I almost laughed out loud when the nurse practitioner recommended that I start taking Centrum 50+ for Men. I’m only 37 years old, but these days I have more in common with old men and pregnant women than men my age. From bladder infections to dietary supplements like Ensure and multivitamins, the life of a stem cell transplant patient is rife with new considerations uncommon to healthy men.
Our discussion of what life will be like over the next couple of years was sobering. I will most likely be on the immunosuppressing drug, tacrolimus, for the next year to prevent graft-versus-host-disease (GVHD). Usually, one’s body adjusts after about a year, but GVHD can pose a risk for the rest of a stem-cell transplant recipient’s life.
“For the rest of your life.” I heard that a lot yesterday. I’m thankful that I have a “rest of my life” to be talking about, but the differences from my old life are daunting and certainly will present a new normal for my family. For instance, by having so much chemotherapy, I am at a greater risk for developing other cancers, especially skin cancer. So, for the rest of my life, I will have to limit exposure to the sun and wear SPF 50+ sunblock every time I venture outside.
For the rest of my life, I will be at risk for developing GVHD, although the probability decreases after about three years. This still necessitates regular labs and doctor visits, as well as vigilance on my part to identify any new symptoms as early as possible. For the rest of my life I’ll need to wear medic alert jewelry that identifies me as a “bone marrow transplant” recipient who can receive “irradiated blood products only” should I need a transfusion. Getting non-irradiated plasma or platelets could kill me. Leukemia really is the gift that keeps on giving.
There are some limitations that should only last as long as I’m taking tacrolimus. No yard work since I could be exposed to mold and develop an infection. I can’t eat raw fresh fruits and vegetables unless they have a thick skin, like a banana, and are thoroughly washed. No salads, apples, fresh berries, carrots, raw nuts, or sushi. Any fever greater than 100.5 Fahrenheit is an automatic trip to the emergency room. I’ll have to wear my mask when I leave the house and avoid crowds during flu season. Please don’t be offended if you come to visit and we ask you to wash your hands and take your shoes off at the door.
For the rest of my life I will also live with the possibility that the cancer could relapse. I don’t live in constant fear of this now, but with each blood draw there is a bit of apprehension as I review the report. I’m sure at some point the threat of relapse will become a less permeating thought.
But maybe it shouldn’t. Before I got sick, I understood that I was never guaranteed anything, that each day could be my last. But, I’m not sure how much this reality affected my day-to-day reliance on God. But now, I have unavoidable reminders that each day could be my last healthy one.
The truth is, however, that God already knows the number of days I have on this planet, as they were written in His book before one of them came to be (Psalm 139:16). I am secure in knowing that He is fully in control, that none of these afflictions will come apart from His will. Each day is no less certain now than it was before, I just pretended that it was. Even though the GVHD in my eyes is mostly better, I still cannot see what each day holds. But then again, we are to live by faith and not by sight, trusting God to lead us through the uncertainty.
For we live by faith, not by sight. (2 Cor 5:7 NIV)