Wednesday, October 31, 2012

Sister stem cell superpower!

Tuesday, October 30 was stem cell collection and donation day, also known as "day zero" and what a beautiful, sunny day it was. The sun was shining, the birds were chirping, Melbourne was hustling and heaving under a deep blue sky … 

Beautiful day for a stem cell transplant (view from my window)
Megan came into the Royal Melbourne to begin collection fresh and early at 9am. For about 5-6 days prior to collection, Megan had been given twice-daily injections of a drug called GSCF to boost her stem cell production. This was more an inconvenience for her than anything, but GCSF can also cause symptoms like bone pain, which luckily Megan didn’t experience much of. Since my counts were still good on stem cell day, I was able to trundle down with my "pole" from the BMT ward to apheresis where Megan was hooked up to the machine (much similar to the machine I was hooked up to for my autograft, but smaller and more 70s looking) and chat to her while those stem cells were filed away. Megan’s blood was being divided into three bags, one of plasma, one of the “dregs” and one of the precious stem cells, which resembled a burgundy-coloured liquid in the bag.

Phase 1: harvesting ...
Megan had to remain attached to this machine for a good three to four hours to ensure they got a decent collection. At about 1.30, they were done, and a cell count was conducted. They had collected about 10 million stem cells from Megan; they would be giving me 8 million (more than enough) and freezing 2 million for a rainy day.  (She didn’t manage to smash my record of 63 million over two collections earlier this year, but I won’t rain on her parade. She did a good job!).

The process of the allo stem cell transplant is rather anticlimactic. It’s nowhere near as involved or complicated as getting an organ transplant. As my nurse Andy quipped, “It’s just like a blood transfusion, only crunchy”. The nurses had all warned me it was boring, “even more boring than an auto transplant”. When I had my auto SCT in April, it was all very futuristic looking with the cryogenically preserved cells arriving in a frozen cylinder and being dipped into a “mini pool” for defrosting. But this time, for the allograft, the cells were delivered “fresh”. They were slung up onto the pole and as they like to infuse them quickly, they vanished rather fast. Nonetheless, there was a captive audience (mum, Jacqui, Megan, Tim and about 2-3 nurses) to witness their delivery, and while it wasn’t a cataclysmic, Captain Planet-esque combination of sister superpowers like some might’ve hoped, it was a jovial occasion.
Megan's stem cells, transported to my room via a state-of-the-art cooler bag
Before they gave me the cells, they had to give me some pre-meds, one of which was Phonergan, used to treat allergic reactions. Phonergan has a habit of making me very drowsy, and as expected, this dose went straight to my head, when I instantly started slurring my words and letting slip some “Bethisms” (that were then published on Twitter, thanks Tim and Jacq). At least it added a little excitement to what was a seemingly mundane process.

But despite outward appearances, it was a momentous occasion. I now have a little bit of Megan inside me, a gift that hopefully marks a new lease of life. Now I just have to wait for a week while her stem cells grow and develop, and produce vital white blood cells which we will hope will fight the cancer, and finish the job that my immune system, and the chemo, couldn’t manage to do. I will have a new immune system, a new blood type (from B+ to AB+) and maybe even a cure for my hayfever if I’m lucky. (Just kidding, I don’t really care about the hayfever part, though that would be nice.)

In the lead-up to and following the transplant, I have been on a constant infusion of anti-rejection drugs to ensure my body doesn’t reject her stem cells, and I will stay on this medication until they eventually wean me off it, hopefully around that magical day 100.

I am now on day +1 of my transplant and for now, it is just another waiting game.  Waiting for my blood counts to drop, and Megan’s stem cells to kick in. I am unable to leave the bone marrow unit, but they encourage me to walk around, so all I can really do is little pathetic laps of a very small space, wheeling my “pole” along with me. If anything, I now have some idea of what it must feel like to be Julian Assange.
If all goes well, I will be out of here in 3 weeks, give or take. I am bored already, but the less eventful the coming weeks are, the better, really. I know I still have a long way to go, but every day is one day closer to getting out of that door. 

Me and Hippo Jo, in this together

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