Graft Versus Host Disease (GVHD)

GVHD is the medical shorthand for Graft Versus Host Disease. 

Today a quick, non-geeky look at the phenomenon of GVHD, and how it differs from Transplanted Organ Rejection as seen in the previous cartoons noir post.(click here )

     For those of you just joining us, the procedure I have undergone here at Duke Med is technically an Allogenic Myleoablative Stem Cell Transplant or Bone Marrow Transplant. 

Allogenic: Taken from a donor (as opposed to autogenic, where they take your own cells out, hit you with some chemo, then put your own cells back in, or the syngeneic using stem cells donated by an identical twin)

Myleoablative: High-dose chemotherapy designed to completely wipe out the diseased blood-forming cells in the bone marrow. This chemo can cause side effects, often severe.

SCT: Stem Cell Transplant 

BMT: Bone Marrow Transplant, often used interchangeably with SCT 

As part of this I volunteered to participate in a clinical trial, A Randomized, Multi-Center, Phase III Study of Allogeneic Stem Cell Transplantation Comparing Regimen Intensity in Patients with Myelodysplastic Syndrome or Acute Myeloid Leukemia.  The regimen intensity refers to the pre-transplant chemo. I was randomized into the High Dose group, read about it in this post from March 27th. .

Let's Jump right in for it is pretty fascinating...

Transplant Cartoons Caution:Humor Noir

This is the first in a series about our Immune System, Organ transplant, Stem Cell/Bone Marrow Transplants, and Graft Versus Host Disease. Heavy subject matter, so I thought we should start light with some bootleg 'toons.

Ok let's get somewhat serious over the jump

Ear Worms (no, not that kind )

The Dreaded "Ear Worm"

from the German  Ohrwurm

We have all had it happen. A snippet of a catchy tune or jingle that gets stuck in your head, for hours, sometimes days.

Maybe just a short phrase of the chorus, maybe the hook.  When I was working at Chesters ' in 1969 I had  "Celia, You're Breaking My Heart " plague me for three days.

So Friends, Romans, Countrymen....Lend me your ears!

Jump on over the endless tape loop for a look at  Ear Worm acquisition and removal.

Sun 1 UV ABC's, ratings, indices, and more

Sun 1 UV ABC's, ratings, indices, and more...

      According to my Dermatology Duchess, a specialist in Transplant and Melanoma  patients,  sun exposure can trigger Graft vs Host Disease ( GvHD ). Protection requires not just  sunscreen, but clothing cover ups  for even a  short  car ride on  sunny day!  (Think newborn baby skin ) Since I will be living with this to some extent for the rest of my born days,  I have been studying  up on Sun Protection.

       My only alternative to become nocturnal, and for me, that is not yet an option.

      Today's post is the first of a multi- part series. There will be plenty of cartoons, and I will intersperse them up with some music posts, a series on the immune system, and any medical updates. This one is a little longish, the rest will be more compact.

     This topic has become much more important to me in the wake of my Stem Cell Transplant, as I am now at great risk of complications that can arise from exposure to the sun. This is not just because I now have new "baby skin",  the chances of kidney failure and vision loss are compounded by my compromised, albeit brand new, immune system.

To get things cooking, today we will lay some ground work and have a look at

* some definitions,
*the Visible Light Spectrum,
*UV  ABCs
*UV Index
*Your Skin Type, your propensity for burning
*SPF ( Sun Protective Factor ) rating for Skin

     If you are in your middle years or beyond, chances are you didn't do much in your youth to protect yourself from sunburns.  We usually started our summers with a burn and peel cycle, but the public consciousness about skin cancer was not as elevated back then as it is now.

There is a lot to cover, or uncover as the case may be, so jump on over

Cabin Fever and our Cure.( non medical )

Cabin Fever and our Cure

We are now on a Mon/Wed/Fri schedule for blood draws, labs, and IV meds, so we have Tuesdays, Thursdays, and the weekends off, and we are getting a little stir crazy. Cabin Fever. The soles of my feet are starting to toughen up a bit, which makes walking more feasible.

From the little porch on our apartment here in Durham we hear that lonesome whistle blow several times a day. (Listen to it here Amtrak Whistle) It has been calling to us, so we started planning a round trip by rail to Greensboro.

A dear friend from Connecticut had sent us a check  with the caveat that we not use it for Medical bills, but to treat ourselves to something special.

My Hemogoblins were over 8, other counts pretty stable, so after mentioning it to the medicos and not being expressly forbidden so to do,  we bought Round Trip Tickets online, downloaded the pdf file onto a memory stick and had it printed at Staples on Tues at 11:00am.

At 12:17 we hopped on the Piedmont at the new station in Durham and  59 minutes later we were in the the Greensboro Depot.

Details of the excursion are below the jump.  We visited two museums, which was a bit ambitious, and  had lunch at a cool burger joint.  It was a challenge to pick a soundtrack for this post, as there are so many train songs.

The State of My Pate

A round or two of Chemotherapy usually results in some hair loss.

This can be the cause of angst and low self esteem in cancer patients, as covered in this monograph by Dr. Tanveer Baig of the Royal Marsden Hospital in London.

The Psychological Impact of Chemotherapy‐induced Hair Loss

It is also enough of a problem in children, that Mattel is going to make a Bald Barbie, with wigs, hats and

scarves.

      I had prepared for hair loss, as I posted back here.  I have now lost all my body hair, save my eyebrows and lashes. I am getting used to it. Regardless of the ambient temperature, it always seems a little chilly, and I usually wear a  Buff Do-Rag, with UV protection  On the plus side, no worries about  having a "Bad Hair" day. 

I have been loggin' my noggin, got a clean bean.

Shaving your head takes the guesswork out of going  bald

So head on over the jump for a look at some famous baldies, 

and a snapshot or two of the current state of my pate. 

Jean Stapleton aka Edith Bunker RIP

Soundtrack

All in the Family / Archie Bunker's Place Opening Credits

LA Times OBIT

Meathead, Gloria, Archie and Edith

What is there to say? 

All in the Family, and later Archie's Place  were pivotal TV sitcoms in the not quite 

post-racial and post-Vietnam era in US history.

HULU has 4 episodes you can stream for free.

 Good for flashbacks, or for anyone born after say 1990 who may never have seen the show. An interesting look at Archie Bunker, "the beloved bigot", who took the role as a tongue in cheek way to point out the bigotry and double standards in 70's and 80's society, many of which persist today.