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March 2014

March 3, 2014

Hi Everybody,
Yesterday was another milestone in my post transplant time line. I’ve been tapering my immune suppressant medications over the last 8 months and yesterday I took my last pill. It takes a while for the Tacrolimus which helps to suppress graft versus host disease (GVHD) to wear off. It is a fine line between the good effects of the donor immune system protecting me against bacteria, viruses, and other bad guys and the donor immune cells still seeing me as foreign and attacking me, GVHD. So far things have gone well, my brother’s stem cells seem to like me and I haven’t had any serious medical issues. I saw my Stanford transplant doctor recently and she said that I’m on the right track and that I should still stay on prophylactic Bactrim and Acyclovir for another 6 months while my donor immune system fully comes into its own. I gather that I’ll always be somewhat immune compromised but the question is to what degree. No one knows and it’ll be a process in evolution. What travel restrictions will I have? Can I eat Sashimi? Can I get live attenuated virus vaccines like the shingles vaccine? I’m planning on seeing my City of Hope doctor this May and will be having another bone marrow biopsy this July, my 2 year follow-up. That is the next big milestone.
I’m involved with stem cell transplant related education and issues as well as staying up to date with general internal medicine via conferences and journals. Come the beginning of 2015 I hope I might be able to return to the practice of medicine part-time in some capacity, at least volunteering at the local free clinic.
Life is full of activities and I appreciate that I’m healthy enough to partake of them. Although I can’t report any recent psychological, emotional, or spiritual revelations, processing and living the old ones is full-time and just fine by me.
Best wishes to everyone


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  1. Chip Goldeen permalink

    Sounds good. Stay strong.


  2. Alexis permalink

    You sound very upbeat and optimistic with how well your recovery is going. Keep up the great job!

  3. Sempre Fidelis, El Capitan

  4. Patsy Benfield permalink

    Aloha Dr. E., Great news that you are doing so well. Be sure to thank your brother again for being so good to you and supplying you with friendly critters to get you back on track with life. You are indeed fortunate and I’m sure that you are grateful for that. Say hi to Claire for me. I got notices of the quilt show recently held at the fairgrounds but other plans kept me from attending. Life is good..
    I keep you in my prayers and still miss our 5 week visits……….XXXX Patsy

  5. loren permalink

    Remember to have some fun with your flute; not only “practice.”

    Practice can be a bit of a pill…

  6. Merrilyn Marker permalink

    It is always so good to hear from you and know how well you are doing. My sister also goes to City of Hope and she thinks they are wonderful. If you ever need volunteer help when you are out and about with your volunteer efforts, please let me know. I do most things willingly except clean toilets. Ron skied in Colorado with our son last week-end. Temp was 11 with 70mph winds, but he was determined. We keep you in our prayers,

  7. Brent permalink

    Hi grandpa Jim, It is fabulous to know you are still doing very well and on target for full recovery. Our best to you and Claire. Brent

  8. Larry and Diane Levin permalink

    That is fantastic that you have been doing so well. Congratulations!
    Diane and Larry Levin

  9. David Emberson permalink

    Awesome! I can’t wait to get off of tacrolimus myself. Best wishes, Dave

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