Stem Cell Collection (If you like needles, you’re gonna LOVE this!)
There are two things I feel I need to address before I begin this blog post.
Firstly, last Tuesday (the 4th of Feb) I met with a doctor who advised me that the latest PET scan had shown no cancer whatsoever in me. While this is obviously good news for me, it’s terrible news for the blog, as I might run out of things to say sooner than expected. This is obviously a tragedy. Seriously though, this doesn’t mean I’m ‘cured’ or anything quite that dramatic yet, and it won’t save me from having to endure the next two cycles of chemo. I also still don’t know if they’ll end up opting to give me the ‘super chemo’ dose at the end, though given the progress I don’t believe they will. Still, it’s great to know I’ve had such a response to the treatment. The only real downside is that now when the chemo is hitting me hard, while I’m normally thinking ‘if I feel this bad, imagine how bad the cancer feels,’ with the knowledge that there currently IS no cancer in me, I’ll instead be thinking ‘well, poop’.
Secondly, if you aren’t any good with needles and those types of things (I know you’re out there, I’ve been told one of my posts made someone throw up once, which I can add to my lifetime achievements) I must, sadly, strongly advise that you stop reading now. This blog post will contain needles. Many of them. And one in particular that may haunt your dreams. There will also be some blood, and just… overall the images won’t be pleasant. Come back for the next post. I promise it will contain puppies and butterflies and all those nice things. This one, however, is not for you. Go now.
Stem Cell Collection
Now that the weaklings are gone, I can safely assume I’m left only with those okay with needles, and possibly those interested in seeing horrible things done to me. So let’s get to it.
A decision was made several weeks ago (late last year) to have some of my stem cells collected/harvested. The main reason for this decision was the plan to give me a super dose of chemo at the end of my currently planned chemo cycles. As I already wrote above, this ‘super chemo’ may or may not still happen, but I’m guessing not. If it does, the stem cells will be given back to me after the chemo because the dose will be so severe that my body will need extra help to recover. If the super chemo does not go ahead, my stem cells will stay stored away indefinitely in case one day I do need them.
To prepare for this, I met with a doctor from the Haematoligy department who explained why this procedure was going to be performed. With this doctor was a member from the Apheresis team, who then organised me to come back to the hospital so they could go over the procedure with me in detail. This was something that was pretty far against the norm. Hospitals, in my experience, don’t have you come in weeks in advance just so they can tell you what’s going to happen. Usually I just turn up on the day and get taken for a ride full of pain and unexpectedness. Honestly though, I’m fine with that, as long as I don’t have to make extra trips to the hospital for little to no reason. Here, they had me inject a stress ball with a syringe (similar to the ones I’d already been doing the day after chemo) and also had me sign some consent forms. Apparently some people are against the process due to religious or spiritual beliefs. You’d have to be pretty foolish to let any kind of beliefs get in the way of a possibly life saving procedure though, if you ask me.
Once this was all done, the procedure still had to be organised. Basically, 5 days after chemo, I was to start injecting myself with the same needles I had previously been injecting myself with the day after chemo. These were smaller doses, however there were now 2 of them per day (both at the same time, at 8am), and this had to be done 5 days in a row. On the 5th day, 10 days after chem0, I was to go in to the Austin Hospital and have a blood test to see if my stem cells were ready to be harvested.
Again, I’m not going to go into the extreme technicalities of how the injections work (because I don’t know) but basically, as it was explained to me, stem cells are created in the bone marrow and do not normally get released into the blood stream. These injections would not only help encourage the creation of new stem cells, but also allow them to be released into my blood stream for collection, which normally wouldn’t be possible. Whether or not this is simply because of an overflow of stem cells or if the injections have a secondary function, I’m not sure.
The stem cell collection was actually pushed back a couple of times due to the Christmas period and lack of staff. As such, the actual process started almost 2 months after I had this initial meeting. I had chemo on the 24th of January and started injections on the 28th (for those paying close attention, you’ll realise that’s a day EARLIER than I was supposed to – and yes, due to miscommunication somewhere down the line, I started the injections a day early by mistake, but it didn’t matter). This meant I didn’t have to inject myself the day after chemo, but injecting myself with BOTH of these for 5 days straight quickly made up for that.
To add to the joy, on the 10th day (the 3rd of February) the injections had to be done at 6am, so that I could head into the hospital at 8am for the blood tests (to see if my stem cell levels were appropriately high). To make matters worse, after this blood test, I then had to go get a vas cath inserted in my neck (I warned you, don’t say I didn’t warn you) without even knowing the results of the blood test. This means that I could have a needle sticking out of my neck for DAYS while coming back to the hospital every morning at 8am waiting for my blood results to give an acceptable reading. This is quite an unpleasant thing to think about, so at this stage you’re really hoping that the stem cell levels in your blood are high.
Before any of that though, when you first arrive you are seated in a comfortable chair next to the machine that’s going to be taking your blood, stealing the stem cells from it, and then giving your blood back to you again. That machine looks like this (because it is this):
See that hook? The long white part of the hook? That is going to be inside my neck soon enough, going all the way down into my chest. I told you – it is a thing of nightmares. And this is the thing that, if your bloods don’t come back with an acceptable level of stem cells, might be left inside you for several days. Comforting. I should point out, however, that stem cell collections don’t ALWAYS require the insertion of a vas cath. This is only done when the veins of the patient aren’t ideal (as mine currently aren’t, thanks to one million blood tests, chemo, etc etc).
The procedure (of inserting the vas cath) itself, however, wasn’t too bad. I didn’t get any photos of this, but basically you are wheeled into a big spacious room, with a machine that looks a lot like this and lots of monitors along one wall. You’re then asked to turn your head to the side and they put something that appears to be a giant tarp over your head. At this stage you can only see through a small gap to your side, and occasionally a nurse would look through the gap and ask if you were okay. Again I’m feeling fortunate that I don’t have any claustrophic tendancies, because a lot of procedures I’ve been through feel a bit closed in.
The only thing that hurt, as far as the vas cath insertion went, was the local anaesthetic, which tends to always sting a bit. After that though, I barely felt anything at all and it was over in no time. The next thing I knew, I was being wheeled back out of the room into a waiting area.
This was also the first opportunity I had to actually see the vas cath sticking out of me.
At this stage I was wheeled back to the Apheresis department, and advised that the required level in my blood was ’18’ and mine was ‘124’. Clearly starting the injections a day earlier than I was supposed to had worked in my favour. Either that or my blood is awesome. Whatever the reason though, this meant that the harvesting of my stem cells could begin.
Basically the blood is sucked out of me through one tube, cycled around in the machine while it takes the stem cells out, and then given back to me through another of the tubes in a kind of ‘one man blood transfusion’.
I was warned that if I experienced a strange taste in my mouth that I needed to tell the nurse (who was always standing right near by) and as it happened, I did. This is one of the rare times that something I’ve been warned about actually happened to me. They gave me some tablets (calcium and… maybe potassium? That’s probably not right. Maybe I should have paid more attention but at the time the side of my tongue had gone kind of numb so I was distracted) and paused the machine, and when they started it again I had no issues.
This was also probably about the time that I found out that even though my blood levels were great, I was STILL going to have to leave the vas cath in my neck overnight (or more specifically, until the lab had confirmed that they had everything they needed). So yes, my body did all it could, but I would still be going home and attempting to sleep with that thing hanging out my neck. And no, it wasn’t covered in any bandages or elaborate wrappings – it basically stayed as you saw it, sticking out of my neck. And all that, for THIS tiny amount of stem cells, which took several hours to get:-
Having the vas cath sticking out of me overnight wasn’t overly painful, but as you can imagine, it is rather uncomfortable. And knowing that it’s sitting down inside you near your heart can make you somewhat paranoid of bumping it (although I was given absolutely no warnings or anything of the type that this could be an issue). I slept, somehow, rather soundly, on my back, and when I woke up on my side I freaked out slightly before realising that I was indeed, still alive. Earlier I had received a call and was told that everything was fine and that the vas cath could be removed the next morning. While I had received that call I was on the couch, having foolishly decided to lie down and finding myself unable to move.
The next morning, it was taken out. I couldn’t even feel it being taken out (there was no surgery this time, the nurses in the Apheresis clinic are able to do this), but what I did feel was the disinfectant being used around the wound before pulling it out. That stung. That stung badly. Finally though, it was out, and I was left with this gauze on my neck.
Now, the wound has already faded to little more than a small scar and I have a bunch of little life saving stem cells stored away for when I need them. Even if I don’t have the ‘super chemo’ this will likely turn out to be worthwhile, even if it’s just to be ‘on the safe side’.
So that’s all there is to it. Those of you who lasted the whole way through this post, I hope you enjoyed it, or at least learnt something.