Thank you for all of your support here and in Facebook. It helped a lot through what turned into a pretty difficult week. I can honestly say I physically and emotionally could not have done this without my wife Beatriz. The last 3 days were really difficult and she cooked, carried, wheeled and willed me through this.
We finished the harvest yesterday successfully collecting 11.7 million hematopoietic stem cells (per Kg of my weight). These stem cells were collected and will be frozen in anticipation of the lymphoablative chemotherapy and stem cell transplant beginning May 14th. This completes the first phase of the 2 step process and my wife and I will travel tomorrow AM back to NY. We're very much looking forward to getting home to our kids!
The end of last and beginning of this week was great. Each day we were walking, shopping and seeing parts of the city. On Tuesday afternoon we went to a Chicago landmark Gene and Georgetti's steakhouse in the river north section and we split their famous garbage salad and a huge hunk of filet mignon. With all of the blood they were sucking from me I thought it wise to replenish with some great wet aged prime beef from this great spot.
I had started my daily Neupogen shots Saturday AM and really had not felt any effects. Unfortunately, Tuesday evening serious pain set into my lower back and I spiked a fever of 101. I spoke with Amy Morgan who is a Nurse Practitioner on Dr. Burt's team but is smarter than most doctors I know and I have been working with doctors for almost 20 years in my profession. She advised me to come back to the hospital for IV antibiotics.
My wife and I made the trek down to the ER around 9:30 Tuesday night. They were very nice and because I was presumably neutropenic meaning without an immune system from the chemo the previous week they made me wear a mask and put me in a separate room until they could find me a bed in Prentice Women's Hospital for admission.
Around 1:00 AM I convinced my wife to take a cab home so at least one of us could rest. She obliged my wishes reluctantly, grabbed one of the many cabs waiting outside the hospital and she was home in 5 mins. I was admitted around 1:30, saw the doctor around 2:30, did a round of IV antibiotics and caught some shut eye between 4-6 when we did the morning vitals and blood draw. There's really no such thing as sleeping in a hospital, there's just a part of your day when your eyes aren't open.
Around 8:00 AM Wednesday Dr. Burt and Amy came in to see me. I still had fever but it was lower. I indeed was neutropenic so under the better to be safe than sorry we made the right call the night before. They confirmed the harvest was still on track and I could be discharged later Wednesday.
7:00 AM Thursday we reported to the Interventional Radiology dept for the insertion of the Central Vascular Catheter for the collection of the stem cells. The procedure was not painful at all but it was more serious than I thought... I just didn't think too much about it. Several people explained the process thoroughly, then they wheeled me into the procedure room and the physician went to work. This is basically a tube, in my case 20cms which is placed inside my subclavian or as we know it the jugular vein and fed down to right above the right atrium of my heart. They use local anesthesia before the incision and the process takes 5 minutes. They use ultrasound technology to guide the physician down the vessel. I did experience a few heart palpitations which concerned me but after 4-5 seconds they stopped. I learned today that they actually wait for these palpitations (determined by heart monitor I was attached to) so the physician knows he's inside my heart...hmm... They actually have several videos of this procedure on YouTube that I recommend you watch after this thing is pulled out of your chest.
From there we did more blood work so they could estimate my stem cell count. Oh by the way, remember a few posts ago when I was all goobly gobbly about using a wheel chair for the first time?? Yep, not a problem anymore... I can't get my ass into a wheelchair fast enough when I enter a hospital these days. My only embarrassment is I have to carry my wife's purse which is really more like a large duffel bag! Other women compliment her on it all the time so I guess it's fashion but when we have to fish my tiny wallet for my ID and insurance card at every stop its quite the adventure. I look really great with my cane and my wife's purse on my lap cruising the halls of NWMH.
All the blood work was fine and around 10:30 they hooked me up to the Apheresis machine which collects my blood at a very rapid rate, runs it through a centrifuge which separates the blood into plasma, stem cells and red blood cells. It then returns blood back to me through one of the other of the 3 lumins or ports which are attached to the Vas Cath. The high speed at which the collection is done could not be done through a regular IV line.
The only affect I felt from the process were tingling in my lips. This is common for the process. They said I may also experience significant vibration throughout my body which I did... I have MS, I vibrate 24-7 from head to toe!
3.5 hours later we were done. Then we waited another 90 minutes for them to count them 1, 2,3... When we returned they reported 11.7 million stem cells per kg of my weight. The requirement is only 2 million so we had plenty of extras. My assumption is they will infuse me with the entire amount after the chemo as it may reduce my recovery week after next. One interesting development with this process also is that my LDL cholesterol count currently is 321 which is high for overall cholesterol not just the LDL. I'm informed this is normal and will come down, yikes!!!
Then it was time to take the Vas Cath out. At this point I must admit I did get a little nervous. Don't get me wrong, Nurse Heather was really great throughout the entire day but she was about to pull a 20 cm line from my jugular vein!!! I mean, doesn't that sound a little serious?? Of course visions of blood squirting all over the room and Heather holding my vein like a garden hose screaming "I can't stop it, it's too strong and my wife screaming don't get it on my purse!!!" were unavoidable...
She convinced me it would be fine and I really didn't have much of a choice but to believe her, unless I chose to leave the hospital with the line in my chest and live the rest of my life with the 3 lumins sticking out of my neck requiring me to buy all new shirts and suits to accomodate my new jewelry. It was tougher than you think... The lumins look exactly like the red, yellow and white plugs that go from your kids' Play Station 2 into the TV.
My wife was really ready to leave so she talked me off the ledge and Heather went to work. They did make one capitulation at my request that Heather and Bea briefly stop talking about kids while she had the main vein in her hand. It went fine and after direct pressure for about 10 mins she placed 2 criss cross butterfly style bandages on the wound and then a pressure bandage above that which I will remove shortly (after 24 hours).
From there we went home. We slept well although I did sweat all night long and my heart rate today is still about 30% higher than my normal resting bpm. I spoke with Kim Yaung earlier and she thought I was just dehydrated. It is better now and my energy is returning so off we go tomorrow!!!
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