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When Leukemia Knocks At Your Door (Part VI – Final)

Part VI

Philipp received morphine once again, which helped relieve the pain.  Whenever the urine was flowing into the bag unobstructed, he seemed to be in a clear state of mind.  Other times, it gave me the impression he was in another world where his sixth sense was much more alert than all the other five.  A couple of incidents speak for themselves:  his next-door neighbor, a boy of about his same age passed away.  Philipp did not know this, but he had the feeling that something had happened.  He kept asking the nurses inquisitively about his neighbor’s condition.  Another time he repeatedly asserted that there was someone standing at the door.   He insisted that I check who it was.  I knew there was nobody standing there, but decided to comply to his request by opening it and let him see for himself that he was wrong.  Seeing that no one was standing there did not help.  He could sense someone’s presence.  I could not help looking at the clock right above it.  It was 1 pm.  An hour later I had to go home.  As I was on my way to the visitors’ locker room, one of the moms informed me that little T. had just passed away, at 1 pm.

In the first case with his neighbor, Philipp talked with him over the phone several times,  but the boy did not show much interest in him.  He wanted to be left alone, undisturbed.  In the second case, he knew nothing of little T’s existence.  The only thing they both shared in common was the fact that they were treated with Mylotarg.

At that time I was trying my best to help my son in any way possible, from cooking for him every day to balancing his energy level.  I worked with crystals, did some acupressure by not pressing too hard, given the delicate condition of his body.  I also “smuggled in” charcoal tablets.  Every evening at home, I went into my private acupuncture room to release my sorrow and cried, meditated and prayed.  My mantra-chanting-like prayers, which helped me stay focused, aided me to get through the days and while I felt more balanced, the most important thing was that I felt it was helping Philipp through the toughest moments in his life.  This is something I cannot prove with scientific facts and it does not matter anyway.  This is about feelings and emotions, something that cannot be measured in scientific terms.  It was about love, unconditional love, the love that heals.  Each member of our family expressed it in different ways, each doing what they could best to express it in their own terms, thus contributing to Philipp’s healing process.

My son’s way of dealing with the hardest moments of the treatment was by focusing on the now.  He felt that that there was no past and no future.  The future was difficult to predict, if not impossible.  Every new day brought a new situation and no one could tell how the following day would be.  Focusing on the now was his way of concentrating on what was happening at that moment and gave him the strength he needed to help endure the situation.  Despite the difficulties, even during the times when he hit rock bottom, he never lost hope.  It was also during this period, as well as when he experienced the first chemotherapy blocks back in 2005, that he came to realize what the most important things in life are his family and friends, living the now and aspire to do good to others.  The latter one is what makes him especially happy.

The doctors administered him red blood cells to make up for the blood that was lost through the urine and Thrombocytes, or platelets, which helped in the formation of blood clots, perhaps targeting the restoration of the bladder wall.  He also got “legally doped”, as the doctors would say, with Erythropoietin, better known as EPO.  It is a type of hormone that helps produce red cells.  This is the famous controversial drug administered to athletes from the doping scandals.  Its purpose was to help the new developing bone marrow by stimulating the production of red blood cells.

The weeks went by with good and pain-free moments as well as with painful ones.  We were all in an emotional rollercoaster with ups and downs, sometimes turning abruptly when things seemed to be going in a positive direction, when suddenly something new showed up and this in turn put us all emotionally up-side down again.  The first thing I did every morning after giving him his good morning kiss and a hug was to check his urine bag.  It was a disappointment to see blood clotting up in there.  As the weeks passed, it felt like there would be no end to this, but one good day, suddenly, what I saw was Mother Nature’s gift in all its splendor and glory, untainted by red spots, shining its brilliance and magnificence to every corner of the room, every corner of the universe, the humble color yellow!  I was so exulted that I could not hold back my joy and I was not about hide it either!  Philipp was a bit more cautious than me, especially after all those ups and downs.  He remained under observation for about two more days until his wish to spend the rest of his days of isolation at home was finally granted.  His five long months of hospitalization had at last come to an end!

At home he got more exposure to other types of bacteria and germs.  No one had to wear mouth masks or handle him with rubber gloves anymore; only his friends had to whenever they came over.  I began giving him Chinese herbal medications. Their pungent smell and taste, made it difficult to swallow, but after a while Philipp got used to them.  Little by little he began having more exposure to people outside the family as well as in nature.  He sat for long minutes in our garden, breathing in all that fresh air and enjoying the sun whenever it was shining unobstructed by clouds.  He needed to work out with a physiotherapist at home, slowly building up his physical strength.  After the obligatory 200 days of isolation were over, Philipp was finally able to go back to school.

After graduating from high school in 2009, he attended college and obtained a Bachelor’s Degree in Neuroscience and Cognitive Psychology in June 2012.  He will soon begin his MA this coming October in Neurocognitive Psychology at the Ludwig Maximilian University in Munich, Germany.

Life places many hurdles in our paths.  They are not there to block our way as a “no entrance” sign, but rather as a challenge that we are suppose to overcome.  There are many lessons to learn along the way and many ways to learn them.  Philipp chose his own hurdle and perhaps we were made part of that decision.  It feels like a wake-up call to his soul, and ours’ as well.  Dear son, I thank you for your beautiful gift!

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*Since June 2010 Mylotarg has been withdrawn from the US market.  According to medical reports, this monoclonal antibody did not prove to be better than other medications used to treat cancer patients and has been linked to deaths from liver and lung complications.

**As I mentioned earlier in part III of this blog, we were introduced to Mylotarg as the best and perhaps the only option in the market to help fight the disease.  I am not an advocate of Mylotarg nor do I believe my son’s recovery can solely be attributed to it.

I should point out the difference between ‘curing’ and ‘healing’.  To cure someone is a process by which the patient is treated with medications, an external agent that helps get rid of the symptoms.  It is based on the belief that everything in the universe is separate and the modus operandi of the patient is thus passive.  The holistic approach of healing involves dealing with the dis-ease from within by making the patient actively involved in the process in order to return to perfect health.  Becoming active in the restoration of our health means that we must first understand that everything in this universe is made of energy.  Since our thoughts and feelings are also a form of energy, they can very well influence our health.  Negative thoughts (negative energy) will eventually cause negative effects in our body.  Likewise, positive thoughts (positive energy) will have positive effects.  When a person is diagnosed with a disease, this is indicating that something within that person is out of balance.  Martin Brofman, Ph.D., creator of the Body-Mirror System said, “Everything begins in your consciousness”.  It is there we have to look at and make the changes for the healing process to take place.   A change of thought pattern and staying positive throughout the treatment can enormously help the healing process.   Furthermore, focusing on the now allows us to be completely aware of the present moment and deal with it effectively.  We are each creators of our own realities.  What is it that we desire?  Remember that energy flows where the focus goes.

There were many factors that contributed to my son’s total recovery, among them, a very efficient and professional medical team who handled every step of his recovery process with excellence and dedication and to whom we will be eternally grateful.  However, the patient himself must not be forgotten.  His own contribution in focusing on the NOW, handling every complication with courage, never losing faith and keeping a clear vision of his target “at the end of the tunnel”, has not only aided in his recovery, but in his healing process.  This target was life.  His is an excellent example of how a patient should actively get involved in becoming healthy again.

A balance between mind, body and soul are imperative in order to achieve complete healing.  The doctors’ excellent performances as professionals cured the body; Philipp took care of healing his mind and soul.  His family and friends also contributed to the mind and soul healing process through prayers, alternative medicine (TCM, acupressure, energy healing, charcoal tablets), love-infested food and above all, our purest, deepest and ever-present love.

Family photo at the top of Mount Birkenstein, Germany, July 2012.

Philipp (22 yrs. old) and Helena (15 yrs. old) during Philipp’s graduation from Jacobs University, Bremen, Germany, June 2012.

A typical homemade vegetable dish.

Helena’s manifestation of her wish:  in March 2008, Mia, a beautiful Bernese Mountain Dog became a member of our family. (Lake Ashinoko, Japan, January 2012)

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When Leukemia Knocks At Your Door (Part V)

Part V

Every day I brought lunch for Philipp from home.  I cooked everything he liked, especially vegetables.  Fresh vegetables and fruits were at the top of his list, but since he was only allowed to eat over-cooked food, fruits had to be discarded from his wish list for a while.  Philipp’s days in isolation were centered on the little yet important pleasure of eating.  Lunch for him became the highlight of the day as well as all the frequent visits his friends paid him.  I used to cook the vegetables only half done since whatever food he got had to be heated up in the microwave oven at the hospital before he ate it.  This was a measure of precaution, “doctor’s order” as the nurses would say.  I wanted my son to get some more of the nutritional benefits of the vegetables so I consciously, sort of, broke the rules by not cooking them thoroughly and would ask the nurse to simply heat it up a bit.  There are times when breaking the rules can be beneficial to your health, and by doing this, it did not harm him in any way.  The quote, “Rules are made to be broken” applies here very well.

Sunday, May 27th arrived.  It was Philipp’s birthday.  Extremely happy to be back in the BMT, we showered him with presents and a huge birthday card from the series “Ohne Dich Ist Alles Doof”  (“Everything’s bad without you”, or “Nothing is good without you”, either way).  Here is a YouTube video of the main character, the sheep and what the card more or less contained, excluding the romantic part: http://www.youtube.com/watch?v=XApCHTvgNbg

The doctors and nurses came that afternoon bringing an inflated plastic birthday cake since he was not allowed to eat a real one at that time.  For Philipp it was a great achievement to have made it that far.  I truly believe he will never forget that birthday.

By this time the drinking marathon had become one tearful torture.  This though, came to a sudden stop as the next complication due to the chemotherapy treatment arose, the result of which caused the eight to ten liters of water drinking order to be reversed.  He was diagnosed with Hemorrhagic Cystitis, an inflammation of the bladder that leads to dysturia (painful and difficult urination) and hematuria (presence of blood in urine).  Its cause could be attributed to either the bladder wall becoming so thin due to the chemotherapy that blood began filtering in, or a small hole opening up from which blood flowed in.  This blood started clotting inside the bladder creating at times blockages at the base of the bladder that is connected to the urethra.  The instinctive and most basic need to pass water became an unimaginable torment.  Not being able to relief himself freely, the urologist connected him to a urine bag, which was in turn connected to his bladder through his penis with a catheter.  He was immediately instructed not to drink too much, to the effect that his intake of water was rationalized to about one liter per day.  Extreme thirst followed, where every drop of water was more precious than gold.

We were told that this was not an unusual occurrence among bone marrow transplant patients and that it was very difficult to say how long it would take until his condition would heal.  From experience, the urologist said, it could take from two to nine weeks.  That was certainly not a very comforting thing to hear!  Philipp wanted to leave the hospital, go home and spend the rest of the time of the isolation period there, but that had to wait, and wait he did, not for two, not for nine, but for twelve weeks.

My husband Stefan and I visited Philipp every day, never skipping one single day.  I went there after dropping Helena off at school and stayed until 2~2:30 pm, time when I had to rush back to pick her up; Stefan went in the evenings after work. Sebastian went in the afternoons whenever he could as well as Philipp’s friends.  Helena had to wait until the weekends to see her brother.

I remember a Sunday morning when I went to the hospital taking Sebastian along.  It happened during the week when Philipp was extremely afflicted by the edema.  I needed help to wash him. It was becoming more difficult to fulfill this simple chore alone since he was getting heavier by the day and was under the effects of morphine.  I needed Sebastian to help me hold Philipp.  He had not seen his brother for a few days, so it came to him as a big surprise to see his brother in such a state.  It took us tree hours to properly wash him, moving and supporting his body slowly, carefully, to avoid more unnecessary pain.  This experience, which may seem unimportant, will remain ingrained in our memories as one of the most dreadful period during his hospitalization.

If there were times when I was driven to the extreme, when I thought I would “lose it”, a time when I felt hopeless and that my son was helpless, two of them come to mind.  The first one was when he was suffering tremendously from the edema.  It was for me, as a mother, a terrible and painful experience to see my own child in so much pain, gaining so much weight, his eyes bulging out like if he were to explode at any moment.  I am still finding it very difficult to write about this after all this time.  The fear, the pain, his crying, our helplessness as parents, I can still feel it and hear it.   The second time was whenever his bladder could not be emptied out because the catheter got obstructed with clotted blood.  The situation had to be handled manually by the doctors.  A new catheter had to be inserted and jerked in and out once, twice, three times… as if trying to unclog a sink pipe.  As a woman it is difficult for me to explain how intense that pain must have been in the most vulnerable part of a man’s body, but as a mother, I wanted to push the doctors away from him and somehow stop this craziness he had to endure.  Every scream, every cry was becoming unbearable.  I did not know if I should stay in the room or walk out while he was being treated, but the thought of leaving my child to suffer his own fate was not an option.  I felt emotionally defeated; by then I was at the lowest point of my existence.  I held his hands and we cried together, sharing his pain, giving him my energy to endure it.

To be continued…


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When Leukemia Knocks At Your Door (Part IV)

Part IV

During the four weeks following the transplantation, Philipp felt quite weak and with no will to do much.   A passionate piano player, he missed playing his favorite pieces (classical, jazz, ragtime).  We borrowed a keyboard from a friend of his who happened to be a young man of about his same age and also a leukemia patient.  We brought all the music scores he requested from home thinking that this would cheer him up, and in fact it did, but he felt too weak to play.  Sebastian, Philipp’s younger brother, volunteered his PC, a big sacrifice for any teenager!  We tried to make his room as pleasant as possible and to surround him with things that would comfort and keep him entertained.  As expected, the PC became his only means of communication with the outside world and it turned out to be the only thing he was willing to spend some time with during the days when he felt more energetic.

He had to deal with the side effects of two different therapies simultaneously:  the numerous tiny pills of the chemotherapy to destroy completely his bone marrow as well as the cancerous cells and Mylotarg, which took care of the cancerous cells in a more targeted way.  It is also a form of chemotherapy.  In the case of a bone marrow transplant, the patient can be hit strongly with chemotherapy because the aim is the total destruction of the bone marrow.   The side effects of both therapies are similar; the sum of them only intensified them.  Each day they became more evident:  loss of appetite, nausea, constipation, swelling of the legs, chill, fever, cataract, pneumonitis, mouth sores and much later, cramps in the calves and pulmonary edema. Hair loss should be included in this list, but by the time the conditioning regimen began, which is the preparation for the transplant itself, Philipp had already lost all of it.

Normally, a healthy immune system is able to fight and reject cells that do not belong to the body.  Patients getting a new organ have to take medication that suppress the immune system (immunosuppressants) or else the new organ will be destroyed by the body.  In Philipp’s case, the reverse was happening:  The new cells were proclaiming their new surrounding as their territory and started destroying the remaining bone marrow. This is called the Graft versus Host Disease (GVHD).  To a certain extent this is a desired effect because the new stem cells are able to identify and destroy cancerous cells much more effectively than chemotherapeutic agents. On the other hand, this effect could, if too intense, cause irreversable damage to other parts of the body because the new stem cells start attacking the rest of the body. Here, immunosuppressants such as Cortisol are also necessary, not to suppress the immune system, but the new bone marrow.

The effects of the GVHD appeared :  his skin became reddish and started peeling off, including the palms and soles, spreading throughout his whole body.  Then it got flakey followed by a pigment disorder, with lighter patches of skin and the normal skin color becoming darker.  His liver swelled, became clogged and his body began retaining fluid.  This is known as the Veno-Occlusive Liver Disease (VOD), another GVHD effect.  Jaundice was clearly visible in his eyes.  Day by day we watched him gain more and more weight.  Within a week he had gained twenty kilograms!  To fight the unbearable pain he felt all over his body, the doctors began administering painkillers, but it got so out of control that he ended up getting morphine.  His body had accumulated a great deal of toxins from the chemotherapies that his kidneys could not function normally anymore.  He was being monitored day and night and the doctors were hoping that the kidneys would kick in again, but this did not happen.

I was called into the doctors’ office.  Philipp would have to be connected to a dialysis machine.  I was relieved to finally hear what my husband and I had been requesting throughout the week.  There was a catch to it, though:  he would have to be transferred to the Intensive Care Unit.  “NO!”  “Not together with other patients who are suffering from God knows what kind of diseases!!”  “He must stay in isolation!” was my answer.  I became terrified at the possibility of our son catching something or other and that his body would not be able to combat any disease.  They knew this was all true, but the risk had to be taken because there was no other solution and immediate action was imperative.  What they did not tell me was that most of the patients from BMT who were previously sent there did not make it back.  They simply said to me, “We have priorities.”

My husband and I did not leave Philipp alone at the Intensive Care Unit (ICU).  He was under our constant supervision.  We took turns, I would be there during the daytime and he would take over for the night shift.  After months of watching the nurses in BMT change the bandages of his wound daily, I knew exactly how to do it, but that was their job.  I took care of the rest, like washing him, changing his clothes and even wrapping his legs with bandages so that they would not get too thick due to the increased capillary permeability, or, engraftment syndrome.  The nurses were happy that I willfully took care of these minor chores and Philipp preferred it that way.  So while he stayed in the ICU, every time a nurse changed his bandages, I made sure to stand next to her and show her how it was done in BMT.  One particular nurse appreciated this very much.  The procedure was different and I was not going to allow any mistake, any contamination from either carelessness or different methods of doing things.  Every day I went to the BMT to get two liters of bottled lukewarm water, disinfected towels and a change of gowns to wash and change him.  I did energy healing.  And I prayed, prayed and prayed.

Philipp has no recollection of his days in the ICU because of the amount of morphine he was receiving.  It remains as a period of confusion in his mind.  The only thing he can remember is a dream he had there.  In it he saw himself being in a very dark, old basement.  It had a small window from which sunlight came through.  The light from the first floor illuminated the stairs that led to the basement.  He could hear children’s voices playing loudly upstairs.

He got connected to a dialysis machine, which functioned well for about twelve hours when suddenly it broke down.  Sometimes the way things happen makes one wonder why destiny plays such games!  I was not there when this happened, but from what my husband later told me, someone came to try to repair it, but was unsuccessful.  After an hour or two, Philipp’s kidneys suddenly began functioning!  He remained there for another day until the situation became stabilized and was allowed to return to BMT.

All the nurses gave him a huge welcome, surrounding his bed, sincerely happy to see him back, pampering him with ice cream and with warm, welcoming words.  One of them said to him that she was truly glad to see him back because most of the BMT patients who go to ICU don’t make it back.  As I heard this, I was totally flabbergasted.  I could not believe what I was hearing!  As I let that comment sink into my heart, I thought, “Thank God we didn’t know this before he was sent there!”

Our doctor and family friend from China came that summer for a short visit to Berlin, mainly to see Philipp.  He brought along some more Chinese herbal medicine, which could not be administered at that time since we were confronted with opposition from the medical team at the hospital.  According to our friend, the herbs promote the production of blood cells, thus speeding up the process.  These herbs could be used in conjunction with the treatment he was receiving there as a complementary support to Western medicine.  After the herbs were sent to the laboratory, the doctors decided not to allow its use. “Of course not!” I thought sarcastically.  This opposition from the medical team was not based on hard facts, but on a lack of evidence, from the Western medical perspective, that Chinese Phytotherapy could serve as a complementary therapy (at least in this ward).  The only result that came from the laboratory was, “the herbs contain no fungus”, meaning, it would not be harmful for the patient to ingest them, but the doctors did not want to take any risks.  Was this a smart decision?  Personally speaking, I have my doubts.  Fungus is one of the main reasons why patients who have gone through a bone marrow transplant are not allowed to consume any raw or barely cooked food during this period.  In order to avoid further interference, our Chinese doctor advised us to wait until Philipp’s release from BMT.  “Once he’s back home, he should take it”, he said.

At this point, our son had to drink a lot to flush the toxins out of his body.  He was instructed to drink between eight to ten liters of water a day!  This is an extremely difficult task, even for a healthy person.  His kidneys were doing their job and the fluid retained in his body was being drained out.  His eyes remained yellowish as a sign that his liver was still affected and the pigment disorder continued.  Since he was not suffering from pain anymore, morphine was no longer necessary.  His nails began getting thinner until eventually they too were lost, just like his hair.  He got daily blood and platelets transfusions.  The doctors seemed to be doing a good job at juggling the dosage of the medications he was taking; only Philipp had to do his part, to drink as if he were the world’s water-drinking champion.

To be continued…


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When Leukemia Knocks At Your Door (Part III)

Part III

On Easter Sunday 2007, Philipp was admitted to the hospital.   Room number 4, at the hematology/oncology pediatric ward for bone-marrow transplant (BMT) of the Charité Clinic, had a double door and two long, horizontal, wall-to-wall windows of about 30 cm. (12 in.) wide on either side of the room, allowing visual communication with the next-door neighbors.  They were conveniently protected with blinds from both sides, acceding privacy when desired.

The specialists of the ward informed us about a relatively new type of targeted cancer therapy.  The drug in question to be used is called “Mylotarg” (generic name: Gemtuzumab Ozogamicin) which basically consists of monoclonal antibodies.  These antibodies only attach themselves to the antigens (cancer-causing cells) leaving the healthy ones intact.  When this happens, the antibodies move into the cells and release a substance called “calicheamicin” (a chemotherapy drug), thus attacking the DNA of the cells and destroying them.  During the period when our son was ill, Mylotarg was being administered to patients over 60 years of age in the United States suffering from the same disease.  Administering it to our son who was sixteen years old at that time in Germany meant he would be used as a “guinea pig” for which the doctors needed our consent.

There are times when unspoken words can say much more than a thousand.  They were sincerely trying to save Philipp’s life, there is no doubt about it, but in their rational minds, his chances of overcoming the disease were minimal.  Asking us for our consent to test the drug on him felt as if they were saying that we would make a great contribution to the medical world.  That was all.  Rationally speaking, this all made sense, but to sacrifice our son’s life for the sake of science was too much to ask from us, I thought.  On the other hand, the alternatives were not any better.  We felt we were between the sword and the wall.  My husband and I decided to hold tight to that infinitesimal probability of success and gave our blessed consent.  In Philipp’s mind there was never a doubt of defeat.

Preparations were made for the treatment.  The insertion of a catheter through a large vein in his chest located very close to the heart would make it much easier and less painful to administer the drugs as well as to take the numerous blood samples required.  The complete destruction of the bone marrow and the cancerous cells were the next steps in order to give leeway to the new bone marrow to be transplanted and allow it to reproduce.  From this point on, anybody coming into his isolation room would have to disinfect the hands, wear gloves, a hospital gown, a mouth mask and change shoes to a pair used specifically for this purpose.  No physical contact was allowed as a preventive measure to avoid transmission of undesirable bacteria or infection.  Whatever was brought into the room had to be meticulously disinfected prior to contact.

The food being served at the hospital became a serious point of concern.  Everything that Philipp was allowed to eat was pretty much overcooked and tasted bland, to be polite.  He had always been a food lover and their weekly menus looked unappetizing to him.  I have always been a strong advocate of expressing love to my family through nutritious food.  It is the best gift I can give them on a daily basis and a way of knowing that at least once a day I am contributing with love and care to their well-being.  From the moment he entered that isolation room, he was already yearning for homemade food.

Ten days prior to the bone marrow harvest for the transplant (the collection of the bone marrow from the donor), Philipp’s younger sister, Helena, was not allowed to attend school or to come into contact with people outside home.  This was a sensible measure imposed by the doctors in order to avoid any undesirable infection.  She was ten years old at that time.  The days were spent at home, doing her school assignments, watching TV/videos and talking to her friends after school hours.  On the eleventh day she was admitted at the hospital, four rooms away from her brother.  I was allowed to spend the night with her so the three of us spent hours together talking and simply enjoying each other’s company.  My husband came to visit that afternoon after work, but did not stay too long as our second son was at home alone.

For Helena there was not a single doubt about helping her brother.  As parents, my husband and I were in awe at how much she was willing to go through in order to see her brother return to normal life again!  We are eternally thankful for her kindness!  Her dad told her she could wish for herself anything in this world and it would be granted without question as a sign of our gratitude and love.  “A dog wouldn’t be bad at all”, she exclaimed.   The nurses took very good care of her, including showing her which button to press if she had any wishes for the evening.  Helena did not hesitate in making use of that offer, so the orders started rolling in:  a pizza, an ice cream, some coke…

The following morning at eight o’clock a nurse came in to give her some Dormicum, “to make you a bit sleepy”, as she was told.  I could sense that she was getting nervous and refused to take the medication, but eventually agreed to it after long minutes of begging from my part.  Once its effect began kicking in, she started to cry.  She was terrified about the procedure and mostly about feeling pain.  I accompanied her all the way to the surgery room trying to appease her by repeating over and over again that everything would be alright.  A gas mask was laid over her nose and mouth and before she could count to three she was sound asleep.

I waited outside.  Those sixty minutes seemed eternal to me.  I could not bring myself to read or listen to music.  I decided to go out and take a walk through the beautiful campus garden, listening to the birds chirping in that sunny May morning.  I watched some patients going for walks pushing with one hand their infusion stands from where infusion bottles hung connected to the their arms or wrists and with the other, holding a cigarette.

Once Helena woke up, she felt a slight pain around the lower back area.  The bone marrow aspiration is done with a special syringe from the iliac crest.  They punctured her on both sides of the rear hip bone.  She felt somewhat weak, but stable.  The doctors then proceeded by infusing back the blood they had extracted from her a few days prior to the bone marrow harvest in order to help speed up her recuperation period.  Her fresh and healthy bone marrow had to be centrifuged to prepare it for transfusion a few hours later.

Meanwhile, Philipp waited in his room.  At this point of the preparation for the transplant and with literally no more immune system to protect him, he felt weak and had a bit of nausea.  After long hours of waiting, the doctor finally arrived with the treated bone marrow.  It looked darker than regular blood.  He connected it to Philipp’s catheter and after about 30 minutes the transfusion was over.  Now all he could do was wait.

To be continued…