Wednesday, November 19, 2014

Real Friends and a Make-A-Wish

So it's been a really long time. I know. But I'm ready to start again. Before I go into medical things, I just want to quickly say how grateful I am to have amazing friends who stuck with me. During Christmas break of 2008, my best friend, Loren, came to visit me in Cincinnati. She gave me a big hug as soon as she saw me, despite my new, hairless and round appearance. I remember having to ask her to help me stand up and she did it without making me feel embarrassed. And best of all, she asked me questions. Loren wasn't afraid of me. Her first question was "why do you have to walk up the stairs that way?". At the time, because of my atrophied body, I would literally grab hold of the railings and pull myself up step by step. And I explained this to her without shame because she was there with me and did not judge me because she was a true friend. But my transplant really did let me know who my real friends were. And to name a few: Angela, Briana, Jordan. These friends saw me at my worst, but treated me like I was normal.

So I had recovered for a year. Right after my 19th birthday, I got to take my Make-A-Wish trip to New York. And it was AMAZING. While there, I saw three musicals: Mary Poppins, Lion King, and (my favorite) Wicked. They arranged for me to go backstage before the shows for both Mary Poppins and Wicked. I got to stand on the stage of Mary Poppins and speak with the cast. For Wicked, I went backstage and met some of the cast and tried on a costume. That was a wonderful opportunity I wouldn't have had otherwise. Also, I went to the empire state building. The staff let me go to the very top (I didn't know there was more of a top than the observation deck, but there is!). Unfortunately, my trip was cut short because I needed to go back to Cincy for some more testing and treatment. But that's ok. I still had fun! Here are some pics from the trip! (I still look kinda transplant-y in these)

Trying on a coat and hat from Wicked (the Emerald City song).

Dad and I eating at the restaurant under the bridge in NYC.

Wednesday, June 18, 2014

Released with Visitors

Finally, in November, I was released from the hospital. It was so nice to be free! Now, as Carina mentioned, my mom left Cincinnati to go be with Carina for a few weeks while she was at the end of her pregnancy. It was pretty difficult for me when she left, but I also had some backup fly in! Specifically Joyce, Dave's mom, came in to help. Also, my best friend, Loren, and my grandmother, Matto came to take care of/visit me, too!

It was amazing to have Joyce there. And since my brain is a little fuzzy, I think it would be best if she could remember for me.
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I wasn't quite prepared for what would unfold over an extended winter weekend spent in Cincinnati. Excited about seeing Gena, knowing she was in the midst of her very long journey to recovery.  I was thinking a lot about our reunion. What I hadn't expected was that I would be reconnecting with a rather fragile and frail young woman, who was miles from the vibrant teen that I had spent time with just several months before. When I signed on to keep Gena company, so Mercedes' mom would be with Carina and Jason,  I planned on playing a few board games and maybe watching some old movies together.  Instead, I would witness Gena work so hard simply to draw enough strength to stand from the sofa. Dave and Mercedes' butler pantry would become a satellite pharmacy with vials and syringes and medications that appeared way too much for a petite person.  I wanted to help in some way, but when I looked deep into Gena's tired and beautiful eyes, I saw the perseverance and fight that she possessed.
Yes, we had the thrill and anticipation of waiting for Jim and Val's first grandchild, and for Matto a great grandchild. Such delight! But at the other end of the spectrum, Matto and I would prepare a quiet cup of tea as we shared stories of family and life, whispering the time away and hoping Gena would be comfortable for that hour.  And at center of it all was a wonderful father, adoringly caring for his daughter, fiercely wishing that he could trade places with his little girl, but in truth, the very best thing he did for her was to give her better medical care than any doctor or nurse ever could have provided. (Sorry, Dave and Mercedes!)
At last, Carina was in labor.  The house was alive with excitement.  That night, we all went to sleep, dreaming of sweet little babies, only to wake to the wonderful news of Sophia's arrival.  A beautiful baby girl would begin the next generation of the Dullum family.  This would be the shot of adrenalin that would ignite Auntie Gena.  That very morning would be one I will remember for my lifetime. Since her return home from the hospital, Gena was bound to the main level of the house because of the climb of a full flight of steps. But a burst of joy at Sophia's arrival and the promise of the bright future caused Gena to defy any challenge.  The stage was set...We all glared at that endless staircase.  Yes, Jim's brilliant idea of blasting the Rocky theme from his laptop, began the feat.  Matto and I clapped and cheered from the living room, louder than any major sporting event could garner!  Step by step, Gena would climb that mountain, fearlessly forging upwards. Nothing could get in her way.
As I slid into my seat on the United Embraer, heading back to New Jersey.  I smiled and teared at the same moment, as I reflected on a very special weekend spent with a very remarkable person!

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Having Joyce there was a life saver. As she said, I was very weak. I could barely (and sometimes not even) lift myself off of the couch or a chair without help. I was "training" to do steps by wearing a belt around my waist so that someone (like Joyce, my dad, my sister, my mom, etc.) could hold on to me in case I fell.  As Joyce said, Sophia had come and everyone was happy. That was my first motivation to get up the stairs- I was happy for one of the first times in a while. My second motivation was that my best friend- Loren- was coming to visit me in Cincinnati and I needed something to show for myself. My final motivation was that I was bribed. That's right- bribed. Ali Kwiatkowski, Dave's sister, Joyce's daughter, my great friend, had gone to seen Wicked (my favorite musical) and had gotten the cast to sign a poster for me wishing me well. It was so generous of her to take the time to do that for me- so truly special. I think that's when I knew Ali and I would be the best of friends.

So everyone cheered me on as the Rocky theme song played in the background. My dad and Dave flanked me in case I fell. But I didn't. It was one of the hardest climbs I've ever had to do- both physically and mentally. I left the main floor so that I could finally sleep in a real bed after months of sleeping on a couch or blow up bed. I couldn't have done it without everyone. By no means was my climb pretty, but I did it. I literally had to grab on to the hand railing with both hands in order to help hoist myself up one stair at a time. BUT I DID IT. And I think everything really did start getting better from there.

Saturday, May 31, 2014

Bloody Nose and a Sisterly Visit

So the good news is that everything gets better from here. Yeah, there are some dips and lows that sucked, but that has been my lowest low. I hope that I never reach a place like that again.

So I was locked in my isolation room still. Unfortunately, the chemo messes with your senses a bit. I had a really keen sense of smell and no sense of taste. I would have my family bring me the spiciest food they could find just so I could taste something. And if you know me, then you know that I do NOT do spicy. Like at all. But I also had the nose of a dog. I could probably have sniffed out drugs if you wanted me to. But having a great sense of smell wasn't always a great thing. The littlest stench could get me retching. And unfortunately, one time my vomiting had a bit of an issue: Mercedes had come to visit me like she did every day and I would have her sit next to me on my hospital bed. I think she must have just eaten and my super smell picked up just the slightest hint of her breath. Not normally a big deal and she doesn't really ever have bad breath! I was just overly sensitive. So I yelled "Bucket!" and someone handed me my vomit bucket. I threw up- but that wasn't all. Apparently, I must have busted blood vessels in my face and to my whole face swelled and was black and blue! It looked SO crazy.

We called the doctors immediately and were like "WHAT JUST HAPPENED???". We were scared. I didn't have platelets to clot the blood. I was emerging from my depression haze. I was a huge puffball with a puffball face. Also, I had started coughing up these big mucus blood clots and having nose bleeds multiple times a day. It was so disgusting!! The doctors hadn't really seen this happen before. Apparently, I must have thrown up so violently that my blood vessels broke and needed some time to heal.

But I was on the upswing and this was a very minute hiccup. Also, I wasn't too deterred because my other two sister, Brandan and Carina, were coming in town. I was too excited.

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So here's Brandan's perspective:


Reading Gen's blog is an enlightening experience for me.  I was not there for the transplant or much of her time spent in the hospital afterward.  In fact, I was very far away both geographically and in my life circumstances. Gen received chemo treatment a few weeks before my second year of law school.  So, the bulk of the blog takes place during my 2L year, when I was taking a full load of classes while working at the county attorneys' office. At the same time, I was flying around the country to interview at law firms for my big second year internship. It was busy to say the least.  Gen has already explained how we chatted by webcam and on the phone to try to support her as much as we could remotely. I would also call and try to get the 'inside scoop' from my parents and Mercedes to really understand what was going on. As much as we talked during that time and afterward, I don't think I ever did. I am not sure that there was a way I could have considering how foreign the whole experience is. Since I am the closest in age to Gen, I did experience many of her pre-transplant hospital stays. But those were all different: it was a few days, maybe a week while we rotated watch over Gen and the docs solved the issue. Mom, Gen and often Dad lived in the hospital for months during the transplant. For someone who was not there to witness the whole thing, I do not think it is comprehensible. I know this is a somewhat long intro about myself on a blog that is really about Gena, but I am not sure my comments on her transplant make much sense without the context of how isolating the whole experience was, not only of Gen from the world, but also of the world from Gen.

I did get to visit Gen in the hospital and see her life there a few times. The visit that sticks out most was right after Gen got those black eyes she was talking about.  Carina and I came up at the same time for a sisters weekend to try and cheer her up. The plan was to play board games and cards and do whatever else we could think of to make it a fun weekend within the confines of her hospital room. We had heard about the black eyes incident, so to try and bring some humor, Carina, Mercedes and I put black paint under our eyes like football players and called it our 'war paint' for the game day. We showed up in the isolation area and then scrubbed down one more time to go into Gen's room.  I had "seen" Gen over the webcam, but the initial impact of seeing her in person was overwhelming.  The transplant looked like it had literally beaten her up, leaving her bruised both physically and mentally.  I guess the black eyes didn't help.  I tried not to let it show how different she looked and acted, but I don't know how successful I was. My next impression was how the room seemed like an impersonal hospital room and a lived in home at the same time. The imposing IV poles and beeping machines stood next to Gen's pink stuffed animals and my mom's pajamas. As a person used to thinking of hospital rooms as a temporary stop, it was a very discordant image. 

We spent the rest of the time there playing games, solely, but constantly, interrupted by the rhythmic routine of nurses taking vitals and doctors buzzing in and out of the room.  Monopoly was the main event, but the game I remember most was Life.  As we moved those little cars around the board I remember thinking "how strange, we are playing this lighthearted game called Life while Gen actually battles for hers." I considered throwing the game as some sort of small gesture I could make to help, and then realized that this kind of special treatment would have pissed Gen off.  To be honest, I don't recall many more details of the weekend beyond a few snapshots. What I do remember was the poignant mix of feelings of how tough and inspiring it was to be with Gen as she put on a brave face and played games with us while she was so tired and in pain.    

And then I was back home. Back to classes and writing briefs and hopping on flights for interviews.  Perhaps I don't remember the details of the visit well because I couldn't dwell on them as I entered back into my 'real world.' I was flying thousands of miles while Gen couldn't even move a thousand inches.  My dad somehow managed to handle the transition from the solitary room to his demanding life outside those walls with grace. I was not so good at it. Despite my inability to fluently span the two worlds, I'd like to think that our visits and calls helped Gen break through the isolation to the outside every once in a while. To this day, I have no idea how she managed to do it in the end.

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So this is Gen again. Reading these posts from my family really give me a different perspective. What I remember from our game day was joy and happiness (and competitiveness). It was amazing how much better I felt just because all of my sisters were with me. I have to say that laughter is truly the best medicine. And even though they may have been shocked to see me in my somewhat decrepit state, they never let on and acted as though I was normal. And I think that was the best thing they did for me during their visit.

Sunday, May 25, 2014

View From Afar


Throughout my posts, I've mentioned my mom, my dad, and Mercedes a lot. But the thing is, they weren't the only ones going through everything with me. They were just the ones that I had close proximity to. At the time, my sister, Carina, was pregnant and my sister, Brandan, was in law school at UT. My parents and Mercedes apparently sent them daily updates of how I was doing and what was going on (unbeknownst to me). But they had their own view of the events- a much more distant view.

Finally, in December, Carina started having contractions (or what she thought were contractions) and my mom flew out immediately to be with her and to be at the birth of her first grandchild. However, the contractions ended up being a false alarm and my mom ended up staying with Carina for two weeks until the baby came. And I hate to say this, but I was selfish. Mom was the one person I wanted to have near me at all times and she was gone for what felt like forever. I don't think I really expressed this out loud at the time because I didn't want Dad, Mercedes, and Matto (my grandmother who was there to help) to feel hurt. But on the inside I just wanted her all to myself. I was mad at Carina for taking her away from me. Now, I look back and I hate that I was angry. I mean, when I give birth to my first child, Mom had better be there because I'm going to be scared out of my mind! Clearly, Carina was in much more need of Mom than I was. But here is Carina's point of view of my transplant experience so far:

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So I have to admit that I did not read Gena’s blog until now, when she asked me to guest blog on her next post. As we have all established at this point, Gena is the strongest person in our lives. When I heard that she was writing this blog I was so happy and excited for her, I feel that this is a truly wonderful thing that she is doing for herself, and for all of us. And while my family and friends have been telling me how amazing the posts are, and what an incredible insight it is into her experience, I managed to find excuses not to read them. I would see on Facebook that a new blog entry had been posted, and I would quickly scroll past it, embarrassed that I was too scared to read it. Too scared to discover what Gena was really feeling and thinking during her experiences. And while it was even harder to read than I imagined (the pile of tissues next to me as proof), I can’t help but sit here and feel happy. Gena’s right - we do have an incredible family and I’m so proud to be a part of it! And Gena is an absolutely amazing person, and I’m so proud to be her biggest sister. So here’s my version of events - a perspective from outside the hospital room.

I think to accurately describe how I saw all of this go down, I also have to back up for a second. The first few blog posts I remember pretty clearly. But reading about Gena’s experiences after moving to Texas were really interesting and somewhat of a revelation for me. I left for college in 1997 when she was only 7! (and yes, I’m old). And we didn’t live in the same city again until she started at UT in 2009 - twelve years living apart. I of course heard about everything that she was going through, and would visit as often as I could. But I wasn’t exactly living through this like my parents and younger sisters were.

My most vivid memory of the whole ordeal up to this point in the story is the actual transplant. I was 5 months pregnant with our first child. Like the rest of my family, but I think to an even greater extent, I felt that I had been helpless to do anything to help Gena. I wasn’t a match for her bone marrow, I didn’t live with her so I couldn’t help with any daily motivation. I didn’t live in Cincinnati so I couldn’t offer up a homebase. But I thought to myself, I could at least BE in Cincinnati for the transplant, and support everyone as best as I could. I remember feeling somewhat sheepish as I visited with Gen in her hospital room before the big event. Here I was: married, pregnant, with a good job and a happy life. And as she’s described with painful clarity, she was stuck with this situation. And it was so unfair, why her?! I remember her optimism at that point, and I was so impressed with how incredibly brave she was.

Anyway, back to the story. For some reason I most remember being with my parents that day, particularly my mom. We were all back and forth between Mercedes’ recovery room and Gena’s room, but Merce was pretty out of it and I didn’t get to see Gena as much as my parents did. Here is my mom with two of her children going through extremely difficult procedures. One fighting for her life, the other undergoing an intensely painful procedure to save her sister. I remember standing in the waiting room while Merce was in surgery. Hearing the news about the blood in her stomach. Mom almost in a panic but somehow keeping it together. Me trying to comfort her. And then we saw Dr. Filipovitch. The doctor took one look at my mom and pulled her into a huge hug (and anyone who knows Dr. Filipovitch knows that she is not generally the hugging type). Mom pretty much collapsed into her, completely spent and scared out of her mind. It’s bringing tears to my eyes now. It was one of the most touching experiences I’ve ever seen, and exactly what Mom needed at that moment.

Skip forward 4 months. Gena is back in the hospital dealing with her GVHD, depression and pain. We are all so worried about her, me from afar, getting email and text updates daily from the faithful crew in Cinci. Then I go into labor (or at least I thought I did). I call my mom in a panic - I’m selfish and I’m scared and I want her by my side! She decides to fly into Austin the next day to be with me. Only by then we’ve discovered that it’s false labor and I’m already back at home by the time she lands. Of course, selfishly I’m so happy to have my mom with me. She’s been in lock-down with Gen for months. Surely I thought, I’ll be in labor again within a day or two and then she can go back to Gena. Nope. Two weeks go by before the actual event occurs and Sophia arrives. Those two weeks I know were torture for mom. (And I’m assuming for Gena). I knew mom wanted to be there for the arrival of her first grandchild, but I also knew in her heart how badly she wanted to be back with Gena and how scared she was. She managed to keep it all pretty well hidden. But after reading the last couple of blog posts, it really brings the daily struggles of that time into a much sharper focus. And makes me appreciate even more the sacrifice that everyone made at that time - mom being away from Gen, Gen allowing mom to leave her side for more than 2 weeks! Dad stepping in and being the daily caregiver, Merce stepping up her efforts even more than usual. (And a shout out to Brandy and Jason for keeping me sane here in Austin). I know this memory isn’t exactly about what Gen was going through. But it’s how I experienced this time in her life.

I know we’re not quite to this part of the story yet - but I just have to say that it’s wonderful to finally feel like I can be a part of Gena’s life in a regular way now. I’m the only family in Austin with her at the moment, and I finally get to be the one helping Gena whenever she needs it. (Although, as everyone already knows, she’s actually the one helping me out on a regular basis!) Thanks for writing this blog Gen, I’m not scared to know what you’re thinking or feeling any more, and you’ve made me a stronger person by sharing all of this with us. I’m just happy to be a part of the story. I love you.

Tuesday, May 6, 2014

Another View

Like I said before, I don't remember a lot of what happened. And I guess it's about time I found out. So here are Mercedes, Dad, and Mom to fill in those gaps. I'll admit this is a long one, but it's great.
NSFW (because you will probably cry)

Mercedes:
Wow, that was the hardest blog entry to read, Gen. I forget how awful that time in your life was. I think we all try to block it out from memory, because It was miserable for all of us. I was a busy intern, and I remember working in the NICU at one hospital, then driving over to children's afterwards to see you before going to bed. I would go to the Wendy's AND mcdonalds (mcdonalds fries and Wendy's nuggets) to try to entice you to eat something. It rarely worked. It was an exhausting time for all of us, and also depressing. It was so hard to see you like that; not just sick but lifeless. We tried everything we could think of to inspire you, to get our Bean back, but it was like you had disappeared. It was really scary, to be honest. I remember at one point, the doctors worrying that you weren't going to make it, because you had lost your will to keep trying. That was terrifying. I'm pretty sure that's when the psychiatry "team" was called in. A daunting task for them, in my opinion, because for as tiny and frail as you were back then, you were pretty intimidating. Not saying anything, just glaring at everyone. It was a very effective way to try to shut everyone out. I remember watching the Texas vs OU game in your hospital room that year. I would be shouting and screaming at the tv, and you would open your eyes and glare at me to shut me up. That was frustrating, because it was such a good game and I wanted to share it with you, but you didn't care about it, at all. I remember mom and I leaving one weekend for Carina's baby shower. That was the hardest decision to make, because you were still so low and we felt like we were abandoning you. But dad stepped up and made the most of the weekend, helping you dress up for Halloween. Dave even brought in flame-free candles and fake pumpkins and you had the nurses and staff trick or treating in your room! I'm sad we missed that, but it seemed like good bonding time for you and dad. Anyway, that was definitely the hardest part of this process in my opinion; thank god we are so far from that place now! 

Dad: 
Gena asked us to be honest in writing this. So I'll set the tone and start by admitting I cry a lot when reading her blog. Actually crying as I write this (people on the plane next to me probably wondering what emotional movie I must be watching on the iPad). But I am oh so proud of her for doing it. And I'm so honored to be asked to contribute.
If I can, I'll back up to a little earlier in her journey just to lay some foundation for my entry. In some ways, I have always known with absolute certainty Gen would make it thru all this - I think that certainty was born of her Spirit and Sense of Purpose, which has been there from day one of her illness - you could always see her thinking "Ok, let's get thru this!!".
And while I never lost faith in her ability to do it, there were times early on (some of which she has covered) when I did have to take a deep breath as we pushed forward: at initial evaluation when the doctors start by saying she has a 10+% chance of dying from the procedure; when she was identified as having a heart condition complication; when I'm driving us at 6:00 in the morning to the hospital in Cincinatti to check-in on day one of the whole process and my mom and Brandan call from Texas and tell me Gena's cat literally just lay down and died (a secret I kept for the next four months from Gena, Val and everyone in Cincinnati). 

And then we came to the period she is describing now in her blog. I still believed absolutely, but it made those dark days in her room tougher.
In some ways the events of this time seem a little cloudy now, probably a self defense mechanism as I don't want to remember the details.

My overall feelings and rememberances at the time: Bravery, bravery, bravery; Helplessness, helplessness, helplessness. 
Bravery - I have never seen such bravery - in the face of pain and depression. Mostly by Gena, silently, moodily, stoicly soldiering through, but also by Val and Mercedes, coaxing her along and through it. I came to understand clearly the expression "strength of a woman".
Helplessness - that was all me. I couldn't take the pain and sickness from her or for her, all I could do was put cold packs on the bruises when she fell or bumped something, hold her head while she threw up, carry her to the bathroom when she was too weak to walk (actually it was more of a shuffle when she could).
But mostly, as I was traveling a lot at the time, I'd fly in Friday's and try to spell Val to get a few hrs away from the hospital and a shower, before I'd have to fly out again on the Mondays. And while I felt like somewhat of an accessory to the events as Val was about the only one who seemed able to channel Gen during these months, I was so eternally grateful my partner was so strong and able to be there for her. 

But now a more specific anecdote. 
For those few months we lived in that dark room, with almost no sounds but the monitors (those damn monitors). As Gen's GVHD progressed, we started to see the effects of the life saving high dose steroids (which we discovered years later also have huge downstream implications). Gena started to take on the appearance of an Egg on Stilts (Gen, you asked me to be honest). She was completely bald, but as her muscles (arms and legs) shrunk to nothing, the steroids made much of her head and body tissue swell. So while at one point I could get the fingers of one hand around each of her LEGS (the stilts), her body and head took on the shape of a human egg. (For those who know me I'm not a large person so my one-hand grip is maybe 2" diameter - that's how skinny her legs were). But as she started coming back to us slowly, and would raise herself up in bed on the stilts, every day I would think how absolutely beautiful she looked. 

Then in late October came Halloween. She was just starting to emerge from her cucoon, so Dave and Mer decorated her room with ceramic pumpkins (no real ones allowed - infection threat) and battery powered lights. And she and I dressed for the occasion. Val and I had bought costumes. As Gen was still pretty moody (she claims the steroids), we bought her favorite Disney princess outfit and a bumble bee alternative (all black and yellow stripes, wings and bouncy antenna). To my surprise she picked the bumble bee. I was the old hippie (little round glasses, fringe vest, mustard bell bottoms). We dressed, the bumble bee egg on stilts and the hippie, and went off to PT for a strenuous workout with her therapist team, going up and down two steps, with a little help. Once again, it was one of the most beautiful sights I have ever seen. I have the pictures to prove it (but Gen, promise I'll never show them). 

Rambled on way too long, but before I go I must admit, I didn't understand her embarrassment in all this, through the depression and pain, as all I could see was her strength. In hindsight, and with the aid of her blog, I'm starting to get it. I'm still learning from her. 
I'll end simply by saying, Gena is the strongest person I have ever known.

Mom:
Dark days in so many ways. Literally, you wanted the room kept as dark as possible, but also dark down in my soul as I watched you battle the GVHD. Dad was right, we all felt so helpless.  Your coping method of withdrawing into yourself was so frightening and yet you found a way to share your pain with me. We communicated through touch and with our eyes.  No verbal communication.  How you kept your patience with me as I fumbled around trying to guess your needs is astounding.  But eventually, we found a way to become one.

Leaving you for any length of time was almost impossible for me.  But showers must be taken and although shower stalls were provided for parents at the hospital, I was so frightened of picking up some disease that I would rush to Mer and Dave's home (about 20 minutes away), bathe, change clothes and rush back (I actually took extra time on weekends when Dad was with you to wash my hair :).  Dad or Mer or Dave would fill in for me while I was gone, and although I tried to keep my time away to under an hour, it must have felt longer to you because upon my return you stared at me and communicated with your eyes "why were you gone for so long?"

Living in the dark had it's amusing moments, too. All the hospital rooms were set up in exactly the same way - bed against that wall, sleeper sofa by the window (and directly under the AC vent!), nurse's station against the opposite wall etc.  Within the first few days of your arrival back on the BMT floor, you determined that this set up was not functional and had us re-arrange everything! So when your nurses came in later to check vitals and enter whatever they needed to on their computers, etc, they were confused and bumping around in the dark trying to do their job! To their credit, after adjusting to the new arrangement, they agreed that your room was much more functional than any other room.
I have to give so much credit to the majority of nurses that attended to you during your stay.  Not only did they put up with your interior design inspirations, but many of them had suggestions for relieving your pain and making you more comfortable, all of which came from their years of experience on the BMT floor.  Your Head nurse, Ann Marie, at first seemed a little brusk to us, but her insights and suggestions on how to cope, not the least of which was telling us to ask your docs for marinol to help with pain and appetite, added a dimension to your care that we could not receive from your doctors alone. Not to take away anything from your doctors, they were the best in the nation, but your nurses were there "in the trenches" with us, and their experience was invaluable. I'll leave it to you, however, to talk about the nurse you fired...

It is human nature to share what is going on in your life with others in a similar situation. At the hospital, parents naturally gravitated to each other to discuss what they and their children were going through in the kitchen/meeting rooms provided for us. Initially, it was a learning experience for me. Many of the parents had been there for many weeks and/or months, and they shared their knowledge. Every night blood was drawn from every patient and every morning the results were delivered. I quickly learned what to look for - platelets, red blood cells, white blood cells, t-cells etc. etc. Progress was so slow, that, incredibly, the morning results became a ritual that we anxiously awaited, to see if your t-cells were behaving any better or your platelets went from 7 to 8 (normal is around 100). This would give us a clue as to what kind of transfusion you would receive that day - platelets, blood... As I got to know the parents better, their stories of what they had gone through with their children was horrifying. You had your procedure when you were as healthy as you could possibly be.  Most of the other patients started their transplant journey at their lowest point. I began to dread spending time with the other parents, my own defense mechanism jumping in - how could I give more of myself to comfort these mothers and fathers when I was totally drained caring for you? This was a time when I was not very proud of myself. I started to panic when I learned that one of the patients had gone to the dreaded ICU - most never returned. Or not seeing a set of parents, knowing that they wouldn't be back because their child had passed during the night - their room being prepared for the next patient. I bragged earlier about the nurses caring for you, but now I have to brag about your case manager, Laura. So young and yet so wise, she saw what I was going through and gave me very tough advice. Do not become close with the other parents. It sounds cruel just typing this, but it was the best advice I could receive. You needed all my attention, love, time, encouragement. I mentioned Ann Marie earlier, and how we thought she was a little brusk at first - she had to be. Watching over and caring for these patients on their last attempt to regain their lives is mentally and physically exhausting.  I could never do it.


We found out many months later that of the 9 patients who received BMT's when you did, you were the only patient to survive. That should not be a reflection on the BMT program at CCHMC. Their program is number one in the nation, hence they receive the very worst BMT candidates. The ones who have no other hope than to receive a bone marrow transplant.  Also, marrow donors are not easy to come by. The fact that Mer was a perfect match for you is the exception.  There was one very young patient whose parents actually had another child for the specific reason of having a better match for their son. We, as parents, would do anything for you.

I'll admit it now, but initially I was kinda embarrassed about sleeping with you every night in the hospital.  And I literally mean sleeping in your hospital bed with you.  Most of you reading this will probably think this is a little weird, but after the first few days of sitting at your bedside, holding your hand, stroking your head, talking to you, singing to you, telling you stories, encouraging you, but eventually realizing that I needed to lay down and rest, too, it was too difficult for both of us to be separated, even by a few feet.  So we decided that I would lay next to you in bed so that whenever you needed anything I would be right there. The night nurses were so respectful, and never said a word about our arrangement. But, as in any hospital, the day starts early, so usually around 5 am I would get up, change, dash out for a minute to brush my teeth and hair (I couldn't use your bathroom because of the risk of infection to you) and hurry back for the first rounds of the day.  Generally, the first team to visit you was the pain team.  I can't say enough about the pain team at CCHMC.  These doctors were incredibly patient with you.  You barely communicated with them, and yet they persisted in trying everything they could think of to make you more comfortable. But eventually it had to happen - we got caught! I'm not sure why I didn't get up on time, or maybe the pain docs were early, but they came in and there we were, in bed together.  I tried to get up quickly, which is impossible because I didn't want to disturb you - you were finally in a semi-comfortable position, but the docs just smiled and told me to stay where I was. I confessed to them that this was how we spent every night together.  I will never forget what they said to us, "there is no pain medication that can do for Gena what you are doing for her now - the human touch is an amazing healer." So our secret was out, and the embarrassment was gone. We even napped together during the day. No one ever said a word.

Eventually the dark days passed, and you entered your second life with more courage and strength than anyone can possibly imagine. Those dark days were almost intolerable, but we came out of it together, our relationship bound forever by the tough times we shared. Was it worth it? Of course, but my oh my.......

Finally, I have to talk about your amazing sisters and and the wonderful men they married.  Mer, of course, was the lucky one and gave completely of herself without hesitation. You are your sister. Carina and Brandan, through their visits, email, online chats, were there with us all the way, sharing in your suffering and successes.  Jason, Carina's husband, has been your big brother, comforting you (or throwing you across the pool while doing cheer leading stunts) since you were little. Brandy's love, Ian, helped you through those first very tough semesters at UT, when giving up wasn't an option for you. And finally, Dave, Mer's guy, who took in the Dullum clan without a second thought and opened up his home with his then girlfriend, Mer, and through baptism by fire learned the best and worst about us.  I can conjure up images in my head of each one of my sons (not son-in-laws) sitting next to you on the couch, with their arm around you, comforting you, not with words, but by just holding you for hours.  We are so fortunate to have each of you in our lives.

But, of course, there is our main man, our glue that holds us together, who speaks words of wisdom when we need it, encourages us with his strength (that's where you get it from), and guides us gently through the maze that is life.  My partner, your Dad.

Saturday, April 26, 2014

I Don't Remember

I was finally out of the hospital! And it was awesome. I was constricted to a house- but hey- at least I now had 10 rooms instead of one! And I was doing pretty well. Was is the key word here. I had no idea what horrors were in store for me.

Soon my stomach began hurting. And I mean hurting badly. They hoped maybe it was just normal stomach issues and so metamucil became a part of my daily regimen. But it wasn't getting better. If I thought that my Crohn's had hurt, I had no idea what a world of pain I was about to endure. Finally, one night I looked at my mom and said,"I need to go to the hospital".

I had gotten GVHD (graft versus host disease) of the duodenum. Basically, the new fighter cells in my body were attacking my colon because there was previous damage there from the Crohn's. They told me it was likely to happen. I just didn't understand that it would be the worst, and I mean absolute worst, thing I would ever experience in my entire life.

I don't remember much of it to be honest. I was in the hospital from September to November. I remember only glimpes. I was on loads of pain medication. Tons of steroids. Tons of who knows what else. Once, I counted how many pills I took in a day. It was 42. Plus I was constantly on IV drips. I remember the doctors coming in and  trying to talk to me and see how I was doing, but I was unresponsive. I refused to talk and turned off all the lights. I literally sat awake in the darkness. My only form of communication was through my mom. Rarely, I would whisper something to her. Otherwise, she would have to guess at what I was thinking and if I didn't glare back at her, she was correct in her thinking. There was more agonizing pain. More pain meds.

I couldn't sleep. Finally, they put me on Ambien. The first dose was too high and I got up in the middle of the night and fell over a chair. I didn't even remember it happened the next morning. I woke up  with huge bruises all along the side of my body. This was especially bad because I had no platelets to clot the blood. They lowered my dose the next night.

I was still vomiting all the time. I don't think the chemo truly left my body for about a year and a half. I vomited almost every day in that time. And I was so weak. I didn't eat or get out of bed for six weeks. I couldn't because it was too painful or I was too doped up anyways.

I would only get a semi-shower once every few days which basically consisted of wash rags with soap on it while I laid in bed. I hated it because the rags would become cold so quickly. Also, it required me to move just the slightest bit which my muscles refused to do. What really stinks is that to this day I now have PTSD (well probably a milder version of it) to the soap that we used. It was a Dial vanilla brand and if I smell or see it I just start crying. Even writing this here is difficult.

I made sure either one of my parents or Mercedes were always with me. There was only one time during that whole hospital stay that they weren't. And I freaked out. I had to go to the bathroom, but I couldn't move by myself due to my muscular atrophy. My legs and arms wouldn't support me because I had wasted away in the past few weeks. I didn't want to call the nurse because they didn't know how to help me like my family did. I hated being dependent on a stranger and I was so embarrassed. But I eventually did call her to help me anyways. And when my mom returned I cried and cried and asked her never to leave me again. That was selfish. But she understood and she would do the same again.

One of the only other things I remember was a team of psychiatrists coming in to see me. A team. They told me I was depressed because I wouldn't talk to anyone, kept all of the lights off, and refused to move. I didn't say a word to them. I just took turns glaring in their general direction and then dropping my eyes to my lap in embarrassment. In retrospect, yes- I had severe depression. But at the time I was too depressed to see it. And I was too humiliated. There is a huge stigma out there for depression. One that I had back then. It's something you don't ever want to admit to. You tell yourself that you can be happy and that sometimes you even are happy. And when someone says you're depressed you get embarrassed because it feels like an attack on you. They're telling you there is something wrong with your mind. And nobody ever wants to think that there is something wrong with them. But Mercedes was the one to talk me into taking the antidepressants. She said it was worth trying and if it didn't work there was no harm done and I could stop. It's hard to argue with that logic.

But that is all I can recall. My mom says it's good I don't remember a lot of it. It's probably a defense mechanism that my brain is using. I just remember these little episodes. And some of them I didn't even recall by myself. The story of my life came up later. Someone would say "You don't remember when you fell and got so bruised all over your body?". I have one very vivid memory engrained in me from this time though: the image of the dark hospital room. I remember one morning just staring at the little window with the little streams of light coming in my room and hating that light. How could it be sunny out when everything in my life was so horrible and dark? It didn't make sense. I wanted the light shut out.

Sunday, April 20, 2014

Reflection

For more than a week now I haven't posted because once again I've been hesitant about what I want to write. This post will be a quick pause in the story of my transplant because the other day someone said something to me that made me think.

My voice teacher, Liz, was talking to one of my classmates, Sierra, about how even though she's a younger student, she has a maturity about her because of her past. Liz said that not everyone has the fairytale childhood and then pointed out that Sierra and I had very abnormal (and not good) experiences in our pasts that made us sing the way we do today. I think I usually try to push this thought out of my head and say that back then, I did what I needed to do. I don't want to think about how my childhood and teenage years were so different from people that are normal. I'm afraid to think too hard about it because then I will have to grieve for my loss. But two things have made me start to think about this more. First, just by writing this blog, I've been trying to be more honest with myself and in my writing. Second, I am starting to watch my nieces and nephews grow and have a beautiful and healthy life ahead of them. And I love that. But it's also a bright and shining example of what a normal, real childhood looks like.

So it makes me sad to think about how unfair it all was which makes all of the questions come out. Why did my life have to be so different? Is there a reason for all this? And the most frequent one- WHY ME? And there is no reason. Sometimes people try to give me reasons like "you are only given what you can handle" and "by going through all of this, you are meant to do something with your life". But the real answer is there is no reason. My favorite people are the ones who, when I ask "why me?", they just say "I don't know. It's so unfair." Because it is unfair. I have been through so much shit in my life and it isn't right. Sometimes I think to myself that karma will come into play and later my life will be the best a person can have. But that is unrealistic and not true. There are things left over from the transplant that will never, ever leave me no matter how hard we try to fix it.

But that being said, I must admit that without everything that happened to me, I wouldn't be who I am today. Sure, I definitely could have done without a lot of it, but it happened and I can't change that. One of my favorite thoughts is the more sadness/hardships you experience, the more you appreciate the happy things. So yeah- sometimes life sucks and there isn't anything you can do about it. And when it does suck, you should take time to appreciate that suckiness so you can fully appreciate your happiness later. I've also gained a serious appreciation for life. I pretty much never let the small things bother me and I hope that I help my friends and family to do that as well. It's a lesson that is hard to learn, but when you do, life becomes infinitely easier and it is an amazing thing. So next time something bad happens- a guy (or girl) you just met doesn't call you back, you get a bad grade, you get into a fight with a friend- first, wallow in your sadness for a bit so you can appreciate it later. But then, get up. It's not the worst thing in the world and will probably not be the worst thing that will ever happen to you. And let it make you better- know that the guy (or girl) isn't worth your sadness, do better on the next test, make up with your friend because y'all are both being stupid (quick tip: in a fight, no one is ever completely right or wrong- it is always both your faults). :)

So yeah- that is what I've been thinking about for the past week. And thinking about it made me upset, but I reflected on it, told myself it sucked, and then brushed myself off so I could move on. I know that these thoughts will come back to me every once in a while, but I also know I can handle it. So why me? There is no reason. But I know it's made me who I am today- who is a pretty awesome person if I do say so myself!

Sunday, April 13, 2014

Bald and Free!

Something I forgot in the last post that my mom reminded me of... When the nurse was pushing in the bone marrow she was pushing SO hard. And my central line was pushing back hard, too. Finally, there was so much pressure the huge syringe cracked. Marrow spewed up into the air and splattered across the ceiling, onto me, and onto my bed! The nurse stood there in shock. They apologized profusely and said that had never happened before. We just laughed and laughed. It was hilarious! But now back to the story...

Vomiting. Oh so much vomiting. But also hair. Little bits of hair. It was slowly falling out. Every morning I would wake up and find strands of my hair all over the pillow. I had it cut to my shoulders right before I got the transplant in order to donate it to Locks of Love. So at least it was short strands! But after only a few nights of this, I was like "Get this shit off my head". I had had enough.

Now I thought this was going to be an exciting experience! I wanted to make a party out of it! So I was going to have Mercedes buzz off my hair while my parents and sisters (Carina and Brandan over iChat) watched and cheered on. Of course, they humored me. I had the "I'm sick so I get what I want" powers. So Mercedes happily shaved my head as everyone smiled and nodded along with me. It wasn't until years later that I found out that it was kind of a horrible experience for Merce! I had no idea! I mean, of course she wouldn't like shaving off her little sister's hair. She did it for me, but I don't think she enjoyed it which is completely understandable.

So around Day 10 (10 days after getting the transplant, 20 days in the hospital including the pre-transplant chemo), I started going "Hey!... Hey docs!... Hey docs let me out of here!". I was ready to get out of my confinement chambers. 20 days in one room (with marrow on the ceiling!). I wasn't allowed leave it since I had no immune system and could catch whatever little bug was floating around. I was clawing at the walls! Around Day 13 they said "soon". The next day "really soon". Finally, on Day 15, they said I could go! I was so excited. Not only was I going to be released to go home to Mercedes' house, but I also had the record for quickest release from the hospital after a BMT. The next best was 18 days. And I shattered that record! Most people have to stay about 30 days post transplant at least. I think I may be too competitive. But that's okay because I won! :)

So here's Mercedes again... I figured I put her through shaving my hair off so I should at least let her talk about it!


There are few things more difficult for me than shaving my sister's head. For anyone who knows gena, she is absolutely stunning, and she had the most beautiful hair before her transplant (it has since grown back, thank goodness!). Watching her lose it in small clumps was painful to see, but when she asked me to shave her head, I felt like I'd been stabbed in the gut. I understood her motives to just get it over with, but I felt like I was stripping her of her femininity and more importantly, her identity. As a doctor, I see lots of people with bald heads from various chemo treatments, and to be honest they often look very similar. I did not want my sister to fall into that category in my head, and I think shaving her made me see her in a different light- a little less like a sister, more like a patient. I think this also forced me to realize how sick she really was. Gena has an uncanny ability to present herself as less ill than she truly is, whether its her incredible pain tolerance, determination, or unflagging optimism. And I think my family would go along with it, because we really really wanted to believe that she wasn't as sick as she really was. And for me, shaving her head removed one of her layers of defense, making her seem more vulnerable. 

Furthermore, with a platelet count of zero, I was terrified of nicking her and causing her to bleed! Luckily it turns out they are smarter than that and only let you use a "safe" razor that was less likely to cut her. Phew. 

On the upside, if anyone can pull off bald, it is Genevieve. She of course looked beautiful and handled the transformation with more grace and dignity than anyone else I know. 

Sunday, April 6, 2014

Day Zero and a Guest Blogger

Day zero!!! Transplant day!! WOOHOOO!! I was going to be cured and I was excited.
Mercedes was admitted to the hospital. She was going to be put to sleep, have her bone marrow removed from the back of her pelvis bone, and save my life. I hugged her and wished her luck before she left to go get it done. I waited and waited until about noon when the nurse came in with bags and bags of what looked like blood (but was actually bone marrow). They hooked the bag up to my central line and put it on a hanger. It wasn't on any type of a pump because they wanted to let gravity do it's thing and let it go into me at a natural pace.
But gravity wasn't working and so after a few hours of it hanging the bone marrow was going to "spoil" if they didn't get it into me. So to get the last few bags into me, they brought in these GIANT syringes to physically push it into my central line. And by giant I mean a foot long and 3 inches wide. HUGE. I think I had about 7 or 8 of those syringes to get in to me in one hour. So the poor nurse got her work out in. I think the funniest part was that when she was pushing it in, I could taste it. Now most people would think that was really gross. But Mercedes' bone marrow tasted of cream corn and bacon. So I was not too upset about. I got all of my bone marrow and was on my way to a health. Kinda.

So back up a few hours. After I had first gotten the bone marrow, I kept asking about Mercedes and if she was awake yet. How was she doing? Finally after about an hour and a half my mom came in looking kind of upset. She sat down next to me and told me not too get upset and that everything was okay. Immediately I panicked. What was wrong with her? What did they do??
My mom told me that when Mercedes woke up, she began vomiting blood. She said it was because when they inserted the breathing tube, it nicked the side of Mercedes' esophagus or stomach or something causing blood to drain into her stomach. I began to cry. How could they have messed up like that? She was doing an amazing thing for me and they made it that much harder. And the worst part was they took copious amounts of bone marrow because they had "the more, the better" mentality. So not only did she lose tons of blood from the bone marrow, but she lost tons from it was draining into her stomach. She was beyond anemic.
I wanted to go see her. Of course, they wouldn't let me leave my room because I had no immune system. My next solution was to just move her bed into my room, but they wouldn't let me do that either. I hated it. She was saving my life. I wanted it to be as easy as possible for her to undergo, but instead it became a debacle. And she felt so awful. I mean- she had no blood!
She was released late that day (even though she shouldn’t have been, but she’s stubborn and demanded to be released) and she was on bed rest because she was so weak. I finally saw her in person a few days after she had been released and she looked pale and tired- and that was after she had somewhat recovered. She had horrible lower back pain because they went into her pelvis about 40 times (with their giant needles). Her throat and esophagus were raw from the tubes and she was exhausted.
So Mercedes- I'm so sorry you had to go through that. Even writing this it makes me cry. But thank you for saving my life. Thank you for everything that you have done and continue to do for me. I don't think I say that enough. And I love that I will always have a part of you with me.

And now something new. I'm going to let Mercedes describe her experience with what happened. I think every once in a while it will be good to get another person's view.


I am so honored to be a part of this blog post! One thing I wanted to briefly mention was that all the Dullum sisters were tested many years ago to see who might be a good match for Genevieve in the event that she need any donations. Well, I remember clearly the day we were tested: at the age of 12, I walked right into the doctor’s office and declared that I didn’t need the test because I knew I was a perfect match. And it turned out I was right! Genevieve and I have been so close forever, (she is always trying to be just like me) and it only seemed natural that I would be her donor. I remember being so excited about the “harvest day,” or what our family had labeled “D Day,” (Donor Day) because I was finally able to actually DO something tangible for Genevieve, rather than bumbling along trying helplessly to accompany her on this journey. It was funny being on the other side of the table for once, when I was in the OR and they told me to start counting back from 100. I also remember that the IV really hurt! This gave me more respect for what Gen has to go through all the time. She has been getting IVs for most of her life, which was something I hadn’t thought was that big of a deal, and then the first time I had to have one placed it was so painful! Anyway, these were my last thoughts as I drifted off into anesthetic bliss for a few hours.

After the harvest, there were two things that stood out to me. The first was the look on Dave and my dad’s faces when they saw me in the recovery room. They had that expression when you know something’s up but no one wants to talk about it. I immediately assumed it had something to do with Gen, but eventually it came out that I just looked really, really pale. Dave later told me how worried they had been, but that no one had wanted to say anything to me until I was recovering well. I overall felt fine, other than being tired and a bit nauseous. I was then moved to the inpatient unit. The second thing I remember was how vulnerable I felt in a hospital gown. This was yet another way I finally got a glimpse into what Gena’s life has been like. I felt so exposed and open and embarrassed, when really I should have been focusing on rest and recovery.  

I hated this feeling, so I demanded to be discharged the same day as the procedure, changing the original plan of being monitored overnight. They finally relented, and despite being weak and very nauseous, I was released that afternoon. The Percocet they gave me, (72 tabs! Who prescribes 72 tabs for a minor procedure??) made me feel very sick and loopy, and I only took one before I decided on Motrin and Tylenol for the rest of the weekend. Anyway, I also remember talking with Gena via video chat, and being very disgusted by the bag of blood hanging from her IV pole. For some reason, despite my medical background and having watched bone marrow aspirations as a medical student, I had envisioned my bone marrow being thick and of more substance, with important cellular components floating in it (this makes no practical medical sense, but that’s still how I imagined it). Well, as Gena said, it literally looked like a big ol’ bag of blood. I was a bit disappointed, feeling that it did not do the job justice.

The hardest part of the harvest for me was not being able to see Gena for a few days. Up until that point I had visited her every day in the hospital, and it felt foreign not to see her. I was dying to know what was going on and how she was feeling. I guess we’ll just have to wait til the next post to find out!