🌀Mood: Absorbing, Accepting, Trusting

“There are some high-risk features in your case.”

That’s what the doctor said first.

She didn’t launch into the details. Just those words.
And in that pause — before I even knew what they meant — I could feel the floor shifting underneath me.

She went on to explain that based on my bone-marrow biopsy and chromosome analysis, my myeloma was not only advanced… it was aggressive.

“Eighty percent of your bone marrow is filled with cancerous plasma cells.”

I felt stunned. That’s the word I keep using because I don’t know what else to call that moment. I knew I was Stage 3 – the highest stage. But hearing the number — 80 percent — hit differently. It wasn’t just a diagnosis anymore. It was a takeover.

Then came the chromosomal abnormalities.
Out of 20 sets of chromosomes they looked at in my plasma cells, five were abnormal — including a 17p deletion found in 88 percent of the sample. That one deletion is specifically associated with high-risk myeloma — meaning the disease tends to be more aggressive, harder to treat, and more likely to return.

So yes, my treatment was working.
But the enemy was stronger than we thought.

That’s when she introduced the plan forward: Stem Cell Transplant.

The 3 Phases of Myeloma Treatment

The doctor explained the big-picture view of multiple-myeloma treatment:

Phase 1: Induction Therapy
That’s what I’m doing now — a combination of medications designed to drive down the number of cancerous plasma cells and reduce the “M spike.” We want to get those proteins (called M-proteins) as low as possible before moving to the next phase.

Side note for readers: M-proteins are abnormal antibodies produced by cancerous plasma cells. When you see them go down in blood tests, it’s a good sign the treatment is working.

So far, my body has responded really well:

-IGG lambda dropped from 5.7 grams to 1.3 grams

-Light chains went from 2598 down to 9

-Kappa/Lambda balance is now in normal range — huge for my kidney health

Phase 2: Stem Cell Transplant (SCT)
Here’s where things get intense. The idea is to collect my own stem cells (more on that below), then use high-dose chemotherapy to wipe out all the cells in my bone marrow — both good and bad. The chemo drug they use, melphalan, doesn’t discriminate. It kills cancer cells, yes, but also healthy ones.

What the Chemo Takes

The high-dose melphalan doesn’t just clear the slate inside your bone marrow — it clears everything.
I was told my hair will fall out completely, usually within two weeks of the transplant chemo.

It’s strange, because I’ve handled so much already — the infusions, the fatigue, the endless bloodwork — but there’s something about losing your hair that feels more visible, more symbolic.

It’s the part the world will see.
It’s the part that says, something big is happening.

I’ve thought about whether to shave it first or let it go on its own. I don’t know yet. Maybe I’ll let the timing decide.

For now, I’m preparing myself — because even though it’s just hair, it represents what this treatment demands: letting go of what was, to make space for what can heal.

After that chemo clears my system (in about 48 hours), they re-infuse my frozen stem cells — kind of like rebooting my bone marrow. It takes 10–14 days for those new cells to start rebuilding my immune system.

This isn’t a cure. But for many people, it can put the disease into a deep remission and buy valuable time before relapse.

Because my cancer is high-risk, my doctor warned me that I may relapse sooner than average. Still, the deeper the response now with the induction therapy, the better the SCT will work. That’s why this phase is so critical.

Phase 3: Maintenance Therapy
Once the transplant is done and recovery is underway; we switch to a maintenance regimen — typically a milder version of the meds I’m on now. The goal is to keep the myeloma at bay as long as possible. When it eventually returns (as it likely will), we’ll shift to a new line of therapy — maybe something like CAR-T — but that’s only available after a relapse.

Stem Cell Collection – What It Involves

There’s a window of time to collect your stem cells — and I’m in it now. After six months on my current treatment, the meds can make it harder to collect enough healthy cells, so we don’t want to miss this.

Here’s how collection works:

-Two injections a day for five days to stimulate my bone marrow

-The shots push stem cells from my marrow into my bloodstream

-A catheter is placed, and I’ll be hooked up to a machine that filters the stem cells out of my blood

-The rest of my blood is returned to my body

-The collected cells are frozen and stored for later

This part is outpatient — no chemo involved — and lasts about 4–5 hours per day. If I choose not to move forward with the transplant right away, I can still collect and freeze the cells for use down the road.

If I Go Through With the Transplant

If I choose to proceed with the transplant immediately:

-I will need to live within 30 minutes of Fred Hutch for 4-6 weeks.

-I’ll need a caregiver with me 24/7 during that time.

-In month two, I can go home — but I’ll still need to avoid all public interaction. No crowds, no restaurants. It’s like COVID lockdown… except this time, I’m the one at risk.

-Depending on how I recover, I could start remote work in months 2 & 3.  By month 3, I should be able to begin easing back into life but still can’t go out with the exception of exercise outdoors.

Three months. No people. No hugs. No normalcy.

That hit me hard. I’m a people person. I care deeply about showing up for my team, my family ,my friends and my community. The idea of being sequestered — of having to ask someone to care for me day and night, of missing holidays and life milestones — is honestly overwhelming.

And, there are no guarantees this will get me into remission long-term.

Mentally, Emotionally, Logistically… It’s A Lot

For a while, I was leaning toward the idea of collecting my stem cells now, freezing them, and continuing on my current treatment plan. Why not see how far I can go before pulling the transplant trigger?

But the more I sat with what the doctor told me — about how aggressive my cancer is, and how this next step is most effective before remission is reached — the more I realized… maybe I don’t really have that luxury.

There’s so much to consider:

-The emotional toll of being isolated and vulnerable

-The financial strain of temporarily relocating

-The fear of how my body will tolerate the high-dose chemo

-The hope of maybe, just maybe, hitting remission

The Call That Brought It All Back

Four days after the appointment, I got the call:
My transplant consultation is scheduled for November 26 — the day before Thanksgiving.

My first thought?
Great. I just lost another month for collection.

But then I took a breath. Maybe that’s okay. Maybe I needed this time to process, to prepare my questions, to grieve what might be ahead — and what I might miss.

The transplant team also sent me a video. It talked about Fred Hutch’s track record — they’ve performed more than 17,000 transplants, more than any other center in the country, with one of the highest survival rates.

It gave me a sense of peace.
No one can promise perfection. But at least I know I’ll be in the best possible hands.

I haven’t fully decided if I’ll move forward yet — but I’m leaning that way. When the time comes, I want to be where the odds, the expertise, and the compassion align.

So For Now… I Wait

I keep showing up to my weekly appointments.
I keep responding well to treatment.
And I wait — for the next big conversation, the next choice, the next fork in the road.

But I’m not standing still.
I’m learning, asking, absorbing, preparing.

Because I know now what I didn’t know before:
This cancer may be aggressive.
But my faith runs deeper.

Next up: My meeting with the Myeloma Transplant Team at Fred Hutch