The machine reminds me of an old Star Trek-like computer with knobs twisting and clear plastic tubing everywhere. All the tubing is brand new, installed from a sterile "kit" by the nurse for each patient. (It would be unimaginable that they would somehow be able to clean and sterilize that tubing for multiple uses, so they don't.)The way apheresis works is the machine pumps out a little of my blood at a time and sends it to a centrifuge under glass (under the small black 'countertop' in the photo). As the centrifuge spins, it separates my blood into layers, based on the weight of the blood components: red cells are the heaviest, then stem cells, platelets, white cells, and plasma. There's a skimmer that selects the layer they want to extract (in my case, the stem cells). They position the skimmer in the centrifuge based on the color of the product. They use what looks like a paint pallet card to recognize the right position for the skimmer (the white card above right-hand side of the 'countertop'). After they're done extracting from that blood, it leaves the centrifuge and gets merged back together and sent back to my body. After initial setup, the process is very automatic. They just let it run and run. The machine is not quite as loud as a sewing machine, with lots of clicking, and my stem cells end up filling about a fourth of an IV bag (the right-most IV bag hanging over the machine). In the course of a single four-hour session, all my blood is circulated through the machine almost five times!
They have me lying in a bed with cable TV and remote control, very good wi-fi, and a nurse at my beck and call for everything. I need to hold pretty still or I may pinch a line or cause pressure to drop. As a result, I was treated like a Persian prince. Using the bathroom? portable urinal, followed by careful hand-cleaning.
One thing the nurse had to do was feed me a lot of Tums (like 25 or so). There's some chemical they use in the apheresis process that breaks down in the presence of calcium. If they don't feed me extra calcium, the chemical uses the calcium in my body, which results in tingling in hands, feet, lips, as if they had fallen asleep. The Tums makes the tingling stop almost instantly.
Another thing the nurse had to do was make sure I stayed warm. The blood that comes back from the machine is a little cooler than the blood I sent to it. As a result, I needed a few blankets and hot packs to stay warm.
Leilani was in the room the whole time, just being there and taking care of the little things.
For autologous stem cell transplant for lymphoma, the goal is two million stem cells. Don't ask me how they count them. After the first day, they got almost half of that. Today was my second day. The nurse said that the rest of my blood counts were a little down this morning from yesterday, so she expects that I'll have to come back again tomorrow to reach (and exceed) that amount.
Here's what we did yesterday and today (so far):
Wednesday
7:30 Arrive at clinic to receive Neupogen shot. Wait an hour for it to maximize its effect. Eat something at the cafe or whatever.
8:30 Go to the apheresis room, draw blood for labwork, and get hooked up to the machine.
12:00 Lunch while on the machine
1:00 Wrap up. I'm tired, though I haven't done anything.
4:00 Get phone call with collection results. Did they get enough? If not, come back tonight for a Mozabil shot.
9:00 p.m. Arrive at the hospital for the Mozabil shot.
9:30 p.m. Receive the shot. Wait around an hour to make sure you don't react poorly to it.
10:30 p.m. Go home from receiving the shot.
Thursday
7:30 Neupogen shot.
8:30 Apheresis room, draw blood for labwork, and get hooked up to the machine.
12:00 Lunch while on the machine
1:00 Wrap up.
No comments:
Post a Comment