Photograph by Kevin A. Roberts
Mary Walbridge is a pharmacist and registered nurse, and her Walbridge Settlement Foundation is building a clinic in Kyekyewere, Ghana. Last autumn, she came home from Africa and noticed that her feet were swollen. Then red spots showed up. Then searing pain.
After testing for almost every tropical disease, physicians determined that Walbridge had multiple myeloma, a cancer of plasma cells (a type of white blood cell) that destroys the immune system. It usually shows up with back pain, kidney problems, or bone fractures, but hers had arrived in disguise, and now it was churning out proteins in the blood vessels of her feet.
After six months of chemotherapy, her oncologist started talking about a stem-cell transplant at Barnes-Jewish Hospital. Walbridge is 61 years old and in excellent shape. She says the transplant could give her between three and 20 years of remission from a disease that, 15 years ago, was a death sentence.
Walbridge gulped and agreed, but she didn’t leave her medical training behind: “They gave me an echocardiogram,” she recalls, “and I was just hangin’ off the bed—look at that tricuspid valve! And the girl kept saying, ‘Lay down, Mrs. Walbridge, lay down.’”
What follows are excerpts from Walbridge’s journal.
February 11
Fertilizing stem cells isn’t exactly easy business. I find myself quite fatigued. We shall take that as a good sign: When I was pregnant, the same thing happened.
In pharmacy school, we had vincristine, vinblastine, cisplatin, and other chemo agents that were just awful when it came to side effects. Now they can grow stem cells for a few days, then mobilize them out of my marrow into the blood and harvest them. That isn’t to say I won’t be getting one of the older chemo agents, lose my hair, and feel like crap.
But to get some new babies out before they become infused with the myeloma, freeze them, and put them back to start new and fresh growth—well, that’s a lot to be thankful for, and I will get through the rest of it. This is just hair and some days of sicky sick.
For now, I am just growing babies, and all is well.
February 15
Tuesday morning, they got me hooked up to the machine that “sucks” out the stem cells. A little easier than giving birth but just as tiring! It took six hours. I ate lots of food, watched blood out and blood in, and dozed.
A goal number of stem cells to harvest is calculated. Mine was 5 million. As the nurse was getting me comfortable, the news came in: The harvest netted 23 million new cells!
February 21
Doctor: “Good morning, Mary. How are you today?”
Me: “Fine…” I burst into tears. Well, it was early in the morning, and I don’t wake up and never have much before 10 a.m., and can we say stress? So we are off to a good start there…a sobby old lady on a Monday morning. Heck, I am fine, but scared. Honesty is the best policy in a situation like this.
February 23
Welcome to what I am calling Camp BJC. Granted, we don’t sing “Kumbaya” around the fire, but my floormates have similar interests… I checked in around 3 p.m. yesterday. It was a busy three hours between nursing questions (no, I am not really in a relationship; no, I am not abused, except by the cat) and getting all my drugs straightened out.
My doc came by: a down-to-earth, no-punches, realistic kinda guy. We went over the plan. I start the melphalan at 10 p.m., along with some Zofran and dexamethasone…my evening cocktail. Can we get some rum and a little umbrella with that?
Melphalan is a nitrogen mustard alkylating agent; it decreases your white-cell count and platelet count. You lose your hair, and you can get a rash, itchies, and cardiac arrest! Not being pessimistic, but realistic: This will hit bottom probably Saturday.
February 24
Stem-Cell Transplant Day. Got a little Compazine for nausea a couple of hours before and a Fioricet for the headache, and they started really pumping fluids in my IV lines. Meghan got a water bath to unfreeze my cells in. She then went and got the cells, in a heavy metal container with dry ice. The bag is put on the pole and the line filled, and we are in business. You can feel the stuff going through your body, arms, legs, hands, feet—really weird. Then you get this taste. People get different tastes, some oysters and garlic (that would make me puke right there), some creamed corn. Mine was as distinct as can be…tomato! Once that happened, there was a dryness in my throat and coughing, coughing, coughing…lots of water now, and calmly deep-breathe: In…out…in…out… It is almost finished so I can do this… In…out… Just a little more and that bag is done! Whew.
February 25
Blood counts are beginning to drop now. Mornings are slow, with lots of nausea, and each day is getting a little worse. This is what is supposed to happen, so don’t you all panic.
March 7
When we last spoke, my numbers were falling, and fall they did, right on schedule. We like schedules in the hospital. On Day 8 after transplant, my white cells bottomed out at 0.1. Perfect! Of course, I felt awful, but the med staff was real happy! By this time, I am sure my nurses were getting a little tired of finding me curled up in a ball on my bed with the covers over my head each morning! I don’t remember much from about February 29 until March 5…just isolated events. Selective memory at this point may be good!
Transplant Day 10 (two days ago) was supposed to be the day that you begin to think, “I feel pretty good.” That was the day my hair started coming out by the handful! Day 11 dawned after a rough night, because of bone pain from the Neupogen to grow my white cells. That is OK. OxyContin was made for these occasions. My nurse got the razor, and off went the rest of my hair. My head was cold, and I was a little sad most of the day, but today I am OK with it all. Got my scarf-tying directions out and have been trying new looks on the staff here.
Anyway, Transplant Day 12 is really feel-good day. I am amazed at how much difference there is from last week to this. I did 16 laps today, including passing two men! Labs are coming back in fine shape, and rumor has it I will be going home probably Friday!
March 10
H*O*M*E!!!!!! HOME is where the heart is. There is no place like HOME. Sweet HOME Alabama. All the Way HOME.
Naturally, I got overexcited about being home and wore myself out, but that is an exciting tired. Had a good night’s sleep in my own bed with Izzy [the cat] by my side, and it felt so good not to be woken up every two hours for someone to see if I was still alive!
There is still some bone pain, but when you are growing new babies in your marrow, that is to be expected and a sign, to me, that all is going well inside.
April 5
Doctor visit two weeks ago was great. Blood work is all back to normal. No more masks, and much to my sister’s chagrin, I could drive again! A bone-marrow biopsy and more extensive blood work is scheduled in about two weeks, and probably in June, I will be the lucky recipient of another stem-cell transplant. [Walbridge is in a National Institutes of Health study, which is randomized, and she wound up in the group getting two transplants, while others will receive one and then different drug regimens.] Nice thing is, I know what to expect, my stem cells are safely frozen at Barnes, so there’s no collection process to go through, and hopefully my anxiety level will not be like the last time. But with this record, I don’t think I will take up gambling as a profession!
April 17
My doctor is already talking about getting this second transplant out of the way, which would be more than fine with me. I just can’t believe how much better I feel. I am ready to go back to Ghana!
