We’re back home after an exhausting 5 day stay at Stanford. Paul had numerous treatments and procedures, so today’s blog might be more detailed than most of you care to read about.

At Stanford, we had to learn the locations of all the different places we needed to go – the Cancer Center, the main hospital, the infusion center – even the shuttle stops and the parking garages. It’s a big place and very busy. At Stanford’s Cancer Center, they see over 200 patients a day.

The first day involved several meetings and trainings in preparation for everything that was going to happen over the next few days. The second day they placed a central line (a surgically placed IV line) in Paul’s upper chest to make it easier to administer chemo and take labs without needing to constantly poke him. After that, he was hooked up to a portable pump that administered a constant flow of IV fluid. The pump was the size of a small suitcase, and he had to drag it around with him day and night for 3 days. Unfortunately, because of all the fluids he was getting, it also meant constant trips to the bathroom. The next day, Paul was infused with a high dosage chemo (Cytoxan). After that, he was fitted with a HEPA filter mask (bright pink!) that he has to wear any time he goes outside. On the final day at Stanford, Paul was unhooked from the IV pump and given the first of his daily shots of Zarxio/Neupogen to stimulate the re-growth of his white blood cells that the Cytoxan destroyed – all part of preparation for the harvesting and transplant. He'll continue to get these daily shots at Kaiser until he returns to Stanford for stem cell harvesting.

One of the odd things that we learned at Stanford is that because of the recent hurricane in Puerto Rico, there is a national shortage of normal saline solution IV bags. It seems that Puerto Rico has been the only place making these bags for all the hospitals and clinics in the U.S. Yikes!

Because the Cytoxan will make all of Paul’s hair fall out, he decided to jump the gun and shave off his 45+ year old beard. Also, having a smooth face allows the HEPA filter mask to fit snugly. Now, even his own dad doesn’t recognize him. Even though Paul is holed up either at home or at the apartment near Stanford most of the time, he’s pretty exhausted and will only be getting more tired as the chemo destroys all his blood cells. On top of all this, the Zarxio shots frequently cause severe headaches and bone pain. So, although Paul thought he might have more time to read, write or even watch TV, a lot of time he’s just curled up on the couch or in bed.

Next up will be a return to Stanford to harvest Paul’s stem cells – most likely in another week. Then, a few weeks after the harvesting, he'll get two more chemo infusions (BCNU and Melphalan) before the actual transplant.

Tim is holding up pretty well, all things considered. [Note from Paul: Tim is a great caretaker!] We’re still concerned about the status of Tim’s pancreatic tumor and his bile duct stent which soon may need to be unplugged. We’re waiting for him to develop abdominal pain, jaundice or other symptoms before this clean-out procedure happens. A PET scan later in December will determine the status of his cancer.