If I had to summarize briefly how this chunk of time has been, I’d say that it has been slightly frustrating in some areas, and encouraging in others.
At the end of the day, I still think this period brought more progress than setbacks though, and that’s really all I can ask for.
Anyways, let’s get into it.
Medical
There were a few new developments during this stretch, but for the most part, my appointments were uneventful. The same goes for my blood counts over this period. Have a look below.
Instead of getting discouraged by the lack of movement, I’ve been trying to see it like going to the gym consistently for the first time. At first, you make quick progress, what people often call “baby gains.” Eventually, though, things slow down, and you just have to stick with it if you want to keep improving, even if that progress comes more gradually.
Maybe not the best analogy, but my team has reminded me that at this stage of transplant, especially for someone who received a bone marrow product rather than peripheral stem cells, this pattern is completely normal. As my body continues to adjust, my counts should start climbing again.
On the “new developments” side of things, my doctor told me that based on some symptoms I’ve had since discharge, I may have hemorrhoids. I won’t spend too much time walking you through what that’s been like. I’ll just link the definition above and let the Mayo Clinic handle the details.
It’s a small consolation knowing this is a relatively common post-transplant symptom, and there are options if it ever becomes too uncomfortable. Does knowing that make it any more enjoyable to deal with? I’ll let you guess my answer.
Physical
Physically, I’ve been feeling better and better each week. I’ll touch more on my running and exercise down below, but there are a few things I’ve experienced during this stretch that feel worth discussing.
As you can imagine, there was a brief stretch where I was mildly concerned about some of the hemorrhoid-related symptoms. When they began in earnest, I was still a few days out from my next follow-up appointment, so I was left wondering what exactly was going on.
Could I have reached out if I was really worried? Of course. My care team encourages that any time new symptoms show up, I should reach out. It’s always better to err on the side of caution when something unexpected appears. That said, the symptoms were only mildly concerning, so I decided to wait, see if a pattern emerged, and bring it up at my appointment later that week.
Since the initial spike in hemorrhoid-related symptoms, there have been hardly any issues. My doctor confirmed they may flare up again occasionally, which is completely normal. While hemorrhoids become more common with age, patients who go through the kind of intense treatment transplant requires are much more susceptible, regardless of age.
Another issue, that I mentioned in my last update, was the hemorrhagic cystitis that developed after I received one of the chemotherapy agents. Unfortunately, those symptoms are still ongoing, though thankfully, not every day.
I’ve been working to identify patterns, and I feel a bit more confident now after noticing a few. The times I’m most likely to have an episode are first thing in the morning, when I’m slightly dehydrated, or after exercise. Hydration seems to be the key factor.
I’ve been drinking a ton of water each day to help my kidneys process the medications I’m on and to keep things moving through my system. Still, there are times when I’m a bit more dehydrated than I realize, which has lead to an increase in blood.
From my understanding, the effects of hemorrhagic cystitis can linger for a couple of months post-transplant, so I’m choosing not to worry too much about it. My urinalysis results continue to improve, and it’s something both my doctor and I are keeping a close eye on.
Outside of those two issues though, I’ve been holding up well physically. There have been the occasional one-off things, like a headache here, or a mild sore throat there, but nothing else that has been ongoing or concerning.
Mental
Much like my blood counts, my mental state during this stretch has been pretty steady. I think I’ve mentioned it before, but a lot of my mental well-being seems tied to how my weekly follow-ups go. That feels perfectly rational given everything I’ve been through, but I do think I’ve been managing the appointment anxiety better than in weeks past.
Because of that, I’ve been able to settle in a bit more and actually enjoy myself.
On day +51, I celebrated my 25th birthday. If you told me a year ago that my 25th birthday would find me in this state, I’m not sure I would have believed you, but it ended up being a good day, and I was more grateful than ever to be able to celebrate it.
I’ve also been increasing my activity level during this time, which has felt great and made my days mentally more satisfying. It’s part of the reason I loved and missed running as much as I did. I’ve found my mental health is always better when I’m able to move and exercise. It’s already proven to be a cornerstone of my recovery, just like I figured it would.
In arguably the biggest news from this period, I was able to return to work full-time on day +74. I’ll likely have more to say about that in the next update, but for now, I’m just very happy to be back.
I’m fortunate that my job has always been fully remote, which allowed my care team to approve my return much earlier than if I had to go into an office. I felt that I did a good job structuring my days during recovery, but I’d be lying if I said I wasn’t grateful to finally have the added structure that working provides. Not to mention, it just feels normal, which anyone who’s been through an experience like this knows is a very underappreciated feeling.
Exercise
Finally, into the good stuff. This is the area where I’ve seen the biggest difference since the last update. When we last spoke, I was just starting to run again, going out for roughly one-mile runs that left me completely exhausted and feeling like my friend down below.
Since those early days though, I’ve felt some strength return to my legs and my lungs begin to readjust. I’ve been taking the runs slowly, gradually increasing my weekly mileage, not too much at a time to cause injury, but enough to challenge myself a little.
This past week, I managed to hit 8.65 miles over four runs. That may not sound like a lot, but I can’t help but compare it to a few weeks ago, and going even further back to when I could barely walk a city block after discharge without needing a break.
While I’m extremely proud of the progress so far, I know I still have a long way to go. In some ways, I’m excited about that. It feels like I’m rebuilding a part of my life that has meant so much to me in years past. The fact that I’m even able to do that is something that was never guaranteed when all of this started.
It hasn’t been all upside though. I’ll be the first to admit that. I lost a significant amount of weight during my hospital stay, much of it muscle from my legs and other areas. Years of playing soccer and running kept my legs lean but strong, and it’s going to take time to regain that.
My favorite part is that rebuilding that strength and fitness can’t be cheated. It requires showing up for myself day in and day out. It gives me a sort of north star to focus on over the next months and years, hopefully helping me cope both physically and mentally with whatever setbacks recovery might bring.
Anyway, rambling aside, I’m back to consistent exercise and loving almost every second of it. I’m currently averaging about 4–6k steps a day. Not a ton, but enough to support my runs and still recover, while also allowing me to continue gaining weight, which is still a priority as I am currently weighing in the high 130’s.
It’s a balancing act that, with the holidays coming up, will almost certainly tip in favor of weight gain.
Closing Thoughts
The hope is that I can continue to share mostly positive news with you all. There have been setbacks, of course, and some unpleasant moments, but overall, I’m doing well at this point in my recovery.
As I mentioned when talking about returning to work, it feels like each day I’m inching little by little back toward some sense of “normal”, or at least, what my new “normal” is.
Grateful doesn’t even begin to cover it.
Talk Soon,
– Ethan
Resources
Links directly referenced in this article:
Long Way From Home 
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