2nd Day of Harvesting

I am back in the apheresis clinic and have been hooked up to the machine since about 9:00 this morning. They will be doing 6 cycles of my blood today to ensure they get all the stem cells they need for the two rounds of chemo. Yesterday they collected a little more than half of the target volume. They hope to collect between 6 and 10 million cells/kg of body mass. Yesterday they collected 3.5, therefore they collected 325,500,000 stem cells yesterday. They said that was a good result. They analyze the 'product' within hours of completing the procedure and then call me to let me know if I need to return for another day. They expect that after today I will hit the target range, but if not, I will get a call tonight to let me know they need to harvest more tomorrow. Since I am already scheduled to begin chemo tomorrow, they are pretty confident that today will be enough.

They will freeze the stem cells with some of my plasma and a preservative (DMSO4). Most of it will only be stored for a couple of weeks until I receive them as part of treatment, but a small amount will be kept forever as a reference sample. I will be receiving 3 days of chemo, then I will have two days of rest, and then they will give me nearly half of the stem cells back. That should be next Wednesday. They will administer them via an IV push through the catheter in my chest. The preservative is very unstable at room temperature, so they will bring the sample to my room in a cooler with liquid nitrogen. They will allow it to thaw and then inject it through my catheter, so it will still be very cold! The process will take about 20-30 minutes. I will receive the other half of the sample at the same time during the next round of chemo.

This process is called a stem cell rescue, because it will be rescuing my immune system. The high doses of chemo will be enough to kill all of my white blood cells and enough of the stem cells in my bone marrow that they would not rebound on their own. These stem cells are the ones that differentiate into blood cells, so without them my body would not be able to grow new white blood cells to fight infections. By harvesting my own stem cells prior to treatment they can return them to my body where they will quickly replenish my lost white blood cells. This is also sometimes referred to as a transplant, even though they are all my own cells. There is less risk with using my own cells, and it works much quicker than using someone else's cells.

I had more Neupogen today to stimulate the growth of the cells. I have not had a lot of bone pain, but I have had a back ache that intensifies with each dose of Neupogen. Thankfully, I think this is the last day I will need the injections.

Last night Megan and I went out to dinner while her Mom watched Ethan. It was nice to get out together before the treatment begins. It has been a real treat lately, because we went out to eat on Friday in Ann Arbor while my parents watched Ethan. Sadly, I don't think we had been out just the two of us since Ethan was born. The pressures of parenthood and the restrictions of low blood counts had kept us at home. I enjoyed a wonderful steak at the Weber Grill in Indianapolis last night. I am sure I will be savoring the memory of that steak the next couple of weeks that I am confined to the hospital!

One thing about treating cancer is that there are a lot of things happening to you that you never imagined you would go through. When I was first diagnosed with cancer, the treatment began with such urgency that I didn't really have time to think about the procedures I was undergoing until after the fact. Withing 10 days of diagnosis I had had numerous blood draws, 2 CT scans, an MRI, an ultrasound, a PFT, surgery to place a port (only 2 hours after learning I needed it), and countless drugs administered. For someone who has been exceedingly healthy all of his life, this was a lot to take in and I am glad I did not have time to think about it. This round has been very similar. After finding out last Tuesday that I needed 2 rounds of high dose chemo, I have been through another battery of tests, had 4 days to prepare to move my family for 3 weeks, another surgery to place a catheter in my chest, and am now spending a second day watching my blood get pumped out of my body and through a machine sitting next to me. This is a surreal experience to say the least. The severity of the cancer has determined the urgency with which this has all begun, yet it is the urgency that denies me the time to think and worry about the procedures before they begin.

Sometimes lacking the time to prepare for the future is a good thing.