High Cy

According to Wikipedia: Cyclophosphamide (the generic name for Endoxan, Cytoxan, Neosar, Procytox, Revimmune), also known as cytophosphane, is a nitrogen mustard alkylating agent,[1] from the oxazophorines group.
An alkylating agent adds an alkyl group (CnH2n+1) to DNA. It attaches the alkyl group to the guanine base of DNA, at the number 7 nitrogen atom of the imidozole ring.
It is used to treat various types of cancer and some autoimmune disorders. It is a "prodrug"; it is converted in the liver to active forms that have chemotherapeutic activity.

Got up early today and hit the rowing machine for a quick 4,000 meters. Pretty lame distance, but a good idea after last night’s spectacular turkey fest at our friends, the Luikarts, in San Francisco. Off to the hospital by 10:30. And waited...
This phase is called “Cytoxan mobilization.” As we were setting up, I asked the nurse what was in store for the day, as I have already had regular Cytoxan doses as a part of my R-CHOP. After she runs the numbers, she tells me that I will be receiving about 10 times the R-CHOP dose. “It’s really a different drug at these doses.”
Great.
At 4:30, the session begins with Harry Nilson’s Jump Into The Fire playing on my ipod. This seems appropriate. Initially, the nurses administer a panoply of anti-nausea meds including Benadryl, Dekadron, Zofran. Benadryl, when administered in industrial strength doses leaves a metallic taste in my mouth. It also makes it difficult to fully form words or type accurately. I persevere, as I am not otherwise occupied.
Now that I’m suitably armed, the Cytoxan begins to flow like water.
This will continue for another 90 minutes. There may be drama, or not. To keep me occupied during my overnight stay, they have administered a drug to stimulate VERY frequent urination. It works as advertised. I am on the 30 minute sitcom schedule. This will protect my bladder from burning that the Cytoxan can cause, if it stays too long.
My venue is now more private. I am in a hospital room in the E-1 wing of the main hospital at Stanford. This is a somewhat specialized area—the transplant unit—where all in-patient transplants are performed. Super sterile conditions. Everyone wears a mask. While it can be of some interest for an overnight, this is where I will come for the transplant and spend three weeks. Probably longer than I will want to stay. The food is fine, but no wine is served with meals—or in between for that matter.
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It’s the next morning and things are fine. No particular drama, although the hospital is not the place for a good night’s sleep. The nursing staff, as usual, is excellent. Now I go home for a week or so of self-administered neupogen injections, to stimulate stem cell production in my blood stream. A note for those who are debating national health care this month: Jane went to the drug store to order the neupogen, and was presented with a tab for $12,000 for a ten-day supply. Not a problem for our BC/BS policy. Less likely so for others.

Once the mobilization and stem cell harvest are complete—hopefully by the 12th of December-we are free to go, and hope to get back to Bethesda for a week to feed the dog and let him out.
11/28/09