John Forloine turned to the Internet for answers. His wife's gums had swollen terribly, so he searched the Web for "swollen gums." Beyond such likely results as gingivitis, he found the unexpected: cancer.
In late August, when they told the doctor what they'd found, Brandi Forloine said, "It looked like a light went off." Tests and chemotherapy soon followed.
Adult acute myeloid leukemia (AML) is a particularly vicious cancer of the blood and bone marrow that typically strikes people in their 50s and 60s. Brandi Forloine's diagnosis was rare and grim.
Chemo helped some, but it became apparent it wasn't the answer. The only chance Forloine had, the doctors decided, was a bone marrow transplant.
Good match is vital
On its face, a bone marrow transplant sounds deceptively simple: You find a donor, take about a liter of marrow and put it in the patient. But this is medicine, a blend of science, art and insurance companies. The process is rarely easy.
Medically, the first and often hardest part is finding a donor. Matching marrow is nothing like matching blood type. It involves the intricacies of DNA and antigens, a biological calculus so complex that even siblings are suitable matches only 25 percent of the time.
A good match is vital; the better the match, the greater the chance for success. Identical twins, who share the same DNA, are ideal. For others, siblings provide the greatest odds.
For Brandi Forloine, her best chance lay with her two brothers, Jason and Todd, 35, who also lives in Garrard County. They all bet on Todd.
"We thought they'd match because they look so much alike," Bisher said.
In this case, looks deceived. They found out Halloween night.
"My sister and I were a perfect match," said Bisher. "Any closer and we'd be twins."
Said Forloine: "It was a miracle."
After additional testing, the transplant was set - just in time for Christmas.
He checked into the Cleveland Clinic on Dec. 23
On Dec. 23, Bisher checked into the Cleveland Clinic, the nation's leading bone marrow transplant hospital. He was given a general anesthetic, and a surgeon used a long needle to harvest marrow from his pelvis.
"The only ill affects from this whole thing is you feel like somebody hit you in the back with a board," he said.
For Forloine's part, the transplant was simple, just another IV.
The hard part came in the weeks before the procedure, when she received high doses of chemotherapy to kill what was left of her bone marrow. This was done so that Bisher's marrow could move in unimpeded by her immune system - which is generated in the marrow - and replace his sister's.
If successful, Bisher's healthy marrow will "graft" so completely that Forloine's blood type, which was O-negative before the transplant, will become Bisher's O-positive.
With the transplant completed, Forloine is in for years of regular testing for signs of leukemia cells or complications. The worst of the lot is graft vs. host disease, in which her body would try to fight off Bisher's marrow.
"Right now every sign is pointing to working as planned," Bisher said, "even faster than planned."
If Forloine continues to progress, she'll be discharged from the hospital in about a month, but she won't be able to go home. She'll have to stay in Cleveland for up to three months so that she can go to the hospital for testing three to five times a week.
With a husband and 2-year-old son Max at home in Columbus - about a two-hour drive - it's not been easy.
"He always says, 'Mommy, come home,' " Forloine says.
Treatment is expensive
As difficult as it's been, she knows first-hand that it could be much worse. Her husband is a vice president at Barbasol, and they have good insurance, even if the company "tries to fight you on every little thing, like you're making things up."