Collecting 5 Million Stems Cells… the Old Fashioned Way
Road to a Stem Cell Transplant – The Stem Cell Collection
Sorry for getting sidetracked from the story but I had to get to the stem cell collection part of the story while it was still really fresh in my mind. If you remember back in Part 2, the “plan” was to drive the lymphoma into remission and then knock it out for good with a stem cell transplant. After 6 rounds of chemo and against pretty high odds, I produced a negative Pet Scan. I barely had time for a victory lap before it was time to get back to business… the bonus round.. the stem cell transplant.
Back in June, the whole harvesting part of the stem cells was presented as “sort of like giving blood”… No big deal. Now that we have 5 million stem cells in a bag with my name on it, I can tell you that the only thing stem cell collection had in common with giving blood is that both donors go to the same place to give.
There are basically 2 different types of stem cell transplants used in the treatment of liquid tumors like lymphoma. One way is to use the patients cells and the other is to use donor cells. In my case I am able to use my cells. Apparently stem cells hide out in the bone marrow. Stem cells are cells that have not yet turned into white cells, red cells or platelets, The trick is to get the cells to leave the marrow and go into the blood stream so they can be harvested something like platelets. The donor goes into the blood center, gets a couple IVs inserted and the blood is taken out of the body, stem cells removed, and the blood returned to the body. The whole process takes a few hours…..MMmmmmm,, sort of.
The trick, of course, is getting the cells out of the marrow, in enough numbers, to be able to be harvested… Intellectually, I assumed there was a little more that ringing a bell or something to get them to leave but…. Here’s the deal.
Friday I started the process in the OR having a Hickman Catheter inserted into my jugular vein (sub-clavian, actually). The procedure was simple enough,as long as I didn’t think about it too much. The drugs were great. The surgeon was playing some great old rock and roll while I was nodding out and before I knew it, I had this “Matrix” looking thing with 2 leads, hanging out of my shoulder. It didn’t take long before I realized I had taken my last great shower until Christmas, because the world ends if you get this contraption wet. The good news was that from now until the end of the process, I would not need anymore IV’s. I was running on “straight pipes”. To get anythng in or out of my blood system you needed to merely “hook up” and give or take.
The “increasing the number of stem cells” part, I mentioned above was not drinking a few extra glasses of orange juice or taking a pill. This was accomplished by not 1, not 2 but 3 injections each day until enough cells were collected. And the moving of these cells was not done by beating a drum but by a bonus injection in the evening. By Tuesday morning, when I showed up at the blood center, I had 12 injections of drug A and one injection of drug B.
The donation part was pretty much, as advertised, with one small detail missing. The nurse told me that the doctor ordered 5 million stem cells (per kilo body weight). She then said that most people netted about a million the first day. WTF….. Not me, nurse, I’m going to be one and done. “Nope”, replied the nurse… “nobody does it in one day”. Another WTF….(Non-verbalized, of course). The doctor in charge of the blood unit came in for a visit and she repeated the same line but added… less than 10% get away the first day. Bingo…. now we’re talking… my kind of odds.
Three hours later I was being unhooked from the machine and a smallish bag of stem cells were shown to me, with my name on it, before it was whisked away by messenger to be counted by the cell counter. The nurse said she would call around 330p with the number and that she would see me the next day. After popping into the office for a few hours, I was on the train home when the call came in… Hello… long pause… “How many do you think we collected” asked the nurse. Normally I would have been into a little chit chat but opted for the direct response, “Don’t know.. How many”. We got 4,969,000… pause… we round that up to 5 million…. Good luck with your transplant. Whew!! The rest of the ride home was nice. I went to bed early to watch a movie and didn’t quite get past the opening credits before I fell asleep… one step closer to the man event.
PS: A funny side note. When the nurse first hooked me up to the machine, she was explaining something about if you have a reaction to X, we do Y. Part of this “reaction” included tingling in the hands and feet. I have MS and tingle all the time so I didn’t give it a whole lot of extra thought. I was focused on 3 hours… and not coming back. About 2 hours into the process my body started to vibrate like a tuning fork. This happened a lot with the MS so I didn’t say anything other then confirm I had 50 more minutes to go. The more time that passed by the more my body vibrated to the point my wife noticed an expression change and asked me what was going on. Of course, my answer was “Nothing”. The vibration continued to get worse to the point that I called the nurse to ask how much more time I had….. Three minutes, plus 10 minutes to get the blood that was left in the machine back in your body… Why. With three minutes to go I figured I might as well confess… Ohhhh said the nurse, who turned around and grabbed something from another table…. “Here, take 3 of these”. She had a large bottle of Tums in her hand. Huh? “Oh yes”, she said, “That vibrating is the sign that you need some calcium…take 3 tums and you’ll feel fine”. She was right. I could have felt fine an hour earlier. The hard headed German thing that gets me through most days, sort of got in my way that day. Maybe I’ll rethink keeping symptoms a secret next time.