DAY SEVEN ALONG THE MARATHON COURSE

AUGUST 30, 2022 – (Cont.) “Day 7” is feeling like mile 13 of a marathon. I’m still flying along, on pace, but the pavement’s beginning to burn underfoot. I’ll spare the reader the details I shared at today’s appointment—“It’s all good!” as it is said—but not qu-i-i-i-te as good as it was the previous day, at least as far how I feel is concerned. The white blood count has dropped to near zero; platelets, down as well, and hemoglobin beginning to trend downward too. And then there’s the business of the lower GI tract, which, well, is better attended to than described. None of this is more remarkable than what the marathoner is told to expect at the halfway mark of the critical, first 14-day period following transplant.

Today I received my third “grow factor” injection. When I was reminded that it was already the third, I stated that I questioned its efficacy, given that neither my height nor weight has changed since the first shot. As I jested, however, I noticed that the angel wings of my medical attendants were bigger than the day before.

Yesterday evening I dodged a bullet. Or rather, I was grazed by one that could’ve been more serious. With my platelets temporarily down—platelets allow the blood to coagulate and skin lacerations to heal—I have to observe caution when moving around the house. Heed can be challenging when one resorts to time-honored habits. In my case, a habit is kicking up the dishwasher door, then catching it in hand and closing it, after having loaded dishes into the machine. This saves me the “trouble” of stooping over. I have this motion down well: toe goes under the open, horizontal door, followed by a light upward pop by my lower leg. I’ve done it dozens of times—only occasionally hitting my shin but thinking nothing of it.

When yesterday’s “closer-kick” drew serious blood, I had to think more than nothing of it. First, calm. Second, stop the bleeding. Third, prevent infection. (With my white blood count temporarily down to near zero, I have to rely on an anti-biotic, anti-fungal, and an anti-viral for protection until the transplanted stem cells, aided by “growth factor” injections, can produce white cells.) Twenty minutes later, the fire was extinguished, thanks to my 24/7 on-site attendant, my wife, in fulfillment of a nearly 40-year vow. By the time the crisis had abated, there was a fourth thing to think about: Be. More. Careful.

At the 13-mile mark, this runner is “feeling it”—mentally and physically. Running a good half, 6:00.00-mile pace takes its toll after 13 miles—an hour and 18 minutes. The runner has reserves, but they’re being drawn down at a faster clip. The cost of each mile, each six-minute increment of time now feels greater than the price of the one before it.

This physical reality begins to afflict the mind, which flits from the “now” to the long stretch ahead to the distance already covered to . . . thoughts of, Why, again, am I doing this?

This is the time for the runner to summon his inner trainer, who’s there—always has been, ready to shout out encouragement. “Keep your wits, man!” the trainer says. “Use your mind as a wrap. Wrap it around everything—your pace, the race course, your fatigue. And most important of all, wrap your mind around itself, as tightly as you possibly can. And remember—in fact, repeat after me: I’ve got this!”

“I’ve got this!”

“Good!” says the trainer inside my head. “I’ll check in with you at Day 8, mile 15.”

“Thanks.” (Cont.)

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© 2022 by Eric Nilsson