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Treatment Decisions: Bone Marrow Transplant

Treatment decisions are not always easy, but this is one I don't regret making.
PUBLISHED December 11, 2017
Kim is a nursing student who is hoping to find her place amongst the phenomenal oncology nurses and doctors who cared for her sister. She loves reading, volunteering and enjoying the outdoors of Colorado.
After many treatments and almost two years with cancer, my sister finally reached remission in late October of 2015. For most with Hodgkin’s lymphoma, this would have meant the end of treatment. For her, it meant the beginning of what was arguably one of the hardest parts of her treatment process. She needed a bone marrow transplant because, based on how aggressive her cancer had been, it was only a matter of time before it came back.

When diagnosed, she was stage 4. Despite five different treatment regimes, it ended up metastasizing and seemingly became more and more aggressive as time passed. It was quite disheartening to consistently hear that no matter what was done, nothing seemed to actively help fight the cancer. No matter how many assurances we were given that a transplant would be her best chance at remission, it was hard to buy into.

Although the choice to transplant was hers, as her power of attorney during that time, it was also very much mine. Her care team did not make promises for success, and everybody on her team knew what an anomaly she was.

I know that so many who find themselves where we were don’t have a moment of hesitation. The thing was, she had never had a successful treatment. Nothing that she endured – including the many side effects – seemed to be worth it. Here we were being told that without yet another treatment, she was facing the end.

At every juncture, it was an open discussion about quality over quantity – giving her the best life, despite what time frame it may have to be lived in, and to do all that we could to ensure that she would be happy as possible, given the circumstances set before us. So, having come from what was her fifth bone marrow consult, many things were racing through my mind.

She was not perfectly healthy by any means, but she was better than she had been in a long time. We had taken a girls’ trip in October to an amusement park and the zoo in Utah. She was not tethered to oxygen and stayed out of the hospital for weeks. She finally was able to go back to being a semi-normal adult, yet the choice to transplant was about to change all of that.

It meant having her miles from home in downtown Denver, admitting her to a hospital room, checking her in with an expected discharge date of nearly 60 days followed by an additional three months in isolation. Those were generous estimates, assuming that nothing would go wrong. Time away from the family dog, friends and everything normal that I and those around her had fought so hard to maintain. It was not a guarantee of remission or a cure, and it is one of the hardest choices that I have ever had to make.

Going through transplant was not easy for her, or for myself. It was physically taxing and just like with the rest of her journey, she faced complications. Given all that happened, she did remarkably better than anybody expected. Much to all of our surprise, far more complications came after transplant than during, but as hard as that time was in her life and in mine, it did work.

This coming January – the 14th to be exact – she will celebrate her second birthday. On that day two years ago in the corner room at Presbyterian St. Luke’s, nurse Bryan Fuller infused her with the stem cells that saved her life. Just as with every other choice I made for my sister during her cancer journey, this was a choice that I reflected on, sought advice about and didn’t know if I was making the right or wrong choice when it was made. The difference between this choice and some of the others: I can say without a moment of hesitation that I made the choice that I did.
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