As you know, the biggest risk of death and disability during a transplant, besides the chemo and transplant themselves, is Graft Versus Host Disease, GVHD. It's the condition where the transplanted stem cells that become T and B white cells (if I may anthropomorphize them for a moment) "forget" that they are in a different body now (the patient's) and begin to identify that entire body as foreign, as if they were still protecting the donor. GVHD ranges from comparatively minor issues such as dry eyes and mouth sores to full-on scleroderma, loss of lung function and other nasty situations. The short story is that GVHD can affect any organ system of the body, from epithelial to digestive to connective. In some cases, GVHD can create a health crisis almost worse than nonfunctioning bone marrow; it can be disabling, crippling and often life-ending. In short, it's a nasty, nasty business that you just definitely do not want to have to live with or die from. You also know it was my worst fear entering this stem cell sojourn.
GVHD can strike at any time, especially as they are tapering me off the immunosuppressive drugs as we get toward May'08. For that reason, every time they taper me I am sent home with instructions to do daily checks for signs of GVHD. I check my eyes, I check my skin, I check every inch of myself for anything weird. It's a little nerve-racking because, not being a medical doctor, I'm not precisely sure what all I may be trying to identify beyond the recommended, "anything different or out of the ordinary."
So today I was getting worried. If I may share some (Too Much) Information with you, I was having, um, how shall we say...gurgling in the intestinal region. First the gurgling. Then the "movement of air" that you can feel internally, like your colon is shuffling back and forth on its feet. And then. Then you get the need to visit the facilities. Then it starts all over again. It was like that scene in Austin Powers where he's beating up a bad guy in a bathroom, flushing his head in the toilet saying, "Who is Number Two?" and Tom Arnold in the next stall, thinking Austin's had some bad shrimp says, "Hey Man. How about a courtesy flush over there?!" All I'm saying is that I was in serious "courtesy flush" territory.
It was so bad that I was seriously starting to think that I was getting GVHD of the gut (a completely unpleasant phenomenon wherein your stomach and intestinal linings are destroyed by your white cells) because the first sign of it is "changes in bowel frequency and consistency." I was so worried about it that I mentioned it to the BBDD, like, if it's not better by Sunday I'm going to call Dana Farber to have my excrement assessed. His response? "I don't blame you for being worried; but if it makes you feel any better, you did eat a large quantity of beans last night."
Turns out "cassoulet," "(A casserole of white beans, various meats, vegetables, and herbs, slowly simmered or baked in a slow oven)" comes from the French: "diminutive of cassolo, earthenware vessel."
Aah, 'earthenware vessel." As in the one you sit on for three hours apres-manger. Merde Indeed.