When I asked the nurse at the Cancer Center what I would be doing when I met with the transplant coordinator at Presbyterian Hospital on Monday morning, August 29th, she said the coordinator would go over my labs from Sunday, explain the process for harvesting stem cells, go over the schedule for having the VAS CATH installed, and look at a probable schedule for harvesting stem cells based my labs, then I would be done. It all sounded so reasonable, and my nurse at the Cancer Center must simply had forgotten to mention that I would be having labs done and getting another high dose Nuepogen shot to begin with. She hadn't said anything about all the paperwork we'd be going over, and signing more papers acknowledging the risks of a stem cells transplant. Or that I would meet with the Social Worker offering lots of support services, but since I didn't look to be on my last legs like many of the patients she said she meets with, she didn't think I looked particularly in need of social services. Or that I would have to go see a doctor, to show him the scars from the shingles I had developed about 3 weeks ago, and the Cancer Center treated immediately, but failed to mention to the transplant coordinator. So much for a quick orientation.
It was nearly noon when they were finally done with me, or so I thought. I was getting ready to leave when the transplant coordinator came in a said "your absolute CD34 count is 40! It only needs to be 15 to harvest, so you are at an optimum level to start harvesting. I'm waiting to see what the doctor wants to do!" The problem was the VAS CATH is scheduled for tomorrow, so they would have to draw my blood from one arm, run it through the machine to extract the stem cells, and then put my blood back using my other arm, forcing me to lay still for up to six hours without moving my arms. The only real problem with the scenario was that I have intense bone pain from 10 days of high dose Nuepogen shots that are forcing my bone marrow to create white blood cells and stem cells — the pain is a necessary indicator the Nuepogen is working, but pain nevertheless.
I told the transplant coordinator that I would do whatever I needed for them to harvest the stem cells, so I spent four hours on my back, huge needles in both arms, with very restricted movement while the machine harvested my stem cells. Unfortunately, I had intense pain and was very uncomfortable for the first two and a half hours until they finally gave me an injection of a potent anti-inflamatory that cut the pain level, after the other pain killers failed to work.
They took a mid-session sample of stem cells and sent them off for analysis. From that sample, they may have harvested a sufficient number for the transplant in today's 4 hour session, since the new machines are more efficient and my absolute CD34 count was so high. However, I have to wait until after 8:00 am tomorrow before we know whether we need to harvest more stem cells or not. In the meantime, the transplant coordinator juggled the schedule for my VAS CATH until after we get the total counts from today's harvest. If they are good we will cancel the VAS CATH. If they need more stem cells, they will install the VAS CATH, and we will do another session.