Apr 16 2013
Leave a comment
My Life.

10 Year Motto: Share Knowledge. Share life.

ImageToday, April 16th 2013, marks the 10 year anniversary of when I went through the procedure to donate bone marrow stem cells. 10 years! I am still wrapping my head around that number, mainly because it still seems like it was only yesterday when it all happened.  In honor of this day, I posted a photo to my instagram and facebook of my donor sticker marking the date.  I have gotten people messaging me asking about the details of the procedure, what and whom it is actually helping, as well as how to go about signing up.  I figured I would take this time to give a brief overview and explanation.

Thousands of people are in need of a donor for a life saving stem cell transplant.  Now, what’s a stem cell?  Stem cells are Immature cells that can become either red blood cells (which carry oxygen), white blood cells (which fight infection), or platelets (which help to stop bleeding).  A wide variety of diseases and disorders are treated with stem cell transplants. Such as: Inherited immune system & metabolic disorders, blood related diseases, and specific cancers such as leukemia, lymphoma, and myeloma.

So what is a stem cell transplant? It’s when a patient’s diseased marrow is replaced with healthy stem cells from a volunteer donor. Stem cells are found in bone marrow and in our peripheral blood, either source may be used for donation. To prepare for the transplant, the recipient is usually given high dose of radiation, or chemotherapy, or both, to destroy the diseased marrow. Donor stem cells are then given intravenously as soon as possible.

The likelihood of a patient finding a compatible donor within their families is about 30%. The other 70% rely on strangers, on people like you who can sign up to be unrelated donors. At any given time there are about 800 Canadians waiting for a match from an unrelated donor. Sadly, only about 2% of our population are registered to do this. And of that 2%, only 18% are from Canada’s many diverse ethnic backgrounds. It’s a renewable resource inside all of us, and yet people are dying because they don’t have a match, you, could be that match.

Joining the registry isn’t hard.  You can attend a swabbing event in your city to sign up in person or you can go online and have a registration kit mailed to your house. There’s a knowledge and health questionnaire to fill out, and then a cheek swab. It doesn’t take long, you fill out a form, and then you swab.  Pretty simple.

Anyone between the ages of 17 and 50 years old are possible candidates. Certain conditions and diseases will prevent you from being considered a donor: such as: most cancer, heart disease, insulin-dependant diabetes, kidney disease, HIV/AIDS and hepatitis B and C. Joining One match represents a long-term commitment to donate to anyone in need. Not just a friend or relative.

Now, what does it mean to be a match? Stem cell matches are determined according to the compatibility of inherited genetic markers called HUMAN LEUKOCYTE ANTIGENS (HLA), which are inherited from your parents. Up to 12 antigens are considered important in the matching process. The genetic markers used to match donors to patients occur with different frequencies in different ethnic groups. For this reason, a person’s best chance of finding a matching donor is within his or her own ethnic group. It is important to note that your HLA typing is unrelated to your blood type.

If the day comes when you are contacted to be a donor, at that point it is up to you to decide whether you want to proceed to the next step. You are free to decline at any point during the process. However, there is serious risk to the patient if you decide to withdraw after their treatment has begun. You will be informed of when the patient will begin treatment and have every opportunity to decline before that date. When contacted You will have a medical assessment and blood tests to determine the full extent of your compatibility, and you will be informed of which donation process will be used.

There are two ways that the stem cells can be collected: directly from your bone marrow or from your peripheral blood.  Nowadays, more than 85% of procedures are done using the peripheral blood technique.

If your stem cell donation process is from bone marrow, you’ll be given general or spinal anesthetic so that you don’t feel anything during the procedure. A needle is inserted into the large bones of your pelvis, not the spine. You can take a mild pain reliever afterwards for any discomfort. The procedure will take 3-5% of your body’s marrow, which will be self replenished within 2-3 weeks.

If your stem cell donation process is from peripheral blood, you will go in prior to your donation day to receive doses of granulocyte colony stimulating factor or G-CSF. Basically what that does is increase your production of stem cells, for example, say your bone marrow is 50% full of stem cells, what the stimulating factor does is increase that to 100%, that way your bones are overflowing with stem cells, and that causes more of them to appear in your peripheral blood. Now the collection process uses this lovely machine called an apheresis machine, and it is closed system for your blood to travel though. You will have a needle inserted, usually in your arm, and it will take your blood into the machine where it is into its components and only the stem cells are removed.  The rest of your blood is then put back into your body. This procedure can take anywhere from 2-6 hours, depending on your size and how much is needed for the recipient.  I know 6 hours seems like a long time, but you can watch movies while this is happening, so it actually passes pretty quick.

If you cannot donate or are too fearful of the procedures, you can still help!  We need more people to be aware of the unrelated donor registry.  It is not something you are on automatically; you are not added if you donate blood, you have to specifically sign up.

There is no easier way to help save a life.  You don’t have to pay to be a donor, and you don’t have to die.  This is something you can do while still maintaining and living your own happy, healthy life.

For more information, check out One Match in Canada.  Or organizations such as Gift of Life, Be The Match, or DKMS.  There are currently drives happening all over North America for two adorable little girls (Jayden and Sarah) who are both in need of a donor. How can you look at these faces and not help?

Tagged , , , , , , , , , , ,
Feb 23 2013
2 Comments
My Life., Uncategorized

Fragility.

I haven’t written much lately, unfortunately I have been up to my eyeballs in work and haven’t had a moment to sit down and reflect.  This weekend I had one of those smack-you-in-the-face moments where I just needed to take a step back and remind myself of all the things I already know but tend to forget.

In clinical, the majority of patients that I treat are older adults.  I am fully aware that young adults get cancer too; if you know my history, you know that this reality has forced itself upon me in the past.  Lately though, I haven’t had interactions with younger patients.  I have been busy going about my routine days: 8 hours of clinical, go home and study, try to sleep, and then repeat again tomorrow.  It is an all too familiar habit, that sometimes I do it all in a blur.

On Friday as I was prepping for patients, I saw something that made me freeze: 28-year-old female, palliative intent.  Shit, seriously?  Even though I am working in the cancer field, I still sometimes have the “it would never happen to me” mentality, until patients like this come across my plate.  I sat there thinking about what this poor girl must be dealing with and I couldn’t fathom what it would be like.  I’m 28 years old, a few months from graduating, and planning my wedding.  How would I handle the news of knowing that everything I had done in the past few years, every plan I had made, every goal I had set, could be derailed with only a few words from a doctor.  I left work that afternoon and drove home, a long and traffic filled drive spent thinking about my own life and my own mortality.  I realized that it isn’t something I have given much thought to for a while, I just took for granted that I would finish school, work in the field I am passionate about, have an amazing wedding, and live a great life.  None of those things are guaranteed to me, or to anyone for that matter.

By the time I made it home, I was emotionally drained. I just wanted to kick back, shut off my brain, and watch one of my favourite shows, “Say Yes to the Dress”.  There was a young girl 24 years old there to pick out her wedding dress. She was newly engaged and newly bald, thanks to her cancer treatment. Really?  This had to be happening on tonight’s episode?  I watched as this hopeful and beautiful young woman picked out the dress of her dreams.  It made me think about when I picked out my wedding dress.  Although we were both celebrating a similar moment, there were clearly differences in our thought processes.  I was thinking about whether I could lose a few pounds before the big day.  She was thinking about whether she would live long enough to make it to her big day.  At the end of the episode, they showed a picture of the girl in her wedding dress at her wedding.  They also showed the date of her birth, followed by the date of her death: 2012.  My heart sunk.  I found myself googling her name, which took me to her blog.  I sat there in tears reading through her story.  She talked about her experience of being diagnosed, hearing the doctor say, “I wish I had better news for you”.  She wrote about her feelings before going in for surgery, chemotherapy, and radiation therapy.  She wrote about her family, and her fiancé whom had proposed only weeks before she was diagnosed.  Here she was, in the excitement of the engagement and planning her wedding, never once thinking it could be taken from her.  Although she lived to her wedding in August, I am sure it was nothing like she had ever envisioned, but she made it none the less, before passing away in September.  The last entry in her blog was one written by her mother.  The pain in that mother’s heart poured out of my computer screen; a pain that no mother should have to bare.

The message that I took from the days experiences, and the message I hope to pass on to you, is that life is fragile, life does not owe us anything, and life is never a guarantee.  These are all things we know, but when everything is going right in life, we tend to forget about the alternative. We tend to be naive to the possibility that things can go horribly wrong in the blink of an eye.  So today, give an extra hug to those you love. Don’t expect things to stay the same forever. Life is change.  If everything is right in your life, maybe think about what you can do to help others when everything is going wrong in theirs.  It doesn’t take a lot of time or a lot of money to reach out, you can give someone a moment of your time, or even a simple gesture.  Donate some clothes you never wear, take that old homeless man a sandwich, give blood, or simply just hold a door open for someone.  There are endless possibilities, but if you are happy and healthy, why not celebrate it by passing on some of that happiness.  Wouldn’t you want someone to do it for you?

Tagged , , , , , , ,
Nov 02 2012
4 Comments
BC Lions, My Life., Uncategorized

Motivational Medicine

Last week I stumbled onto something, or should I say someONE awesome.  I was aimlessly browsing my twitter feed, something I do too often while procrastinating doing actual work, when I happened to see a YouTube link.  I honestly don’t even remember who had posted it, I think it was one of the many international cancer charities that I follow.  The video was a news clip from KTLA5 in Los Angeles, about a radiation oncologist (simply put, a cancer doctor), who would go above and beyond for her patients.  She had purchased tickets to an Andre Rieu concert for an elderly terminal patient.  In the video, the Doctor talks about when she told the woman and her husband about the tickets, “They said this is incredible, why are you doing this for me?  You know, why do you care so much?”  Then the doctor, fighting back tears replies with “Why not?”

I found myself googling this Doctor (her name is Krupali Tejura) and watched another YouTube video, this time of a TEDx talk she gave.  From this video I learned about how she helped send a patient of a colleague of hers, whom she had never met, to a Pittsburgh Steelers game.  She talks about when she phoned the couple to tell them about the flight, hotel, and tickets she had rounded up for them through donations.  “You don’t know me, but there are a lot of people in the world, including me, who care about you and we’ve put together a package for you and your wife to go see the Steelers play.  They were overwhelmed. [The patient] started crying on the phone, who are you?”

I’m not going to lie, I was in tears.  Granted though, I was in tears already from the first video.  I then went to the Doctors blog (http://krupalitejura.com), and I was moved beyond words.  I read stories of her inspirational patient care, in that she truly CARES about her patients as people!  I read about how she deals with working with cancer every day, how she deals with death, and how she deals with hope.  People ask me about my career choice and those three things all the times.  I sat for a few hours, mesmerized, reading about this woman, who not only worked in the same field I was dedicating my life to, but had the same outlook on life, death, and people as I did.  She was the American, slightly older, smarter version of me!  At the end of her bio it reads:

“I love meeting people who dream big….people who love to laugh….meeting new people…silly people…people who make me think…. people who love adventure…people who like to do rather than sit and watch the world go by…people who dare to do the unthinkable…people who don’t follow the norm…people who make me smile…people who believe the impossible is possible….
I am a random soul…who knocks on doors.. and believes that anything can be made into reality.
Who I want to MEET?  Witty overachievers, ambitious save-the-world types who still maintain a sense of humor, people who hope to accomplish great things and have big dreams, a sense of idealism, unceasing curiosity and passion for something…”

So for those who know me, you can understand why I think she is awesome.

With coincidental timing no doubt, the next day I get a text from my friend Chris saying, “Hey I won 2 tickets to the BC Lions game next week, what should I do with them?”  (We already have season tickets with all our friends, so really had no need for extra tickets somewhere else in the stadium!)  I sat at my desk looking at my phone and had a thought, let’s donate them to someone.  I talked to  a non-profit society for kids with disabilities.  They told me about a boy who had disabilities from acquired brain injuries, who was also dealing with cancer in his family and didn’t have the luxury of buying tickets to a football game.  I gathered up some merchandise I could give with the tickets and put together a backpack with two BC Lions hats I had never worn (one was autographed by some players), football noisemakers, souvenirs, and the tickets.  The mother was so grateful when she was given everything, and I knew she would appreciate it more than anyone we could have sold the tickets to.

I know it sounds cliché, but it honestly feels really cool to know that you are doing something good.  You don’t need money to help people, you just need motivation.

Tagged , , , , , ,
Jul 23 2012
Leave a comment
My Life.

Reflection.

I’m finishing up a clinical term for school, and finally have some time off to sleep and reflect, before starting my final year in September.  Now, people thought I was crazy for wanting to go back to school for quite a few years and get my degree in Cancer Radiation Therapy, but I have never regretted my decision.  Through my personal life, my volunteering, and now my work, I have had countless experiences with cancer, each helping to shape the person I am today.

When I started my clinical experience at the Cancer Center in Kelowna, I admit that I was very green.  I knew I wanted to make a difference, but I was just starting out.  Since then, I’ve had experience working all over the Province.  I have treated children, new parents, great grandparents, and everyone in between.  I have worked with some amazing people who have inspired me to be a therapist like them, and to be honest I have worked with some people who have inspired me to be anything BUT a therapist like them.  Every experience, good and bad, I feel I have learned from, and I know I won’t forget it.

People ask me why, after everything my family has been through, would I want to work with cancer patients every day.  But in my mind, I feel that after everything, how could I not want to?

For those of you who are not quite sure what I do, I’ll give you a quick rundown.  Radiation therapy is a cancer treatment that can be done on its own, with chemotherapy, surgery, or hormone therapy.  A patient will come anywhere from 1 to upwards of 40 times.  They come once a day usually for a month, so I get to know patients and their families.  I get to be a friendly face on their journey, and help them along.  I don’t treat people like they are sick, I treat them like they are human.

I’m not saying that everything is sunshine and rainbows.  Death is something real, and it isn’t easy.  I’ve had patients die.  I’ve had patients coming to terms with a 6 month prognosis.  I’ve had a 25 year old with a new born baby who wasn’t going to live to see his child grow up.  Nothing about what I do is easy, just like nothing about cancer is fair.

My goal is to always be a person who cares, a person who smiles, and a person who helps others.  My past has helped shape me into the person I am, but it doesn’t define me.  In everything I do, I don’t listen to the angry, bitter, hateful people, I listen to the positive, hopeful, inspiring people.  I take pride in what I do and how I live, and encourage others to ignore the outside voices and just stay true to what you believe in.  Be accountable to yourself and to those who you care about, because those are the only opinions that matter.

Tagged , , , , ,
Apr 23 2012
5 Comments
My Life.

Share Knowledge. Share Life.

When I was 18, I honestly didn’t understand what cancer was.  I knew it sucked, and that I had lost both grandfathers as well as my cat to it, but I admit that I was ignorant to the details of this disease.  My older brother, who was 22 years young, had been sick for a few weeks while doing his midterms at University.  We joked about him having a cold for so long because I was usually the one who got sick, he rarely even had a sniffle.  It had been weeks of this when the doctor suspected pneumonia and instructed him to go to the emergency room for a rather routine procedure to deal with the fluid in his lungs.  A routine procedure turned into his lungs collapsing and him going into shock.  I met my parents at the hospital that night when I got off work at 10pm.  I didn’t fully comprehend what was going on, things were a haze for me.  I remember they wouldn’t let me into the ICU for a few days because I came down with a cold (see, I told you).  Then, just as I was feeling better, my brother was being transferred to a regular hospital room, “hooray!” I thought.  I remember walking down the hall of the hospital to his room with a ‘tra-la-la-la-la’ attitude.  At that instance, I saw my mom at the end of the hallway, walking towards me like a heat-seeking missile.  “We need to talk.”  She said while dragging me into a family room.

Cancer.  It’s such a small word that packs a hurricane force punch.  My brother was transferred to the major hospital in Vancouver and began his treatment.  Because he was lucky enough to have a rare type of cancer, he spent most of the next year living in an isolated room the size of a closet.  He needed a bone marrow stem cell transplant to potentially save his life, and I was his match.  I went through with the whole procedure and it was nothing as I had imagined it, just mild discomfort.  When I thought about the horrible pain that my brother was going through 12 floors up, mild discomfort was insignificant.  After my brothers transplant I signed up to be an unrelated donor, because if that was all it took to save someone’s life I’d do it again in a heartbeat.  I can only imagine what would have happened to my brother if I hadn’t been his match.  It is those thoughts that have motivated me to fight for those people who have yet to find a match.

Patients have about a 30% chance of finding a match in their family; the other 70% rely on strangers to save their lives.  Sadly, only 2% of our population are registered to be unrelated donors.  People are dying because they can’t find a match; you could be that match.

One of my life goals is to educate people about unrelated stem cell and bone marrow donation.  If you think that the only way to donate is a scary and painful surgery done through your hipbone, you would be wrong.  Sadly though, you would be part of the majority.  Over the past 10 years, great advancements have been made in the donation process, allowing for over 85% of donors to use a process called peripheral blood stem cell collection.  What this involves is similar to donating blood platelets.  You have one needle in each arm that acts on a closed loop to filter out stem cells from your blood and then return your blood to you via the opposite arm.  It isn’t painful, it isn’t scary, and you can watch a movie while you donate.  Nobody is automatically on the registry, you must sign up, which basically means you fill out a form and do a simple swab of the inside of your cheek.  It’s that simple to begin your first step towards saving a life.  When I talk to people about being an unrelated donor, I usually get the same few responses: I have no idea what that is, I’m not tough enough to go through that, or I’m sure there are enough people registered.  The one that hurts me the most is when people say that they would do it if they knew the person.  Well, they may be a stranger to you, but to somebody they are a parent, a sibling, a child, or the love of someone’s life.  And you could save them.

In Canada, we only have one organization for this called One Match.  In the USA, there are organizations such as Be The Match, DKMS, and Gift of Life.  I encourage anyone who is even slightly inspired by my story, to read up on these organizations and consider registering.  Knowing that you are saving a life, giving somebody a second chance, and allowing a family more time with the ones they love; It’s a beautiful thing.

Please feel free to ask me any questions you may have, I will ALWAYS have time to talk to people about this!  Or anything really!

Tagged , , , , , , , ,
Apr 13 2012
Leave a comment
My Life.

Inspiration.

The following is a journal entry from a few years ago.  It may give you a better understanding as to why I live my life the way that I do.

————————————————————————

Nobody expects to get that phone call.  Nobody expects to pick up a phone and have the world crash down on them.  For me, that day was July 7th, 2007.  I was at home, my parents were in Vernon, my oldest brother was working up in Alaska, and my other brother was at home here in the city.  The number on the call display showed Seattle Hospital.  A woman on the other end of the phone asked, “Is this the residence of Roger?”

“Yes.” I replied.

“What is your relation to him?”

“He’s my older brother.”

“I’m very sorry, but your brother has been in an accident.  He is being airlifted down from Alaska as we speak.” Her voice cracked as she fought her own tears. “You are going to need to get here as soon as possible.  I am very sorry, but we don’t think he is going to survive.  I am so sorry.”

I stood there in a moment of nothing.  Who knew that the sound of the world crashing down on them was cold, calm silence?  A flood of emotions then hit me at once: denial, anger, frustration at life.  It wasn’t fair.  My brother deserved to live.  No, he didn’t just deserve to live, he didn’t deserve to be in that accident in the first place.  My brother had already lost a year of his life to his battle with cancer: a battle that almost killed him a few years before this accident.  He is the strongest person I know, he fought back and regained his life only to have it slipping away again, and it just wasn’t fair.  I began to pace- a habit of my brother’s that I made fun of him for doing.  I figured that this was as good a time as any to start the ritual myself.

A few hours later, my boyfriend and I met my parents at the hospital in Seattle.  Oh the hospital, a place where life begins and ends, and creates some good stories in between.  Now, I had seen my brother in the hospital for months on end during his cancer treatment, but he had always still been himself.  Even when his body was being battered with chemotherapy and radiation in preparation for transplant, he still had a spark of life in his eyes.  I was unprepared for what I was about to walk into.  My brother had essentially drowned.  Having his body in the water for who knows how long, did not just produce ‘pruned’ fingers like the ones I get if I sit in the bath too long.  His entire body was swollen.  His hands were like paws and his face had seemed to lose all of its features.  He was not breathing on his own; the magic of tubes and machines was doing that for him.  I held his hand for a while, a team of doctors and nurses were buzzing about but I heard silence, my mind was trying to process everything.  As I walked into the waiting area I made a beeline for the washroom door, proclaiming to my family in the most normal voice possible, “I’ll be right out.”  When I heard the click of the door behind me, I collapsed into the wall, and then sunk down lower than the floor and just cried.

Even though it wasn’t technically allowed, we all slept on the floor of the intensive care unit family waiting room.  Actually, I didn’t sleep, I paced.  I think I was afraid to sleep because the sooner I slept, the sooner the next day would come.  I wasn’t ready to deal with what the next day could bring.  The doctors had told us that if he made it through the night we would have a lot to be hopeful for.  It was a very long night, but he made it through.  A few days later, the tube was removed from his throat and he was awake.  My brother had survived when they thought he wouldn’t, again.  The next week he was back at home in Canada, chomping at the bit to go hang out with friends.

Sometimes it almost doesn’t seem like it was real.  Perhaps it was my crazy imagination running down a very dark road.  However, I can’t slip into denial, and I especially can’t slip into disregard.  Things happen for a reason, whether they are great or horrible, they exist to shape each and every one of us.  They exist to challenge us, to push us, and to strengthen us.  What good is living your life if you are not accountable to it?  Some people do not have the fortune to take their lives for granted.  They have fought for every additional day on this Earth.  Shouldn’t we fight alongside them?  Seeing my brother get to live his life, even the day-to-day boring stuff, keeps me motivated to live my own life.  Not just to live, but to live in a way that helps others get to live their lives too.

Tagged , , , ,
Apr 13 2012
Leave a comment
My Life.

My Grandpa.

My grandparents are very important people in my life. I grew up lucky as a child to live in the same house as my grandmother and grandfather. I love them both dearly. When I was 10, my grandfather passed away from cancer.

Instead of staying in a hospice, we had a hospital bed brought to our house so that he could go in peace surrounded by those he loved in a place he called home. He was a goofy, accordion playing sweet man who I miss to this day. It breaks my heart that even now, 15 years later, I sometimes still find my grandmother by herself crying, and when I hug her all she says is “i miss him so much”. This is what all love should aspire to be.

Lately she has been going through lots of old boxes and things of his showing me old letters and pictures. Last night she said that she had found something, it was an envelope with my name on it. She didn’t know anything about it and he must have left it with his belongings. The envelope was fragile and worn yellow with age. Inside was a guardian angel and a note that read “to sit on your shoulder, watch over you and keep your spirits high”. I was overwhelmed. He has always been my guidance even though he is not with me anymore, and I feel like he knew that.

So if you’re up there on the internet in the clouds reading this grandpa, I just wanted to say “thank-you for my present, thank-you for the time I got to spend with you, and thank-you for inspiring me to be a person like you”.

Tagged , , ,