Glossary

Term	My Description
Acute Myeloid Leukaemia (AML)	This disease affects the myeloid cells (which are basically the granulocytes, platelets, monocytes, and red blood cells) but mainly affects one form of the white cells called the granulocytes. The development of these cells goes wrong causing the rapid multiplication of immature cells. AML occurs when the accumulation of useless immature myeloid cells causes a shortage of useful mature myeloid cells able to be used by the body. When too many of these immature cells accumulate in the blood they can start to block the blood vessels. If the disease is left untreated you will surely score yourself a free pair of kicking boots and a bucket.
Bone Marrow Aspirate	Affectionately known as the "bum drill" because of the use of a thin hollow metal boring tool to "drill" into the bone of the sacro-illiac crest (just above the bum). A needle is then used to suck out some fluid and cells from the blood marrow. In some cases a trephine is also completed at the same time as the aspirate. From my experience, never turn down the use of sedation for this procedure.
Bone Marrow Biopsy (Bone Marrow Trephine)	Also known as the "bum drill" because of the use of a specially designed marrow coring needle to "drill" into the bone of the sacro-illiac crest (just above your bum) to obtain a core sample of both the bone and bone marrow. If offered sedation there is no need to be a tough guy - unless you are given the option of biting on a leather strap.
Busulphan	Chemotherapy drug used, in my case, to clear out the bone marrow (to be taken 4 times a day). Comes originally in 2mg tablet form. However, the required dosage is 1mg per kg of body weight. This translates to a lot of tablets to swallow. So the clever guys down at the Royal Perth Hospital Pharmacy crush down the required tablet dosage and create a 50ml shooter which tastes much like extremely watered down strawberry flavoured milk.
Chemotherapy	Chemotherapy is the use of cytotoxic drugs to destroy or control the growth of malignant cells. It is designed to target rapidly dividing cells such as leukaemic cells, but it also affects normal cells that rapidly divide also (like bone marrow, hair follicles, and the mucous membranes of the mouth, stomach and gut). As such, side effects can include reduced bone marrow function, loss of hair, nausea, vomitting, diarrhea, and loss of appetite.
Clobazam	An anti-convulsant medication given because Busulphan is known to cause seizures. I am glad to hear that the instances of seizures has dropped to almost zero since the use of this drug.
Crudness Factor	My own rating system from 0 to 10, with 0 being very well (ie no crudness), and 10 being extremely crud. The Crudness Factor is subjectively rated based on the level of pain, mucositis, nausea, vomitting, diarrhea, drowsiness, tiredness etc. being personally experienced.
CVC (Central Venous Catheter)	A line inserted surgically into the Superior vena cava. The CVC line generally has about 3 or 4 lumens hanging externally and is used primarily in this situation to administer chemotherapy, give blood and platelet transfusions, give any intravenous medications, and for taking blood. The CVC line is excellent for freaking out friends and small children.
Cyclosporin	A drug used to suppress the immune system. It is used to prevent or treat GVHD (graft vs host disease). This drug can be given intravenously or taken orally. In its oral form the tablets can be quite a challenge to swallow due to their large size. You certainly do not want to be too queasy when having these tablets. Also, the tablets stink.
Dexamethasone	Used in my situation as a stronger anti-nausea medication. It is a steroid but unfortunately is not of the anabolic kind so I won't get any muscular benefit. In fact it is actually anti-anabolic and is more likely to work against me.
Engraftment	This is when the graft is so happy with its new environment that it applies for, and is granted permanent residency in the bone cavities. Successful engraftment is usually signalled by an increase in the blood counts as the graft is forced to work non-stop in blood cell producing sweat shops.
Folinic Acid	Used to counteract the side-effects of the Methotrexate, in particular, to reduce further damage to my mouth.
Fragmin	A drug used to prevent Veno Occlusive Disease. Fragmin is an anti-coagulant and essentially thins the blood. Much to my joy it is an injection and is given subcutaneously whilst I am on the chemotherapy. Also, the bloody stuff stings for a while after it is given. With borderline platelets, the injection is only given when the count is above 30 (x10e9/L).
GCSF (Granulocyte Colony Stimulating Factor)	Yet another enjoyable subcutaneous injection used to assist in firing up the function of the bone marrow. It primarily stimulates the growth of granulocytes.
Graft	In this case the graft refers to the bone marrow taken from the generous donor.
Granulocytes	Granulocytes are the body's infection fighters and are divided into neutrophils, eosinophils and basophils.
GVHD (Graft vs Host Disease)	A condition that generally develops after a matched unrelated or related bone marrow transplantation. GVHD occurs when the transplanted marrow (graft) identifies the recipient's (host) cells as being foreign and attacks the host's cells. GVHD can be mild to moderate (eg. skin rashes and diarrhea) or severe (eg attacking major organs), and can be acute (occurring immediately) and/or chronic (occurring after 3 months).
Haemoglobin	An iron rich compound in the red blood cells that carries oxygen around the body. The Haemoglobin (Hb) counts in the diary are in units of g/L. The normal male range is 130 to 170 (g/L). During treatment, my Hb is generally between 90 and 100 g/L. I had a cunning plan of doing heavy training during times of low Hb so that when my Hb eventually returned to normal I would be a superb athlete. However, the only flaw in that plan is that chemo combined with low Hb makes you feel tired and crap.
Maxolon	In my opinion, a softcore anti-emetic medication used to relieve mild nausea.
Melphalan	Another strong chemotherapy drug used to prepare the bone marrow for transplantation. It is given intravenously and is disappointingly clear in colour. Therefore, it does not produce the exciting coloured wees of other brightly coloured chemotherapies that I have had (eg the fluorescent blue of Mitozantrone).
Methotrexate	A chemotherapy used in this situation to reduce the effects of GVHD. It works by trying to prevent the new graft from attacking my body.
Mucositis	Inflammation of the mucous membranes that line the mouth, throat, and gut caused by chemotherapy. With the high dose chemotherapy used here (ie Busulphan and Melphalan) the damage caused to the mucous membranes is expected to be quite severe and very painful. However, I am hoping that my strict diet of Hot & Spicy KFC, assorted high powered curries, and Tabasco Sauce shooters have helped to acclimatise me to the likely pain.
Neutropenia	A reduction in the number of neutrophils circulating in the blood which has the consequence of leaving the patient very vulnerable to infection. A patient is defined as being neutropenic when their neutrophil count is less than 0.5 x10e9/L. After chemotherapy treatment a patient can be neutropenic for several weeks until marrow function returns.
Neutrophils	These are a type of white cell that protects the body from infection. They act by engulfing and ingesting bacteria and other infectious material that enters the body. The neutrophil counts quoted in the diary are in units of 10e9/L. The normal neutrophil range is between 2 and 7.5 x10e9/L. During treatment, my neutrophil count gets as low as 0.01 (x10e9/L).
Ondansetron	A hardcore anti-nausea medication. Ondansetron can cause constipation, but the chemotherapy can cause diarrhea, so with a bit of luck the two effects will cancel each other out.
Platelets	Platelets are cells that circulate in the blood to prevent bleeding and assist in clotting. The platelet counts quoted in the diary are in units of 10e9/L. The normal platelet range is between 150 and 400 x10e9/L. During treatment, my platelet count is usually around 20 to 30 (x10e9/L) so care has to be taken not to cause bleeding or bruising.
White Blood Cells	These are the body's defense system and help to fight infection and disease. The total white cell count is made up of neutrophils, eosinophils, basophils, monocytes, and lymphocytes. In the diary the white cell counts are quoted in units of 10e9/L. Typical white cell counts are between 4 to 10 x10e9/L.