It is truly amazing to think that a full three years has gone by.  Wow, how does time fly... 
I have really been contemplating how to put to paper my thoughts and experiences over the past three years.  At the end of the day, I'm just not sure how to go about it, so I will simply start writing and see where this takes me.  
Of course, after three years, the million dollar question is how am I?  Personally, I am great, MS wise, it leaves a bit of room for improvement.  So how have things progressed? I will take it back to six months post HSCT and start from there.
During the first year post transplant, everything went according to the scheduled recovery. My blood work slowly returned to its normal values and with, that my energy slowly returned.  It was not always a smooth road though and with that I will segway into the first area I wanted to discuss.  There is a debate among people who have had hsct whether they should have a hematologist or a G.P. follow them post treatment.  For all of you listening, I would like to chime in on the subject. So what is the difference you ask?
Your general practitioner will typically order a cbc (complete blood count) along with TSH, T3, T4 etc.  These are pretty good indicators for general blood health and give a fairly good global picture of how the leukocytes are performing post transplant.  That's great, isn't it??  Well, yes, except when you bring in the expertise of a hematologist, he/she will not only check all of the regular stuff as above, but also every subset of blood type there is.  As an analogy, it's kind of like if the GP checks out how North America is doing as a whole, the hematologist also looks at how  the individual cities that comprise North America are performing.  Why is this important?  When I first transferred to my hematologist (a transplant specialist) my global blood work was looking really good.  I was surprised when he got my blood work back, that several of the subsets of lymphocytes were still yet to come back to normal.  They have all since then and look really good, however I would never have been the wiser had he not checked it all.  Secondly, as in about 10% of post transplant patients, I had a protein show up in my blood work that isn't typically supposed to be there.  Now, what's the big deal about this protein?  Isn't that just going to make me look more like Arnold in his glory years?  Well, when first found, this scared the living you know what out of me.  Many sleepless nights.  I had to do blood tests every 3 months as we watched and waited to see what it was going to do.  Thankfully, it stabilized at a low level and as long as it stays this way, it's not a problem.  As I say, it happens in about 10% of hsct'ers and should just fine in the long run. However, it needs to be monitored!  I don't care how many 'doctors' we have in our hsct forums that like to give out health opinions, safety first!  Get checked by a specialist who can guide you safely through the years following your transplant.   That's my rant...moving on...
Now, onto MS.  For the the majority of the first two years, my MS was actually relatively stable.  No new lesions on the MRIs and outside of the recovery from the treatment, I feel I was doing quite well.  Over the past year, however, my MS has reared its head and let itself be felt again.  It has again, hit me in the same manner as it did before, targeting my legs and gait for the most part.  I do use a cane for doing walks outside of the house.  (I never used any supports of any sort prior to treatment).  My spasticity, which I honestly feel has been a bit worse since the three month mark post hsct (steroids wore off), has been awful for the most part.  I am back taking baclofen, fampyra ( for walking) and copaxone.  Why copaxone?  Simply because it has one of the longest running safety profiles.  Can't say  I enjoy the daily needles...
So in a nut shell, am I worse than before hsct? I can now say yes and that things are now changing again and while the transplant slowed my MS for a while, it has now come back...crap...shit...fuck... 
The next question I get is would I do it again?  This is likely the question I have thought about the most over the past few years.  Of course, knowing that it did not work, I would tend towards no, but who knows where I would be if I hadn't.  Would I be worse?  Further disabled?  I will never know the answer to that so a tough one to answer.
I think I would simply like to pass on my thoughts so if in some small way it helps those considering this treatment.  I would summarize it as this...this treatment treats inflammation.  There is no doubt it is the most effective treatment in the world, however, if you don't have inflammation, it is much less likely to work.  Not that it won't...I know personally of people who didn't fit the ideal criteria and have had wonderful success. That being said,  it is less likely.  If, however, your MRI's constantly show all those glowing enhanced lesions...game on.  That's what the chemo targets,and that is the demographic that all of the research says it works best for.  Believe the stats.  Your body does go through a lot for this (as well as many other components of your life), so my suggestion is, that if you are not a prime candidate for the treatment think long and hard.  You may not like the decision you have to make, but it may be the correct one.
As for me...life continues on. My three wonderful kids and beautiful wife help me navigate these waters every day.  I am still working as a chiropractor full time, but even that may eventually have to give.  And if and when it does, I will still do my best to keep moving forward whether with legs or wheels.  I maintain a positive attitude and while there is always those days you don't want to come out from under your sheets, I try not to allow them to come over me too often.  Life has a lot to offer, it just may be in a different way than I originally planned.  
Laugh often, love always, live life to its fullest!
Love from Ottawa.

     Incredible to think that it has now been over 6 months since my life altering trip to see Dr. Fedorenko in Russia.  It truly feels like it was so long ago.  There are times when I ask myself 'did I really do that?!'  With that being said, all I have to do is look in the mirror and see my now thick, wavy hair and realize 'oh yeah, I certainly did!'
     So the burning question for so many people is how am I feeling?  Was it successful?  What has improved?  All great questions and I will endeavor to answer them all for you.
     Overall, I have to say I am feeling quite well.  My energy has returned for most days, which is a good thing since I went back to work starting in early January. I certainly still have up and down days and the chemo fatigue will still surprise me by kicking in out of no where.  I can be great from 6 in the morning until mid afternoon, then out of no where be dragging my bottom for the next couple of hours.  The good thing at this point is that once you can identify it for what it is, you can adjust your day a bit to accommodate it and it diminishes often quite quickly.  
     As I mentioned, my hair is now back and full!  Little different color with some grey in there too!  Whaaat?  Maybe it's because I turned 40 today, but I'll blame it on the chemo!
     Relating to my MS, there have been some subtle changes in some departments, less so in others, but no progression.  Things that have improved are no bladder and bowel urgency and some areas of paresthesia (sensory numbness) that I used to have are now gone.  No more MS hug either since the second week back to Ottawa.  Good riddance!
     Gait changes have been minimal, but I certainly have the confidence to walk a farther now.  I do not notice my drop foot on the left to nearly the same extent, but I do still find my gait gets quite sloppy after about a km.  It is an area that I am going to be working on going forward.  
With going back to the physical demands of my job so early, I have to this point been quite hesitant to work out.  That has all changed since the six month mark as that was the personal benchmark I set out for myself to achieve before I started to push.  Now that we are there, I am on the eliptical every second day, stretching, and doing physio.  Very quickly, my energy has improved and I feel much stronger.  I have always been an exercise junky, so it feels so great!  Nice to be back in the game!
     After treatment, I did my best to try to eliminate all of my medications as well.  I am no longer on any DMD's (disease modifying drugs), amantidine, and use only 5-10 mg of baclofen a day.  On the advice of the new physio I am seeing (who specializes in MS), I may try to regulate my baclofen a bit better as she feels a lot of my gait issues are currently tied in with my spasticity.  Hopefully with the balance of stretch, strength, cardio and proper meds, I can get back to moving properly again!  I told her my ultimate goal is to run again....something to aim for:)
As for was it a success?  I had my first neurologist  appointment this month as well. So far, EDSS is stable with no progression!  I've always said, I took on this treatment to stabilize and any imrovements obtained were a plus!  So far so good and I will be working on those improvements in the months to come....stay tuned!
Love from Ottawa!

     I can't really comprehend how two full months has gone by since my stem cell transplant!  Sorry to all those who have awaiting an update.  As always, I am flattered and taken aback by your caring comments and wishes for continued healing
     I can truly say, it is wonderful to be back in Canada!  As much as I felt safe and in great hands in Moscow, nothing is like coming back to the comforts of home.  It  was quite a reunion with my wife and kids at the airport.  I actually held it together for the most part, but I think there may have been a few tears of joy on the plane home!
     So where are we after two months?  Well, as with most people, the first couple of months has been a bit of a roller coaster.   In the early weeks of being home, my gait was much improved thanks to the steroids but as they wore off my spasticity slowly returned.  I still experience the left foot drop, but find my ability to walk longer distances without it becoming a problem is improving.  
 I have good days, followed by not so good days.  In general, however, I feel that every day I am getting better and better.   MS symptoms are a strange animal and every person with the disease will tell you the same.  I had two days about a month ago where my symptoms were absolutely terrible.  I was fatigued, a lot of leg spasms and heaviness.  I suspect it was a reaction to my over doing it physically ( I 've never sat still well) but boy did I pay for it!!  Then, as if nothing ever happened, I awoke during the middle of the night, and it was gone!  Very bizarre!
     My energy levels are slowly improving each day.  I have to respect the fact that I am still anemic (low red blood cells, hemoglobin, and hematocrit).  While the treatment was aimed at destroying the white bone marrow (Leukocytes), there is collateral damage to the red marrow (red blood cells) as well.  Every two weeks, my MD monitors my blood work and so far we are heading in the right direction. 
     I suppose the long and short of it is that I am recovering, but it is a slow process.  The chemo is pretty serious stuff and I continually have to remind myself not to get frustrated by my body as it has only been two months.  Not a long time when you consider the amount of recovery that has to take place.  I am going to return to work on a part time basis in a few weeks to test the waters.  I figure it is a good time to try it, followed by a nice long break for the holidays!  I am very much looking forward to a bit of normalcy in my life!
     In terms of the MS, no new symptoms, which is a good sign.  I have always maintained that I hoped for remission and if I get some improvements that is a bonus.  While some experience improvements early on, I still think it is too early for me to tell what may be gained. 
I should also mention that for the first time in years, I am on absolutely no medications!  No disease modifiers, no anti fatigue meds, and no anti spasmotics.   What a great feeling!
     My days are filled with gentle exercise, rest and recovery.   Each day is better than the last and I look forward to all that my future holds.  I will do my best to update everyone at the three month mark!  Until then....
All the best from Ottawa!

Just to clarify what it is you are looking at.  You can see the dark blue catheter being held by the nurses hand...that portion to the right was external, had three ports which were used to take blood, use IV's etc.  The light blue portion to the left (about 8" long) was inserted into the Subclavian Vein.  The reason, is that whenever a medication or fluid is injected, it is immediately perfused throughout the body due to it's proximity to the heart. 

Mom, Dr. Julia, myself and Dr. Fedorenko 

One last pic prior on the day the isolation doors were finally opened!

Today was the to represent the last of 'major' drugs I receive during the course of the HSCT process.  This is called Rituximab, which is a mono clonal antibody used to deplete any of the extra B cells which may have eluded the chemotherapy  portion of the treatment.  While it is not technically a chemo drug, it does pack some punch with it.  It has a very good safety profile with it, with the most common types of side effects involving histamine reactions.  So to counteract any of this, first and foremost, you get your normal dose of steroids (which are already on the taper for me) and an hours worth of antihistamine drip.  
    I should preface by saying that last night was not a good night sleep, 2 hours, here, 2 hours there, so between that and the increased exercise I threw at myself yesterday, I was not a ball of energy today. 
    The process of rituximab infusion takes minimum of 5-6 hours, up to several more if the person is reacting with any allergic symptoms.  Mine started about noon.   It's all about slow and steady.  So the lovely head nurse Galeena comes in, gives me the steroids, antihistamine, etc then hooks me up to the Ritux....Ever gone to the dental surgeon for procedure and they say count back starting from ten and you usually don't make it to eight?  Well, lets just say I woke up long enough to scarf a 2 pm meal, then back asleep until 6pm!  Crazy...must have switched the bottle with the elephant tranquilizer!  Wow, did that feel good.  Not to worry, the doctor apparently checked in on me no less than four times while I was in full drooling mode.  No concerns just making up for lost sleep I guess. 
I have always been fortunate in my lifetime to not have to take more than a handful of any type of medications, so no surprise these things are doing what they are supposed to do to help me out here!
Last big one today!  Very pleased to have it done.  The next week will be plenty of blood work, weaning meds, getting my conditioning up, and hopefully getting this Subclavian line out of my neck at the end of the week or weekend!  Cant say I'll miss it! 
All the best from Moscow!