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Peter Coulthurst
05.01.98

Melbourne, Australia; coult@pac.com.au

1941/ Class of '96 / Last Update: 5/98 - stem cell transplant

Report prepared by his wife, Nola Coulthurst

My husband Peter was diagnosed in February of 1996. He had 6 months chemo - once a month, which he tolerated very well, putting on weight and looking terrific - albeit without hair!! - I digress - but I have a theory that only people with really well shaped heads undergo chemo - because I haven't seen one person yet who has lost all hair, and didn't look really good without it! - BMB showed plasma cell count dropped from 17% to 4%. Recommended auto transplant - which was done 10/96. He was 55. We were not part of the list at the time. Took the specialist's advice that it was better to hit the MM early rather than wait until it 'broke out' again and was more aggressive. It made sense to us - we just wanted to get rid of the 'enemy'.!

After the transplant things happened very quickly - Pete became very ill with a fungal infection (the body turning on itself), ended up in intensive care - touch and go. Without harping on, practically every organ in his body was affected. Then the massive antibiotics and other drugs, which helped fight the infections and bring his heart back into proper rhythm, also left their mark on his ravaged body. He was 8 weeks in hospital with several return visits over the next months. He dropped 25 kilos in weight, had veno-occlusive disease (VOD), in the liver, causing ascites, which had to be regularly drained, and oesophagitis. In true British-upper-lip style, Pete suppresses anger but he was very resentful and angry about the after effects of the transplant. To deal with it he became withdrawn and depressed. He started to 'come good' 6 months after the transplant, was weaned off the various continuing drugs, and touch wood, the ascites hasn't come back. His sense of humour did! He is now pretty good - has had Aredia once every four weeks and Interferon 3 x 3 mu a week, and his 18 month BMB showed status quo. in 'plateau'. Pete has a pretty good life at the moment, but the transplant ravaged his body, and it shows.

To make a decision against the recommendation of medicos is difficult. The doubts we have now, are obviously with the benefit of hindsight.............Hindsight as foresight -- now wouldn't that be wonderful! Pete says that if he'd known what was ahead, he would never have undergone the transplant.

I know that at the time, we were very much motivated by the thought that all those rotten, destructive cells could be knocked out, and we were not so attracted to the idea of 'waiting it out'.

Despite the MM and six months chemo Pete was 'fit and healthy' when he started the transplant procedure, and felt confident it placed him 'ahead of the game' to ride the usual discomforting side-effects. If the medicos know who is likely to come through relatively unscathed, they don't let on, but frankly, I think it's 'pot luck'. Pete's autologous transplant experience was hellish, and I wouldn't wish it on anyone, but I think it was the exception to the rule. Dozens of people will tell you of their very successful auto. experiences......so the majority of people come through very well. Here, they are rarely done on people over 65, but in the U.S. they seem to be carried out on much older folk. Maybe the techniques are ahead of ours.


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