How to identify and cope with chronic GVHD of the stomach and intestines

Posted June 30th, 2017 by Be The Match and filed in Patient Stories
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Dominique, transplant recipient (center), with her parents

About 6 months after her transplant, Dominique knew something was wrong when trying to eat caused too much pain.

“I was having a great amount of pain after I ate. I couldn’t drink anything. It hurt too much to swallow,” she says. “So when I told my transplant doctor what was going on, we got a gastrointestinal (GI) doctor involved.”

It was important that Dominique contacted her transplant doctor right away. Getting help from your transplant team as soon as possible means that any treatments they give you will have a better chance to work.

And, involving a GI doctor, who specializes in the stomach and intestines, helped her get the best possible treatment. In Dominique’s case, the GI doctor ordered a colonoscopy and an EGD (a doctor places a flexible tube through the mouth into the stomach and small intestine). Those tests, plus a biopsy (testing a sample of tissue taken from the GI tract) led to a diagnosis of chronic GVHD of the stomach and intestines.

Keeping an eye out for the symptoms

Dominique, now 23 years old, received a transplant for severe aplastic anemia 2 years ago. She offers some advice on how to identify and cope with chronic GVHD of the stomach and intestines.

“Pay attention to your body. If something doesn’t feel right, go get it looked at or checked out,” she says. “Don’t ever feel like you’re making up your symptoms.”

Some of the symptoms Dominique had, in addition to not being able to eat very much, included constipation, feeling sick all the time, and extreme tiredness. “It was just hard because I couldn’t eat. I was getting frustrated. I had to watch what I ate because certain things would irritate it more,” she says.

These symptoms are quite common in people who get chronic GVHD of the stomach and intestines, according to Dr. Alousi from MD Anderson Cancer Center. Other signs to look for include:

  • Bloating
  • Decreased appetite
  • Diarrhea
  • Feeling full after eating very little
  • Nausea or vomiting
  • Stomach pain
  • Weight loss

Dr. Alousi notes that when chronic GVHD of the stomach and intestines is diagnosed, doctors pay close attention to two key symptoms: weight loss and malnutrition. In fact, he says, “weight loss is the main symptom used to measure how severe GVHD of the stomach and intestines is”. He recommends that people “track their weight after transplant and tell their doctor right away about any weight loss.”

Because people can have problems eating after transplant, he also suggests keeping a food diary to help you and your doctors determine the causes of any symptoms or weight changes. You can even use your phone to help. “There are a number of smartphone apps that help you track your diet and keep your nutrition goals.”

Treating chronic GVHD of the GI

To treat her GVHD, Dominique’s doctors prescribed steroids, which is common for this kind of GVHD. The steroid treatments eventually worked for her, but the medicine had some side effects that lowered her quality of life for a time.

“Just being on the steroids I couldn’t be outside, I couldn’t walk,” Dominque says. “If I did have the energy to go out, I could only do it for an hour or two before I was sleeping or too tired to do anything else.” She says, “It put a good pause on my whole life for a while.”

Seeing a dietitian is important to help patients with chronic GVHD of the stomach and intestines improve their quality of life, says Dr. Alousi. “Dietitians can recommend dietary supplements and offer advice to manage symptoms.” And because weight loss and malnutrition is related with lower strength and endurance, Dr. Alousi notes that “patients with these symptoms should also see a physical therapist.”

Dominique says that she’s now feeling better. “I’m not cooped up in my house anymore,” she says. “I’m out doing stuff. I’m doing pretty well emotionally.”

Her message to people who get chronic GVHD of the stomach and intestines is to give the treatment time to work. And most important, she says, if you feel sick, tell your doctor, tell a family member. “Get it looked at because you can never be too cautious.”

For more information on chronic GVHD of the stomach and intestines, view our new fact sheet, developed jointly by Be The Match and the Chronic GVHD Consortium.

Honored and humbled for a second chance at life

Posted June 13th, 2017 by Be The Match and filed in Patient Stories
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Khalia was just 3 months old when she was diagnosed with sickle cell disease. After 18 long years of dealing with pain, she finally received her cure: a bone marrow transplant from an unrelated donor on the Be The Match Registry®.

Khalia, transplant recipient (right), with her mom

Kimyacta, Khalia’s mom, remembers how ready she and her daughter were once the donor was identified. “We had many meetings to prepare us for this journey and the journey itself was literally life changing!”

Khalia is now pain free and enrolled in college where she’s pursuing her degree to become a Child Life Specialist. She and her mom continue to let others know how important it is to become a donor. “I hope I’m able to save a life just as someone did for my child,” says Kimyacta.

A bone marrow transplant is the only known cure for sickle cell disease. Join the registry and be someone’s cure!

Choosing transplant to cure her sickle cell disease

Posted June 12th, 2017 by Be The Match and filed in Patient Stories
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On August 1, 2012, Aya got her second chance at life while a patient at Hackensack University Medical Center – she received a bone marrow transplant that cured her of sickle cell disease (SCD).

Aya, transplant recipient

For Aya, her transplant was a welcome relief from a lifetime of dealing with her illness.

“I was born with sickle cell anemia,” she said. “One of the main stresses of the sickle cell disease is pain crisis. I began experiencing this painful ordeal from the age of three.”

After her first pain crisis, managing her symptoms became a familiar part of Aya’s routine.

“The ordeal would start with pain that would escalate,” she said. “When it got to its worst, my mom would have to take me to the hospital.”

Once in the hospital, Aya said her medical team did everything they could to help her manage sickle cell disease.

“Once they admitted me, the process would begin,” she said. “Generally, they would always hydrate me and give pain medication. I would always require oxygen – because of the pain, I could not take deep breaths.”

While Aya’s childhood revolved around managing her sickle cell, as she grew, her family knew she would need a bone marrow transplant.

“The older I got, my stays in the hospital increased and my pain levels would escalate,” she said. “I underwent a bone marrow transplant from an anonymous donor. The procedure was a success and I am now sickle cell free!”

A bone marrow transplant is the only known cure for SCD. Join the registry and be someone’s cure!

Being a voice for patients with sickle cell disease

Posted June 12th, 2017 by Be The Match and filed in Patient Stories
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Ines received a bone marrow transplant for sickle cell anemia in 2009 during her senior year of high school.

Ines, transplant recipient

Since her transplant, Ines has been focused on becoming a voice for other patients.

She studied molecular biology and English at the University of Pittsburgh.

Ines has also worked with the Children’s Hospital of Pittsburgh Sickle Cell Team as a research assistant. She has dedicated her life to sickle cell research and awareness – including sharing her story at legislative briefings where she offered her perspective on the treatment of sickle cell disease.

As her future continues to expand post-transplant, Ines said she is forever grateful that her match was found.

“My marrow transplant has made it possible for me to plan for the future instead of having to plan around my illness,” she said.

A bone marrow transplant is the only known cure for SCD. Join the registry and be someone’s cure!

Pulling together to overcome sickle cell disease

Posted June 12th, 2017 by Be The Match and filed in Patient Stories
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In January 2016, Desiree became the first adult at the Kansas City Cancer Center to be treated with a bone marrow transplant as a cure for sickle cell disease.

Desiree, transplant recipient

While Desiree was anxious, the timing of her transplant was critical – if her treatment was delayed, she was facing severe and irreversible lung damage that would have made her transplant even riskier.

Despite her nerves, Desiree said her support system got her through the time in the hospital.

“I don’t like being away from home, so it was hard spending all that time away,” she said. “Thankfully, my mother, sister and grandparents were with me the whole time. They put my needs before their own and made sure I had things from home to comfort me.”

Although her family was with her throughout her transplant journey, Desiree’s recovery was difficult due to a complication from sickle cell.

An earlier sickle cell pain crisis had left her with avascular necrosis in her right hip and barely able to walk. This condition occurs when bone tissue dies from lack of blood supply. Her doctors had her get out of bed and walk each day to regain her strength.

Now that she is healthy, Desiree said she is focused on helping raise awareness for sickle cell disease.

“We could cure others of the disease and find more perfect matches if more minorities were bone marrow donors,” she said. “Now I can go more places and do more things without having to worry about pain or being admitted to the hospital. I’ve missed out on doing and enjoying a lot but, my health is a lot better and continues to improve. I’m very optimistic about my future.”

A bone marrow transplant is the only known cure for SCD. Join the registry and be someone’s cure!

Justin’s journey with sickle cell and transplant

Posted June 12th, 2017 by Be The Match and filed in Patient Stories
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Justin had his first sickle cell crisis when he was six months old – for his mother, Kari, this was a day she will never forget.

Justin, transplant recipient

“He wouldn’t stop crying and nothing I did could help him,” she said. “This was the beginning of a lot of heartache, pain and tears, not just from him, but from me too.”

After tests showed Justin’s younger brother was not a match, Kari said the family was at a crossroads.

“My husband and I considered having another baby in hopes that this baby would save Justin’s life,” she said. “I prayed and there was a perfect match.”

Justin had his life-saving transplant in July 2014 – with Kari by his side for every step of the journey.

“I stayed with him every day,” she said. “When he hurt, I hurt. When he could not eat, I could not eat.”

While Justin has had some post-transplant complications including migraines and kidney issues, Kari said he is a healthy and thriving teenager.

“Life is great,” she said. “Justin gets to go to school and socialize. For so long, everything was about Justin and he was the only thing that mattered in our family. Now, life does not revolve around Justin and his sickle cell.”

A bone marrow transplant is the only known cure for SCD. Join the registry and be someone’s cure!

Taking a leap of faith for her cure

Posted June 12th, 2017 by Be The Match and filed in Patient Stories
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In 2008, twelve-year-old Amber’s fight against sickle cell disease had gotten to the point where she had suffered a stroke and had many surgeries.

Amber, transplant recipient

For the next two years, she and her family found themselves anxious as they were educated about a bone marrow transplant as a potential treatment option.

“My mom was scared,” Amber said. “It was a leap of faith.”

When doctors told the family that a 10/10 match was found, Amber put her nerves aside and prepared for transplant.

“I was afraid of losing my hair, chemotherapy and losing my friends,” she said. “I didn’t really know who else was going to be my match – if this unrelated donor would not have done it.”

After her transplant, Amber spent a month in the hospital before she went home to recover.

“It was difficult but, well worth it,” she said.

Now, as a healthy college student at George Mason University, Amber offers this advice to sickle cell patients contemplating a bone marrow transplant.

“Don’t give up hope,” she said. “You feel like you are going to be in pain forever but, just stay hopeful. You are already going to be in pain forever so, just hang in there for the transplant.”

While Amber has not met her donor, she said her entire family is looking forward to thanking the person who saved her life.

“I wouldn’t even be able to say anything – I would just cry,” Amber said. “I would tell them how thankful and how blessed myself and my family is because of this. This is not just about the patient who has sickle cell, this is about the family as well. I am so blessed and so thankful.”

A bone marrow transplant is the only known cure for SCD. Join the registry and be someone’s cure!

Why do I give? Because I feel grateful… and lucky

Posted January 9th, 2017 by Be The Match and filed in Patient Stories
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Transplant recipient and financial contributor Michael Stewart opens up about his relatively smooth transplant journey, and how he hopes to pay it forward to those who endure a different experience.

Michael Stewart, a husband and father of three teenage boys, is grateful for so many things in his life – including his transplant journey. In 2004, Michael was feeling fatigued, and so he set up a doctor appointment. As someone who “works too much” and travels a lot for his job, feeling tired was normal, but this time something felt “off.” Michael’s intuition was right, and after receiving lower than normal blood count tests, his doctors diagnosed him with hairy cell leukemia.

Michael received treatment for his illness, and within 6-7 weeks of treatment, everything felt like it was “back to normal.” Michael continued to be monitored for a while, but after 3-4 years they told him he no longer needed to come in for routine checks. His leukemia had come and gone, and Michael was ready to move on with his life.

Fast forward a few years, to 2013, and Michael started feeling fatigued again. He thought to himself, “I’m getting older and travelling too much… that must be it.” But just to be safe, Michael went back to his doctor. This time, his blood counts had bottomed-out. It seemed as though his hairy cell leukemia had come back. Only a few days later, Michael was admitted to the ICU with sepsis issues, which occur when the body’s immune response to an infection triggers inflammatory responses throughout the body. The inflammation brought on by sepsis can trigger a series of changes that can damage multiple organ systems, causing them to fail. It is also most dangerous in older patients or those with weakened immune systems from treatment – like Michael.

This time Michael spent more than 45 days in the hospital (with a few short visits back home), but his blood counts just weren’t bouncing back like they had in 2004. The doctors performed a biopsy of his bone marrow, which didn’t indicate anything additional was wrong. Michael again followed his intuition, and after not feeling back to 100%, he decided to meet with a doctor who specialized in hairy cell leukemia to see if he could figure out what might be wrong.

Near the end of 2013, Michael found out from his new doctor that he hadn’t suffered a re-occurrence of his hairy cell leukemia – he had in fact developed myelodysplastic syndrome (MDS). MDS affects the bone marrow and blood, causing the blood-forming cells in the marrow to slow down, or even stop, making all three types of blood cells: red blood cells, white blood cells and platelets. It was discovered that his MDS had likely been brought on by the two rounds of leukemia treatment he had received in the past, and the damage to his bone marrow was so severe that his blood counts couldn’t recover on their own. Michael’s doctor started him on a temporary treatment regimen, but the reality was, Michael would need a marrow transplant to survive.

Time for transplant

Michael with his 3 sons, living in their temporary home in Seattle, preparing for his upcoming transplant

Michael with his 3 sons, living in their temporary home in Seattle, preparing for his upcoming transplant

All of Michael’s siblings were tested, but none was a full match. As Michael continued his temporary treatment plan, his doctor started a search of the Be The Match Registry®, and luckily there were multiple match options identified. Although Michael felt like everything was back to normal – and his temporary treatment was working – he was told that every day he continued that treatment, his risk for developing yet another disease increased. Michael met with doctors at the Seattle Cancer Care Alliance and decided to be proactive by pursuing the marrow transplant while he was relatively healthy – knowing he would eventually need it – rather than waiting until his health stated to deteriorate. As a result, he and his family moved from Colorado to Washington to begin the process.

Although Michael had multiple match options identified through the Be The Match Registry, a few of the potential donors backed out for various reasons. Finally, a 24-year-old female – a complete stranger to Michael – came through. She was a 10 out of 10 match, and agreed to go through with donation to help save the life of someone she’d never met. Michael’s initial transplant date was scheduled for right after Thanksgiving, but after a few setbacks, it finally landed on New Year’s Eve. Michael rang in the New Year in arguably the most amazing way – receiving the life-saving marrow he desperately needed – from a complete stranger.

Michael's hospital whiteboard on the day of his transplant, and his "re-birthday"

Michael’s hospital whiteboard on the day of his transplant, and his “re-birthday”

Michael stayed near the clinic for a few months after transplant – with regular visits to the lab and clinic every day. He was allowed to work (from home) and spend time with his family, but he had to avoid public places and his energy levels were very low. At day 12 he engrafted – meaning his body accepted the donated marrow. Around day 45, he was finally able to see his dog again. And at day 98, he got to go home … 22 days earlier than expected.

While Michael was receiving treatment, his family was always by his side. In total, they spent about 150 days living together in a new state, but they embraced the experience and to this day they even look back on it fondly. Michael’s children were able to attend school at “The Hutch” along with other children whose family members were there receiving treatment, providing a sense of community and support that helped them through that difficult time.

Michael’s recovery has been phenomenal. Today, still less than a year out from his transplant date, Michael and his family are back in their home state of Colorado, and Michael is back to working full time and traveling. While he notices a lower ability to “bounce back” after a long travel day, he otherwise feels like he’s pretty much back to normal.

Thank you is not enough

As Michael reflects on his transplant journey, he feels grateful of course, but he also feels lucky. According to Michael, he had it “easy” – too easy, and too stress-free compared to so many of those who endure a long and frightening process, sometimes without a happy ending.

“No stress, no desperate pleas for friends and family to be tested. No social media campaign. Because many people all over the world decided to take the simple step of being tested, I had a match. I have a chance, and a very good one at that, to see my three boys graduate from high school, get married, have their own kids. All because someone did something for someone they didn’t even know and may never meet.”

– Michael Stewart

The Stewart's dog, minutes after arriving back home in Colorado after Michael's transplant journey - happy for things to be "back to normal"

The Stewart’s dog, minutes after arriving back home in Colorado after Michael’s transplant journey – happy for things to be “back to normal”

That is why, when Michael decided to give a large financial contribution of $25,000 to Be The Match, he did so out of pure gratefulness. Gratefulness for his relatively smooth transplant journey and positive outcome, especially knowing he had it easier than so many.

Michael is grateful to Be The Match for providing him with access to multiple donor match options, and so grateful for his donor who never hesitated to save a stranger’s life. She donated through bone marrow extraction which took 4-6 hours. A 24-year-old who was asked to spend all day at the hospital right before New Year’s Eve said “Of course I will,” and Michael is forever grateful for that. “Thank you isn’t enough … you just can’t even put that into words”, he says.

Michael is also determined to turn his gratefulness into action. He is dedicated to furthering the mission of Be The Match through his financial contribution and awareness efforts, to help those who have a harder time finding a match – particularly those with ethnically diverse backgrounds.

Michael worked with Keith Stout, Director of Major and Planned Gifts at Be The Match, to ensure that his financial contribution could help in a number of ways – financially assisting patients and their families, adding more potential marrow donors to the registry, and helping advance research to improve transplant outcomes. Michael hopes that his contribution can help ensure that one day no one has to wonder if they will find a match, let alone survive the process.

“I am blessed and lucky that I’ve had the outcome that I’ve had. Be The Match gave me the opportunity to have lots of matches. I’m a lucky beneficiary of what had already been accomplished before I needed a transplant, and the people who were already on the registry. Now I want to help grow the registry even more, so that other people can be told they have lots and lots of matches too.”

– Michael Stewart

Interested in joining Michael in supporting Be The Match?

Join the registry – you could be the match that someone is searching for.
Give – big or small, financial gifts help continue our mission to help patients and their families.
For more information on major gift opportunities contact Keith Stout, Director of Major and Planned Gifts, at 763-406-8150 or sstout@NMDP.ORG

Hope For Judah

Posted December 2nd, 2014 by Be The Match and filed in News
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In sub-Saharan Africa, an estimated 50-80% of children with sickle cell anemia will die before adulthood*. This is a fact that Maryl and Bryce never lose sight of.

High school sweethearts, the couple always knew they wanted to adopt and the day they met their sons—Judah and David—was the best day of their lives.

Judah fmaily photo (1)

The new family traveled home from the Democratic Republic of the Congo and spent the first two weeks of their homecoming nesting. “The first time we left the house was for the boy’s newborn wellness checkup,” says Bryce. Though the boys were 2-years-old, they had not had access to this important medical screening in the Congo. Everything looked good, but a follow-up call reveled devastating news—Judah had sickle cell disease.

Maryl, a nurse, immediately understood that sickle cell was a life-changing diagnosis. Thankfully, the initial care Judah required was minimal. Then, one morning something wasn’t right. Trusting their instincts, Judah was rushed to the hospital and an MRI revealed that their precious little boy had experienced a significant stroke.

“When we got the call that Judah had sickle cell disease I couldn’t look at our homecoming pictures without being mad. This wasn’t supposed to be us! Then, just about the time we got comfortable with how our lives would be dealing with sickle cell disease, Judah had his stroke,” says Maryl.

The news was hard to take in. Judah’s sickle cell had become much more serious, but a ray of hope shined though—a marrow transplant could be a cure.

“Our doctors explained that, because of his ethnicity, Judah’s hopes of finding a match were low—less than 20 percent,” says Bryce. “Then a 5 out of 6 umbilical cord blood match was located and we thought—wow! He has a match. It felt meant to be.”

Maryl and Bryce sprang into action. With the hospital 3 hours away, the family had to make some hard choices. They sold their house, and Maryl took time away from work so she could be with Judah 24-7. “It was hard, but we got through it,” says Bryce.

Judah_Still_001_small (1)

In total, Judah spent 60 days in the hospital. Fifteen days preparing his body for the transplant and 45 days to ensure his immune system was stable enough for him to go home.  “Restricting a 2-year-old to a 12×12 room for weeks… Judah took it like a champ,” says Bryce. “Especially because he was too little to understand that the chemo and pokes were all for his own good.”

On December 11, the exhausted, but hopeful family was discharged to celebrate the holidays at home. “It was a hard holiday, but we left the hospital feeling like it was worth the sacrifice —that, because of this process, Judah would be able to celebrate many, many more holidays disease free.”

Sadly, on January 7, just as the family was dreaming of plans for a brand new year, they received heartbreaking news. Judah’s body had rejected the transplant.

“We had a lot of sadness after receiving this news,” says Bryce. “It was a true grief process, but we still had hope. We recognized that if Judah was still in the Congo, he would have experienced a very painful life—limited access to clean water, let alone medical care. But this wasn’t his path. He was matched with a family who loves him. His mother is a nurse and one of the best children’s hospitals in the country is only a few hours away.”

Today, the family makes monthly trips to St. Louis for Judah’s blood transfusions. Maryl and Bryce do their best to make “hospital day” fun, but Judah is starting to understand that his disease limits him, asking questions such as, “After no more sickle cell, then can we go to the lake?”

“We are grateful. Because of doctors, researchers and technology—his sickle cell can be cured. And we have dual hope—hope that Judah will find his perfect match and hope that we can inspire others—specifically first generation Africans—to join the registry because so many families have a loved one searching for their match,” says Bryce.

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Their faith and support from family and friends help them get through the day-to-day. “We are confident that Judah’s match is out there. If he had been cured at age two, we could tell him about it. Being older, he’ll better understand what he’s going through and, if we’re lucky, one day we’ll be able to hug the special person who will save his life,” says Bryce.

The family regularly host registry drives and does everything they can to spread the word about the need for marrow donors. “It’s given us so much hope to watch our community give, join or volunteer for Be The Match. For us, it means that people care about our son.”

Do something right now to help patients like Judah. Your dollars save lives.

 

*according to a study published by the Public Library of Science (PLOS)

Meet An Advocate: Betsy Lucas, Minneapolis, MN

Posted December 6th, 2012 by Be The Match and filed in Patient Stories
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Three months to live. Betsy Lucas received that devastating deadline when doctors diagnosed her with leukemia in 2005. But Betsy, a schoolteacher and mother of two, had hope: if her doctors could quickly find a matching bone marrow donor, a transplant would offer her a second chance at life.

Hope became reality with the help of a German teenager. Through Be The Match®, Tobias Hoffman, 19, was identified as a bone marrow match for Betsy. That’s because Be The Match® partners with other international registries to give patients access to approximately 19 million donors and nearly 600,000 umbilical cord blood units worldwide. 

Betsy received her transplant at the University of Minnesota in 2005, and has been cancer-free ever since.

Today, Betsy is healthy and leading an active life with her husband and their young daughters. Still, she hasn’t forgotten about the people who helped her. She had the opportunity to thank Hoffman in person and has reached out to Be The Match to help provide this life-saving gift to others. Betsy has logged hundreds of volunteer hours raising awareness about the importance of bone marrow donation, educating patients and recruiting donors to join the registry.