on the road at 5:30 a.m., arriving in a brand new cancer center that I've never been to filled with nurses I've never met and spaces I've never explored.

It's possible that we'll arrive tomorrow (I'll have Mom and Craig in tow) only to find after my bloodwork is read that my blood cells aren't ready for retrieval. If this is the case, we'll have to turn right back around – try again tomorrow.

If my bloodwork is good then the nurses will examine my veins for their viability and determine if they're strong enough to handle the apheresis machine process. If they're determined to be too scarred, too difficult to work with, then it's in for yet another surgical procedure. Hence, I can't eat or drink tomorrow morning, one of my least favorite directives. They'll have to put another catheter into a large vein in my chest, a temporary one called a Quinton catheter, which has an in and an out valve.

So, as you can see, the order of events and really what those events are is all up in the air. I'm just trying my best to let go of control and let whatever needs to happen happen. I hope the nurses are prepared for a peppering of questions as I try to understand all of this.

It's not just tomorrow's possible procedure and the whole harvesting process, but it's also the fact that now I'll be receiving my care at Smilow Cancer Center, a behemoth of a place that I have never stepped foot in before. It's a brand new facility, which is exciting, but I don't know the city of New Haven at all; I don't have the lay of the land; I don't know any of the people that work there; and I've only met my new oncologist for a brief 15 minutes back in February.

This is a far, far cry from what I am used to. I know Hartford Hospital in and out because, well, I work there. I know all of the lab techs, secretaries, and nurses at the cancer center and they all know me by name, they know my case, they know where I'm coming from and where I'm going. I know who gives the good shots. I know who to ask for when I need something. I know all the procedures and how the place runs. I have the phone numbers at the Avon and Hartford offices memorized. I even know all the valet parking attendants at the cancer center. I don't even need to hand them my stamped ticket, they just know my car and go and get it for me. And of course above all, I'm going to miss Dr. Dailey and the rapport and understanding we've established.

Now it's time to get used to a whole new world. I just hope that I can turn these unknowns into understoods. I just have to remind myself that this is how I must have felt last May when I was first diagnosed and had no idea what chemo really was, had never heard of Hodgkin's disease, never mind a port-a-cath, platelet count, prophylactic antibiotics, anal fissures, skin burns, embryo creation, and bleomycin side effects. I did my studying and have passed the first set of exams. I guess it's time for second semester?

We'll start with finding the right parking garage.

Clichés

As a writer I try to avoid clichés, phrases that are at times so overused that they become meaningless. But lately, I find there are a few that I ponder often for their veracity. I've come to realize that they've become clichés because they succinctly say "it". "It" being what we're trying to convey, wrapped in a tight phrase, tied with a neat bow, for a package that's easily relatable to anyone. So today, I'm letting my cliché guard down and am going to give credit to these phrases that have passed from generation to generation for a reason.

"There's No Place Like Home

I couldn't say it better myself. Home is where the heart is ... . I love, love, love our home. I love its covered porch. I love its big picture window. I love its dining room skylights. I love its gingerbread trim. I love that it's a hybrid space of old and new. I love thinking about what happened in the 1800s Baptist church that it once was. But most of all, I love how I feel when I'm in it. We've decorated it freshly and eclectically – our personalities on display. I feel so comfortable here, and there is no place I'd rather be, especially when I'm feeling awful. I love that I can snooze on our sectional couch – a fantastic Craigslist find – and gaze at the georgeous Japanese maple outside the living room window. I love that our bedroom is so airy and filled with sunshine when I awake each morning. There's nothing better than sitting in my rocking chair reading on the front porch or talking with our neighbors – neighbors that are beyond what one could ask for.

"This Too Shall Pass"

People often say this to me and I often say it to myself. It's one of those phrases that's hard to believe when you're in the middle of "this," but once you come out the other side you realize that nothing is forever. I felt so, so, so awful for several days following ICE chemo and at the time it was hard to comprehend that I'd ever get back to myself again ... but I did. It amazes me every single time how much my body can be knocked down and still have the capacity to bounce back. So it's true, no matter how much harder each step in this process has been, there is always an end and soon enough the pain is a distant memory – so distant that it's hard to even remember how badly I felt.

"Dog is (Wo)man's Best Friend"

I never feel alone because I always have Sammy's companionship. She's there laying on my feet when I'm curled up on the couch. Or, more often, laying right on top of me. She follows me into the bathroom. She sleeps on her doggy bed and watches me with one eye open when I'm feeling particularly bad and have to retreat to my bed upstairs.

A neighborhood kid summed it up best. Craig and I were sitting in our anti-gravity chairs on the lawn the other day and this little boy with dark chocolate skin and milk chocolate eyes and the bounciest tousle of dreds came into our yard and said:

"Excuse me. Can I play with your dog?," pointing over at Sammy who was rolling around in the grass with her tongue dangling wildly.

"Sure," we said.

They played for nearly an hour. They played fetch with the tennis ball. They passed the close-to-airless basketball treasure that Sammy once miraculously and instinctively dug up from nearly 2 feet underground beneath the pine tree. They chased each other around the yard.

While tousling her ears, we overheard the boy say to Sammy: "Sammy, if you were a human, you'd be a really good person."

I concur.

"What Doesn't Kill Us Makes Us Stronger"

I know now more than ever what I'm made of and that no matter what challenge I'm faced with, I can conquer it. I know this is a valuable lesson that will serve me well – it already has. I don't necessarily believe this cliche as it is, but more a modified version. I think that what doesn't kill us gives us the opportunity to realize how strong we already are. That it's not the adversities that make us strong. Instead, the adversities bring out the best in us. There've been many times that I've looked back on a particularly bad blood drawing session or a surgical procedure and thought, How the hell did I get through that? I'm sure there are many more of those moments to come, but it's tests like this cancer journey that has made me realize how strong, adaptable and resilient I am and truly believe that this is the case for anyone faced with something of this magnitude. If there is a good thing to come out of the war that is cancer, it's that you learn that you can conquer the battles.

"You Don't Know What You've Got 'Till It's Gone"

To say that I've learned to better appreciate everything in my life is putting it lightly. Going through these treatments that have knocked me on my ass at times has taught me how much I appreciate my body, my mind, my abilities, and my freedoms. Being tied down to a strict regimen of daily doctor appointments, being quarantined, and being out of my body and out of my mind at times has made me realize how good I have it. Not having full control of my life right now has allowed me to step back and take a look at myself and everything and everyone in my life from all different angles.

I'll keep these clichés in my back pocket to reflect on from time to time as this journey surely isn't over ... it's only just begun ... and won't be over until the fat lady sings. I've heard it through the grapevine that it won't be a walk in the park, but I'll look for the light at the end of the tunnel and keep on keeping on with my eye on the prize – one step at a time. I'll make lemonade out of lemons and find the silver lining in every cloud.

In the Business of Making Stem Cells

Good news is that I no longer need the third round of ICE chemotherapy that we had originally been planning for. Because my "b" symptoms have subsided, there are no palpable lymph nodes, and I've bounced back well from the first two rounds it was decided between Dr. Dailey and my new oncologist down at Yale, Dr. Cooper, that we should go ahead into the stem cell transplant. It was explained to me that there is a delicate balance between giving not enough and giving too much chemo. Since I received the extra chemo administered in the pediatric regimen, I've gotten nearly as much as an adult would in three cycles. This should have effectively put me in remission. They don't want to give me too much more of this chemo at the risk of wiping out my bone marrow's capability to produce new cells. This makes me ecstatic as it means that I may never have to be an inpatient again!

So, here we are. This week I have been in the bone-wrenching business that is making stem cells. Starting Monday I have had a double-dose shot of Neupogen every day and I'll be continuing those shots through Sunday. The Neupogen is forcing my bone marrow to create great amounts of stem cells - so much so that they'll be pushed out of my marrow and into my bloodstream so that they can be fished out. I get the shots in the back of the arm. They don't hurt - just burn some as the drug is going in, but really not bad at all. I'm used to them as I would receive them during my ABVD chemo treatments, though this is twice the amount per shot so that means twice the amount of burning. I also thought it would mean twice the amount of bone pain as my marrow is being worked so hard, but that really hasn't been the case. Every once in a while I'll feel whopping pain in my back and in my hips mostly, but I'm able to kick it with a couple of Extra Strength Tylenol. I haven't had to fill the vicodin prescriptions I've been holding onto. However, driving to the cancer center every day for the shot has gotten old. I have never been able to leisurely sleep in since all of this is started. Every day there is some kind of appointment that I need to get to. But, you do what you have to do and that's it.

On Monday I need to be at Yale New Haven Hospital's Smilow Cancer Center at 7:15 a.m. for what is hopefully my first day of stem cell collection, pending my cell amounts are high enough. The next order of business will be to asses my veins and see if they are viable enough to use for the collection procedure. Otherwise, I'll have to have another type of catheter inserted in my chest, which they will do with local anesthesia that morning. Then I will be hooked up to the apheresis machine which will pull out my blood, snatch out the stem cells, and put the filtered blood back in. I'll come back and do this for however many days it takes until they have enough for them to store and freeze for later use. After that comes the scary, high-dose chemo and then the re-transplant of those stem cells I collected pre-chemo. These cells will help to rebuild my bone marrow and immune system which the chemo will have wiped out completely. To be blunt, without the stem cell rescue, the chemo would kill me.

Over the last several days I've had myriad of emotions starting from total fear and dread to where I am now, which is again focused on getting myself strong and ready to kick ass. I've had much blood work done to be sent down to Yale and have had to fill out lots of paperwork and read over consent forms, the most disheartening being the "Consent to Receive High-Dose Therapy with Stem Cell Rescue for the Treatment of Hodgkin's Disease." This document is a doozy and what sent me into a mild anxiety attack on Sunday. Basically, it's full disclosure of all the possible side effects that could occur, it gives some harsh statistics and numbers, and talks about the risk factors, which include leaving me susceptible to future cancers like untreatable leukemias.

But I have a lot going for me and I like to think that I'm not the "typical" patient. Overall, I did really well with the ICE chemotherapy and Dr. Dailey tells me that many of his patients who go through the stem cell transplant procedure find the ICE to be more difficult than the BEAM chemotherapy that I have to come. I'm hoping that this is the case for me. I am strong. I have been walking every day but the 3 dead-to-the-world post-chemo days, have been working out with exercise bands and doing yoga at home as I'm not allowed around the germs a studio would contain. I've been eating well - lots of organic and whole foods, and my blood cells have also made a good showing with time. Right now, my white blood cells are again so low that I'm neutropenic and am again on prophylactic antibiotics, but that's to be expected, and I'm 1 point higher than what I dropped to after the first ICE round. Tomorrow I'll find out if I need a blood transfusion to get me up to the required levels before I can go through with Monday's procedure.

To balance out the medical jargon, I've found it most helpful to talk with real people that have gone through this. It's helpful to hear that there's a light at the end of the tunnel and that the whole process really isn't that bad. Today I spoke to Ethan Zohn, the winner of "Survivor Africa." He's in his thirties and went through chemo for Hodgkin's Lymphoma, relapsed quickly, and was back in for ICE chemo followed by a stem cell transplant. I've been following his path all along as he was diagnosed in 2009 just a couple months ahead of me. I was connected with him through my friend Jack at the I'm Too Young for This! Cancer Foundation.

Talking with Ethan certainly helped to quell a lot of my fears and helped to reinforce my beliefs in a lot of mechanisms that I've been using to get through everything I've been through so far. He is also a big advocate of exercise, yoga, visualizations, meditating, and diet and gave me a lot of tips for how turning to them helped him get through his transplant. He told me how there were days that he wasn't able to eat hardly anything because of the nausea but that he would force himself to at least drink a shake or a smoothie to get something in and also was devout about downing lots of fluids. He also told me how important it was for him to get up and move/exercise every day even while in isolation. Some days that meant just getting the motivation to get to the shower, but when he was feeling a little stronger he had exercise bands and weights that he brought with him, would do yoga stretches, etc. and swears that this made such a difference for him. I'll be packing them in my bag as well.

He told me that he wouldn't kid me, that it's not going to be easy, but that it's manageable and you get through it. He told me not to be shy, not to try to be a hero, and to ask for what I need when I need it. He told me that I have science on my side and assured me that within 30 days he was back at the gym and walking outside and that he's feeling stronger and that he's there at any time if I have any questions. This is what I'm talking about when I'm talking about being part of this great cancer community.

During his treatments Ethan recorded video blogs for People.com. Here are links to a couple that I found helpful:

• His stem cell harvesting day (this will be me on Monday) - it helps me to visualize what this apheresis machine is all about
• Post-stem cell transplant interview with Ethan and his girlfriend, Jenna Morasca, winner of Survivor: Amazon - in this one he mentions that his journey with Hodgkin's was the most difficult thing he went through in his life - harder than being a contestant on Survivor, Eco Challenge and running an ultra marathon.

The Dream World

Whether it's the drugs or my suppressed anxieties, my dreams have been more vivid - both beautiful and frightening - than ever in my life. Often, I don't like the answer when I try to analyze them, but sometimes, it's these dreams that give me hope.

I receive a regular showing of what I've come to call the "soldier dream." I've been having these dreams long before Beyonce's Grammy performance of "If I Were A Boy" that featured a riot police-like entourage. However, the choreography in that brought my dream to life in an eerie fashion. In these dreams there are thousands of these steel, ebony armor-clad men coming at me in syncopated rhythm. Some are marching on foot and some are on their stomachs doing the Army crawl. As they head toward me they swiftly turn their heads from left to right in perfect synchronization with their movements. Left. Right. Left. Right. Stone-faced and powerful they head toward me. When they reach me, I wake up. But I'm not afraid of them. They're the good guys. They're my protectors. All of these molded muscled men are on the attack for me. We don't need to call on Freud to interpret that one.

Another frequent offender is the running dreams. Running, running, running away from I don't know what. I never see the attacker. But suddenly my legs will give out or I'll hit a dead end or something will stop me from being able to go forward. I always have a gun on me and I raise it, but I can never, ever shoot it. My gun doesn't work or I just can't get myself to pull the trigger. And then I wake up. Usually in screams and sweats.

Often I will wake up screaming, even from deep naps. Or I'll wake up groaning and trying desperately to call out. There have been times that I've been napping on the living room couch and Craig will come running in from the far other end of the house where he'd heard me screaming to find me in a pseudo-conscious state. He'll have to talk me back to reality and comfort me until I realize that it was all a dream. As mentally taxing as the dreams and the realities are for me I think it's harder for my husband. All throughout the night every time he tosses in his sleep I feel him checking my temperature with the back of his hand on my forehead and feeling my skin for the cold dampness mixed with pooled sweat that he's come to dread but is now accustomed to.

For me the paradox is that once I do ease into consciousness it's my real life that's often harder to face. Waking up and remembering all of this all over again every day - what I've been through, what's yet to come, the aches, the baldness, the scars, the unknown - is what nightmares are made of. People wake up to escape those types of things. For me, I wake up every day and have to try to make peace with what is my reality and garner the strength to get out of bed and face it. Some days are more difficult than others. Some days I just lay and stare. Sometimes I cry. But I just let whatever I'm feeling that day happen and the important part is that I do get up and no matter how difficult it is, I am always able to get back to the realization of how lucky I am to have each day to wake up to and conquer. Sometimes it just take a little longer to get to that place.

There are also the beautiful, beautiful dreams. But sometimes these worry me more, like I shouldn't "follow the light." In one I was bouncing on clouds with a huge group of friends. As I bounced on each cloud, out would burst my favorite things - unreal colors - then all my favorite things would pour down over me like rain. We ran through these clouds and laughed and danced like it was an LSD trip.

Then there are the dreams that I can't figure out. Like last night, I dreamed I was carrying a young girl, maybe two years old, my daughter. She had delicate blonde ringlets surrounding her head like an angel. I was carrying her on my hip and holding Sammy on her red leash on my other arm. Sammy was older. She wasn't pulling. We were at a fair of some sort and the little girl on my hip wanted a balloon. I told her she could have any color that she wanted and she picked pink. I went up to the booth and asked if I could just buy a ballon. We didn't want to go in to the fair. I just wanted a balloon for my daughter. They wouldn't give it to us. There was a fat, grouchy lady behind the ticket booth who said we had to get a ticket for the fair to be able to buy a balloon. I begged and begged and finally said: "Listen lady, I am dying and I have no money. I can't afford a ticket. My child just wants a balloon, please." I was bald. This is the first dream that I've ever had where I've been bald. Usually I have long, flowing hair that I'm constantly playing with.

The woman finally balked and told us to go see "Ted." Sammy, my daughter and I climbed over a huge mound of flattened corrugated cardboard boxes to find Ted. An ashen faced man sucking back a long cigarette came around the mound of cardboard.

"We're here for a pink balloon," I said, trying so hard to stay positive and excited for this wide-eyed little girl on my hip.

"We've only got orange," he grumbled and handed her the white ribbon with a gawdy, 70s-home- decor-orange balloon floating feet above her.

She was ecstatic and didn't even comment that it wasn't pink.

Then I woke up and quietly cried myself back to sleep.