Collection success!

Yesterday (Monday), my mom and I went into the clinic at 7:30 am.  They gave me my two neupogen shots, and then had me go get some breakfast.   They told me to eat lots of protein, since that would help the collection process if we were able to do it that day.  So I got an omelet with sausage and ham and mushrooms.  It was pretty yummy.  Then we went back and they drew some blood and sent it to the lab.

The neupogen stimulates stem-cell production in my bone marrow, but usually stem cells aren't released into the blood until later in their development process.  So they checked my blood to see how many stem cells were in my blood.  There have to be enough for them to collect.  It turned out that there weren't enough yet, so they decided to have me go home until 7pm, when I came back to get another shot of a different drug, called Mozibil, which gets the bone marrow to release the stem cells into the bloodstream. 

The rest of yesterday was pretty boring, frankly.  My mom and I hung out, I did some work, we ate food and did crosswords.  Pretty intense stuff. 

This morning started just the same.  First two neupogen shots: 

Then, breakfast:

Then we went into the collection room.  Since they had given me the mozibil the night before, they were going to collect today regardless of my levels, but then decide exactly how long to be on today and whether or not they needed to have me come back more days based on how many stem cells they found in my blood.   This is the crazy machine in the collection room:

It basically took the blood from my body, added some blood-thinner stuff so that the machine wouldn't get clotted up, and then processed it.  It basically works using centrifuge, which separates out the different weight cells in the blood.  Apparently the red blood cells go to one end, being heavier, while the plasma and protein and electrolytes go to the other end.  The stem cells end up being right in the middle.   They extract all three of these different things, and then keep the stem cell part, while putting the rest of it back in my body.  Before it reentered my body, they added a bit of calcium to counteract the blood-thinner (which apparently is naturally occurring, but they just boost its levels).  While this was happening I was just chilling on a bed next to the machine.  The blood gets a little bit cold while it was in the machine, so they bundled me up with warm blankets to keep warm.  I couldn't move much, so I tried to sleep, do crosswords, and watch some tv.  Here are some of the nurses and doctors that were helping us:

Early on they came back with the results of my blood test that morning, and my stem cell counts were much higher.  According to one scale, yesterday they were at 0.02, and today they were at 0.1.  They were optimistic that they could get everything they needed today, but I would have to be on the machine for 5 hours.  It went ok, but got old.  It was weird to think of all of my blood running through a machine.  They said they would run it long enough to have all of my blood go through at least 4 times.  Crazy.

Finally, the time ended.  They unhooked me and sent us home.  We got a call later tonight that they did get enough, and we don't have to go back until monday, for the final pre-admit day.  Then comes the chemo.  Here we go!

and so it begins . . .

On Tuesday I gave a midterm in class, then we got packed up at home, got Alec out of school and drove the 5 hours up to Nashville, Tennessee.   We met up with the guy who runs the company that leases apartments to medical patients here at Vanderbilt.   The apartment is super nice and clean (and furnished) and will be a great place for me and whoever is with me to call home for the next 7 or so weeks.  It has two bedrooms, two bathrooms, a dining area, a living room with big tv, kitchen and a balcony.  It is on the first floor, which will be nice.

Tuesday night my mom flew in, and we got settled in.  It was great to see her, and we had fun chatting and making a late night groceries run.

Wednesday morning Brittney and I went in to the Stem Cell Clinic where I had some blood drawn for labs and a final check-up before everything started.  They said that everything looked good, so it is on.

Wednesday afternoon we met with a radiation oncologist who the Stem Cell doctors wanted us to meet with, just to get their opinion on whether or not it would be worth it to do radiation treatment after the stem cell transplant is completed.  The short of it is that he thinks it would be a good idea, although he hadn't yet seen all of my scans.  There isn't a lot of data on the subject, but he felt in this case it would be good to do.  Of course, he also feels that he should be the one to do it, which brought up a whole boatload of issues, as we considered timing issues of staying here longer.  While it would be over the holidays, it would bring us right up to Brittney's due date, and the thought of being far from home, or apart, when the baby comes is not fun at all.

We have been trying to get more information on radiation, and I think in the end we can probably just do it in Starkville, if it is the doctors' decision once all the scans have been seen.  We will see, but it gave us some unneeded extra stress.

Wednesday night we went we went to the park, then went to look for Costco and a place to eat.  Brittney's iphone took us down a street and we saw a Mexican restaurant and ate there.  It was super yummy.  Then, when we got in the car to finish finding Costco, it took another 10 minutes!  We have no idea why the phone took us where it did, we must have been destined to eat at that restaurant.

Thursday was the first big day.  Brittney and I had to be at the hospital at 6am to get my trifusion catheter put in. This is basically three IV lines that are inserted near my shoulder.  I wasn't put all the way under, but was sedated, and I remember being awake for part of the procedure.  I must have fallen asleep right after though, because next thing I knew Brittney was meeting me in the recovery room (what a sight for sore eyes!), and an hour had passed since the procedure had finished. I was so tired and could hardly keep my eyes open.  I threw up when I moved to get my clothes back on, and then again once we got home. (Now I know why they don't want you to eat before the procedures- nothing by water to throw up).

The trifusion catheter

I basically went to bed for the rest of the day after we got home.  Brittney took the kids trick-or-treating in some ferocious winds, but I think they still had a good time.

Friday morning we went into the Stem cell clinic and I got my catheter dressing changed and two Neupogen shots.  This is the wonder-drug you might remember from before that stimulates stem cell creation in the bone marrow.  Friday night Brittney and I went to the Nashville temple, which was wonderful.   After the temple we got a bit of dessert and then headed back home.

Saturday morning was some more shots, followed by some hanging out in the apartment.  Then Brittany flew in with baby Jane.  We picked them up from the airport and then had a delicious Dixie-made indian dinner at home.  It was so fun to see the kids around new baby Jane, they just want to hold her and love her and play with her.  I can't wait to see them with their own little baby.

Saturday night I started getting the first hints of bone pain from the Neupogen, and so took a little bit of Oxycodone for that throughout the night.  Apparently I am not allowed to take tylenol or ibuprofin for pain, since they can suppress fevers and fevers need to be found out during treatment.  So far the pain hasn't been very bad.  My shoulder has been a little stiff from the dressing that they have on the catheter site, but so far, so good.

This morning (Sunday) we got up and I went in for 2 more shots.  Then we got Brittney and Brittany and the kids packed up and ready to go, and then went to church all together.  After fast and testimony meeting we said goodbye, which was really hard.  Brittney and Brittany and the kids will be in Starkville this week, while my mom is here with me.  We were so glad to hear that they made it home safely.

Needless to say, the rest of the day for me and my mom has been quiet, peaceful, and a bit boring.  Having the kids here was crazy at times, but also made sure we never had a dull moment.  I will miss those cutie-pies.  I am glad they left us with some of their artwork to keep the house colorful.

 Pictures in the Nashville apartment