Miami Herald Jan 14, 2016 By Glenn Garvin
PEDRO PORTAL firstname.lastname@example.org
It wasn’t quite all about the hair when a hundred or so former patients gathered at the Sylvester Comprehensive Cancer Center Thursday night for a reunion dinner with their old doctors and nurse, but sometimes it seemed that way.
“To see you with your hair again is always pleasant,” called out Dr. Stephen Nimer, Sylvester’s director, drawing widespread laughter – but nothing compared to the guffaws that greeted Krishna Komanduri, director of the center’s adult stem cell transplant program, when he widened his eyes in mock sadness and proclaimed: “Unfortunately, some of you now have more hair than I do.”
Giddy cancer-survivor humor (patients almost always lose their hair to radiation and chemotherapy) and tearfully joyous embraces were the order of the day as the patients mingled with the people who helped treat them as Sylvester celebrated its 500th stem cell transplant.
One former patient rushed up to the diminutive Komanduri, and wrapped himself around the doctor like a small child greeting a long-lost parent – which was exactly the idea.
“He’s my daddy!” the patient shouted.
Even some of the valets out front were getting big hugs from those whose cars they parked on visits that marked the beginning of the end of what one former patient called “the darkest days of my life.”
“That transplant gave me a new lease of life!” declared Boca Raton art restorer George Schwartz, Patient No. 200, whose transplant beat back a case of multiple myeloma in July 2013 that other doctors had told him was hopeless. “I am soooo thankful.”
Conversations, meanwhile, bounced weirdly between how-are-the-kids stuff and lurid details of medical dysfunction, riddled with jargon about white-cell counts and abnormal myeloblasts. (Seriously, don’t ask.)
“You become an amateur doctor when you go through this stuff,” apologized Pembroke Pines’ Keith Oliver, Patient No. 500, treated last September for Hodgkin’s lymphoma. “I can’t believe how much medical terminology I know. I can even spell some of it.”
From a tiny program housed at Jackson Memorial Hospital that did perhaps 50 of the transplants in a busy year, Sylvester’s program at the University of Miami Health System has mushroomed to the point that it performed more than a hundred in the last six months of 2015.
“We’re one of the largest programs in the country now,” said Komanduri, who joined Sylvester from Houston’s M.D. Anderson Cancer Center in 2008.
The transplants are mostly used to treat blood cancers like leukemia and lymphoma by bolstering or even replacing a patient’s immune system. The cells are collected from blood – sometimes the patient’s own, sometimes a donor’s, depending on the nature of the particular cancer – and then reinjected in a process that resembles kidney dialysis.
They’re more effective and certainly less painful than the process they have mostly replaced, bone-marrow transplants, which required a patient to be knocked out while being stabbed more than a hundred times with giant hypodermic needles that penetrate right through to the bone. (“It’s painful, but not as much as you imagine,” said Komanduri. “Kind of like being kicked by a horse.”)
Actually, several of the patients said, the transplant itself – the collection and reinjection of the blood – wasn’t painful at all.
“The main problem is sitting there and not getting bored,” said Oliver, who works in the Broward state attorney’s office. “I had to sit there for five hours, two days in a row.”
What follows, though, is much worse than boredom. Just before the patient’s blood is replaced, he or she is blasted with chemotherapy to reduce their auto-immune system to rubble so the stem cells can rebuild it from scratch. “It’s very, very harsh,” said Oliver. “I had to sign a waiver acknowledging I might die from it.”
When the autoimmune system begins to crumble, a few days later, a lot of patients feel like that’s exactly what’s happening. “Nausea, vomiting, diarrhea, hair loss, all that stuff,” Oliver recalled with a shudder. “I lost 20 pounds in 20 days because I couldn’t eat anything.”
In the long run, however, the patients who gathered Thursday night thought it was worth it. Schwartz, six months after his transplant, danced with his daughter at a wedding he feared he wouldn’t last long enough to see.
And Oliver, three months after his, proposed to his girlfriend while on a flight in a small plane over the Miami-Dade and Broward beaches. (Spoiler alert: She said yes.) His transplant was responsible in more ways than one: The flight was a bargain-basement special that he found on Groupon during all those hours having his blood pumped in and out.
“It’s not that I’m constantly looking for cheap stuff,” he said. “But there’s only so many hours you can watch TV while you’re sitting there.”
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