Before I start my column, I want to give a hakarat hatov to the incredible women who run Bikur Cholim of Toronto. I am sure all the Bikur Cholim organizations the world over are amazing, but I can only testify to the extreme competence and chesed that I experienced from the Bikur Cholim of Toronto.
I truly believe the care, empathy and compassion patients are given enhance their healing process in partnership with the medical care. The homemade meals certainly did, especially for patients like me who had no appetite and found that any food ingested, for the most part tasted like sawdust. The soups that were produced were nourishing and a lifeline for me.
As you have likely surmised, I was in the hospital recently. As I have written in previous columns, in the interest of educating people about a relatively unknown blood cancer, I have shared that I have multiple myeloma, which is cancer of the plasma cells that are made in our bone marrow.
Myeloma cells are plasma cells that are malignant, and mutated, thus impeding the production of the healthy cells that produce antibodies that fight infection. The immune system becomes impaired, and this can result in illnesses like pneumonia. Myeloma also causes anemia, bone pain and weakened bones and renal issues.
Myeloma is what I call a baby boomer cancer, since those afflicted tend to be older adults. Sadly, when patients complain of being tired or have chronic back, shoulder or neck pain, their doctors tend to brush these ailments off as being aged related. Although it is afflicting younger adults as well.
Often, people are diagnosed because they fell and broke a bone, but I believe that they fell because a bone cracked as a result of the myeloma “gnawing “on the bone. I visualize PAC MAN icons doing so.
I was diagnosed over seven years ago, and was deemed healthy enough to have my stem cells harvested from my bone marrow, to be used for a transplant. Enough stem cells are retrieved for two transplants since myeloma is manageable but not curable. Often the myeloma cells make a very unwelcome comeback, and usually a second transplant is given to patients who are healthy enough to withstand the very harsh chemo that destroys the white, red and platelet cells in your bone marrow including any vaccines you were given over the years, like tetanus and pertussis. Post-transplant patients are viewed as newborns and months must pass before we are eligible for new shots. I wish my wrinkles had been similarity erased, but it doesn’t work that way!
Eventually the healthy stem cells resurrect the blood cells. But it takes months before the numbers are in the normal range.
Getting the stem cells out of the marrow into the bloodstream is a multiple day process, and ultimately the stem cells are pulled out in a process similar to dialysis, that can take many hours until it is determined that enough was collected.
The stem cells not needed for the first “transplant” are frozen. Mine were in the freezer since March 2018 – not to be confused by the “freezer” yeshivishe bochrim are in before they are ready to date for marriage.
The stem cells are re-introduced via an infusion – an IV drip that takes a few minutes. The term “ transplant” is a bit of a misnomer.
While I recovered rather quickly from my first stem cell infusion, I was clobbered by the second one. The very toxic chemo affected my stomach for weeks and I was afflicted with extreme fatigue.
I actually had questioned why I needed the transplant since the weekly chemo and immunotherapy injections I had received for months in preparation for the stem cell infusion put me in remission within a few short weeks.
But who am I to question my hematologist who specializes in myeloma. He strongly felt that a second transplant was the “best arrow in a limited quiver” of treatments, and since I currently had no co-morbidities, such as heart disease or diabetes, and I had passed my lung functionality tests, that it was my best shot for longer term survival.
I wanted to delay the transplant till after Pesach so I could be with one son and his family (who still is in the States) or just continue what had worked so well, but I was told the immunotherapy drug stops working after a while, (as they all do) and I might not qualify for the second transplant down the road due to possible new medical issues.
But a doctor, even a specialist, is not a rav steeped in Torah knowledge, whose daas Torah is indisputable. I know that in most medical situations, there is a second opinion by an equally learned specialist who can disagree with his colleague’s conclusion as to the best course of action to take and when.
My suggestion is to do as much research as possible and ask informed questions. It’s best to trust your expert doctor, but be mindful that there is no such thing as “ daas medicine.”
There are organizations in the U.S. and Canada, and I imagine in heimishe communities around the world that can help a patient be matched with the best doctor for their particular ailment. Avail yourself of their services. Get daas Torah from a rav who very likely has knowledge of the best doctors and hospitals in his community.
And do what’s necessary to enhance your health by exercising on a regular basis, eating healthy foods, and maintaining if possible an acceptable weight for your body type and as much as possible cut toxic, stressful people out of your life.
Ironically, there is a silver lining from my stem cell experience. I lost weight and my body weight index – BMI – is in the normal range for the first time in decades. But it’s a weight loss method I would only wish on my enemies!
