Stem Cells Collected

Stem cell collection was accomplished this past week. This strange amazing process was another unique experience. I checked in after taking double doses of Nuepogen for a week to boost my white blood cell count in an effort to stimulate more "stem cells" being released from my bone marrow for collection. If you get faint around blood, needles, etc. you may want to cover your eyes before reading any further.

Tues. 1/24
The days start with labs to monitor your counts, then off to the Apheresis cell separator machine with dedicated trained professionals to operate it. The professionals look good, the "machine" which will help save my life looks like it was acquired from the Russians in our around 1952. Bad color, chipped paint (always a sign of good maintenance practices), outdated dials, poor font digital output and lots of tubing that looks a lot like what I've run transmission fluid through in the past.

After absorbing all the tubing runs that are designed to do specific things but look like a random pile of spaghetti designed to confuse, scare and make you wonder if this is really right...you settle in for the insertion of "adequately" sized needles into your veins.

The term "adequately sized" is used to soften the blow of what I'd describe as inserting a modestly sized tail pipe or piece of electrical conduit into your veins. About two inches long, these swords are inserted into your veins where the elbow naturally bends, one in each arm for outgoing and incoming blood flow.

This is extra special because you then get to practice "not bending" your elbows for the next 4-5 hours. I learned how extra special this is by forgetting this about 5 minutes into the procedure as I tried to describe something to the professional with the use of hand gestures which immediately turned into pain at the insertion point, beeping sounds from the machine and an artful slap/clamp down on my forearm from the professional. This was followed by restraints being put on both arms.

The remainder of the day you spend "not moving" except for occasional squeezes of a nerf like ball in your right hand illustrating the globe. The shape of the continents are all messed up and you wonder who laid out this detail for production. Japan looks like the size of Europe, Europe looks like the size of Texas? As I contemplate starting either a company producing "high quality" nerf globes or "high quality" looking Apheresis machines, my arms go numb, my mind goes numb listening to the strange clicking sound of my cells being separated back into raw ingredients.

End of day one, collection of 1.5 millions stem cells, a good day.

Wed. 1/25
Waterboarding; not condoning its practice...but I'm ready if it comes my way. I spent the first one hour and forty minutes developing new mind and breathing techniques for dealing with pain. After one, two, three, four, five (I think we've got it, just kidding as a new form of pain erupts as my arm begins to swell rapidly) attempts to insert the swords I'm becoming zen-like. I ponder my new abilities to cope and realize I can handle anything now.

I also appreciate the cool new words I'm learning. When the event associated with the fifth attempt happened it was labeled as an "infiltration" so I asked what is that? Code name "Infiltration" equals "Rupture". This led to a new appreciation for the technique "apply pressure to a wound to stop the bleeding". This applied pressure feels like a small volkswagen sitting on my newly infiltrated vein, but I"m thankful that the technique works and my badly damaged vein is now not ruptured, just badly damaged. Life is good.

I have to admire the dedication and persistance of the professionals, seriously, they are focused now. Doctors are consulted, Heprin techniques are involved and as they say, "Sixth time's a charm!".

I just realized the evolving black & blue patterns peppering my arm look more accurate than the map on the nerf globe I got to squeeze. I'll just photograph my arm for artwork as this will help me save on start-up costs.

When all is said and done, most of the day is spent wondering in amazement how you can run my entire blood volume through this machine 3-4 times and not really feel it. You can see a lot of blood in all the clear tubing again running all over the place, occassionally I check for leaks but don't find any. The professionals don't seem to be concerned with leaks, they are confident and that's reassuring.

Day two ends with only 500,000 stem cells, not great but we'll take it.

Thur. 1/26
Anticipating an event, all goes well with insertion and we are up and running in no time. Sweet.
Unfortunately, the vein in my right arms decides it can't keep up three days in a row and begins to vibrate/collapse screwing up the collection process about every 5-10 minutes. Professionals say this is relatively common, but it's disappointing. You want to have Superman veins, but I am just a mortal being.

A long day leads to only 110,000 stem cells, not good. Bummer. The ultimate collection of stem cells is really based on your overall condition, how much chemo you've received, etc.. You can only give what you have so that is that.

End of day three gives us a total of 2.1-2.2 million.

While removing your stem cells they remove some platelets (blood clotting dudes) as well. With my count dropping they schedule me for two packets of platelets to end the day with.
This all comes on pretty fast, no choice really, no time to really think about the fact that you are now dependant (odd) and (grateful) on someone else's blood to survive.

As the orange juice looking platelet bags are hung and dripped into you, it's just wierd. They talk about all the potential reactions you might have but no one anticipates any big deal as your body may react to the "foreign" elements now entering your body. The first bag goes smoothly so I envision I'm receiving a world-class triatheletes platelets. The beginning of the second bag brings on an almost instantaneous coughing, tightening of the chest, wheezing, itching so I'm envisioning I didn't get two bags from the athlete, I got one from some asthmatic foundry worker.

Professionals swoop in to administer, some inhaler thing, Hydro-Cortisone and Epinephrine that quickly converts wheezing into heart thumping, body shaking adrenaline. Hey, now I know what I'll feel like if I ever get stung by a horde of bees and need to use my Epi-pen which expired about four years ago.

After discussions with Dr. and others we all decide of all the options available, we are going to go ahead with the stem cells we have and the final transplant as scheduled to begin on 2/17/09.

Take care,
Robb