Sunday, March 13, 2011

Decisions, decisions

Thank you, thank you, thank you to everyone who commented and wrote me on the last post. We went to Milan on Thursday for a second opinion on the husband’s treatment and reading your comments totally made our day, and distracted us from the crazy, insane traffic of a big city. Seriously, you can tell you’ve become totally provincial when you can’t stand traffic and honking and no parking. We have lost our edge, we simply aren’t aggressive enough to live in a big city anymore, we have gotten soft. Let’s blame it on the children, shall we, and move on.

Anyway, my intention is not to keep you on pins and needles so here’s a little update, along with a lesson on recurring leukemia, this blog is nothing if not informative. As I mentioned briefly in Tick, Tock, the Husband has to have yet another transplant and there are two kinds of transplant he can have at this point, from cord blood stem cells or from a next of kin. The hospital here in our tiny rural town is apparently quite “avant garde” as it does the so called intra-bone cord blood transfusion which is relatively new (which goes to show that choosing to live out in the country is not all bad), but we went to the renown San Rafaele Hospital in Milan, where they do the allogeneic transplant from a next of kin, to speak to the head of Hematology there just to keep all our bases covered. (just some trivia: apparently the husband can’t have another transplant from a third party donor because the leukemia recurred too soon and the commission that regulates transplant won’t approve it.)

What we’ve consistently been told is that there don’t appear to be any significant advantages of one type of transplant over the other in our case, some hospitals choose to do one type cause they like the odds of that one others choose the other type for the same reason, but there is no scientific data that tips the scale. Great, we thought, cause doctors consistently sitting on the fence really make us feel better. The conundrum of course remains of how to make an informed decision when we have neither the time nor the patience (nor, frankly the inclination) to go out and get ourselves a medical degree and specialization in hematology. So, in the absence of cold hard facts we have decided to follow the totally arbitrary decision making tool of our gut feeling. (We are nothing if not resourceful). 
So we decided to interpret “the signs”. The signs did not bode well for moving to Milan when both the husband and I had a hissy fit at the new exit from the highway that had us do a figure eight (I kid you not) to merge into the city traffic, the negative trend continued when it took us 45 minutes to cover the 500mt that separated us from the hospital, which, along with the barely breathable smoggy air and the complete lack of any sort of road signage to direct us to our destination threatened to send us over the edge. Then, when the doctor said that in his highly qualified medical opinion he saw no reason why we should suffer the stress of a move we interpreted it as a pretty definite sign that moving to the City was not in our futures (yay!), the clincher of course was when he also admitted that his big and mighty department had already set into motion the necessary procedures to start doing the intra bone technique that our little country hospital is already doing. So basically, 1-0 for the small town hospital.

Satire aside, of course we would move in a heartbeat in the hope of a better, longer term, remission for the husband, but the idea of being able to face this already trying period within the confines of all our respective comfort zones is certainly a relief. We are still waiting from feedback from another hematologist oncologist in Houston (we really are covering ALL our bases), but for now it appears that we will be staying here.
For those of you who are interested, the plan is for the husband to go through just one round of chemo that “mimics radiation therapy” (in the words of our doc, I have no clue what it means) and then have the cord blood transplant directly into the bone via a minimally invasive operation. His total hospital time should be no longer than about a month, after which all we can d is hope and pray that the marrow does it’s damn job this time.

As an aside to those of you that knew us when we lived in Milan and loved it, can you believe we’re actually happy we get to stay here rather than moving back? That despite my ever increasing complaints about the snow in the winter, along with the shoveling, the muck, the wet muddy boots in the house, the smell of manure in the spring and summer, the damn tractors and or cyclists taking up the entire one lane country roads and the total and complete lack of refinement, I have indeed learned to love the fact that the longest I’ve had to wait for a parking space is 10 minutes and that’s because parking further than 20mt from my intended destination is simply unacceptable, that traffic means 4 cars and a tractor, or possibly some cows crossing the road, that it takes me 10 minutes to get to the hospital… you get the picture.

I have indeed been countrified.


  1. Yara, I'm so happy that you have a little bit of tranquility now....or at least, some solid advice on which to make a decision. Not knowing is much worse than knowing, I think.

    Your optimism mixed with seriousness and a little bit of scarcasim, is just the right ancedote for these difficult times. I'm surprised to know that our hospital is on the cutting edge in some fields. I was always told that if I'm sick, it's much better to get sick here, rather than some other town in Italy...and now you have confirmed that advice.

    I had to laugh at your traffic comments. I was driving to the store the other day and was stuck behind a tractor. I thought "Good Lord....I really do live in the country!". I hear ya loud and clear sista!

    My thoughts and prayers are with you all.

    Your other countrified friend. Margot.

  2. No, not horrified, actually quite understandable since you have 2 small kids and since you live in a house with a yard instead of a tiny apartment... but I didn't think I would live to see you write "yaaay! moving to the City is not in our future"...hehe

  3. Margot, you can imagine how happy we are to be near a good hospital, even though tractors, cows and a whiff of manure is the price to pay!

    Nuts, this is why one must NEVER SAY NEVER!!ha, ha

  4. Good!
    Big hug from a little town...called Abbiategrasso...

  5. I always said living in the country was great! I love the fact that while walking the kids to school we can see the cows, goats, sheep, geese, chickens, horses and the one donkey that live here in our little "town" of santa croce. I also love the fact that if I have forgotten something our little local shops has everything. And I mean everything, from cheese to washing up liquid!!!! Our Dr lives down the road and will pop in at any time if you need him. He knows everyone and is an active part of the community. Try finding that in a big city! I could almost live without a car (i said ALMOST). The only thing that drives me nuts is the snow and the cold and long winters. But if the weather was also perfect then we'd having nothing to bitch about and life would be just tooooo perfect!!!!!

  6. Good!
    Big hug from a little town...called Abbiategrasso...