Stem Cell Transplants, Moscow, and Borscht…life with Lisa in Russia.

Surprise!

Who knocked on my door this morning, having returned from his grandnothers’ funeral a day early – my wonderful Dr. Fedorenko. He was worried about my conditioning treatment, and perhaps getting off the prescribed time chart. In this game of stem cell transplantation, timing  is what makes the procedure work. Remember the comment I made not even 24 hours ago about the Hickman surgery postponed until Wednesday, or Thursday? Look!  Seven inches right into in to the jugular. Boom, it was done. The procedure was a little uncomfortable, skin anesthetic shots helped. But it’s sore now!

IMG_0104After the surgical procedure, I was taken back to my room for a mandatory 30 minute “don’t you dare move” nap. I as awakened by one of my favorite charade nurses. She came in with the wheelchair, and I thought we were taking the big trip to the third floor. Nya, she shook her head, and pointed out the window. Why yes, I love to look out the window! Nya, she said, and pointed to my neck. Now I remember…I was wheeled off to the X-Ray lab across the courtyard, to make sure the line was placed properly in the jugular vein. I love that nurse, she has a very long name I cannot pronounce nor remember, but I will most certainly go visit her again when immunities permit. Poor lighting in theX-ray area, sorry. IMG_0258

She returned me to my room, THEN came the big trip up to the third floor, the isolation unit! Excited? Yes! This is the start of the end. Here are photos of the second entry doorway to isolation. There are two sets of key scan doors – no one gets in!

My room is small, but really nice. All tile so it can be sterilized, separate ventilation system that cycles air though it’s own filtration unit ten times and hour; individual water filtration unit; sealed windows; and a sealed anteroom containing my frig, microwave and medical supplies.

And tomorrow is another big day, with the collection of stem cells beginning at 8:00 a.m. That’s 11:00 p.m. this evening for Central Standard Time Okies and Texans…others too…I guess. SIDE NOTE: The nurses call bell here is the sound of an ice cream truck. Please make it go away, it’s stuck in my head. It rings every five minutes! Good grief Charlie Brown!

What is involved in this Peripheral Blood Stem Cell Collection? 

A vein assessment is necessary to ensure that the patient has strong veins with good blood flow for the blood stem cell collection procedure. This test was done on Friday of last week, and I failed miserably, hence the Hickman line above – thanks Dad (Walt to everyone), for the awesome veins.

L1090085

Beginning at 8:00 a.m. the stem cells  be collected by a procedure called “apheresis” (a-fair-ee-sis). Two ends of tubing will connect you to a cell separator machine during the collection. Your blood will flow out of one tube in my neck, inside the tubing, to the machine where it will spin your blood around at high speed. The spinning separates the different components of the blood into layers based on their weight. The stem cell layer will then be collected and the remaining blood will be returned to you via the other neck tube.I will be attached to the cell separator machine for 5 hours for each collection without moving, and wearing my Depends undergarment (can’t move = can’t get up for the bathroom). The nurses and Dr. Fedorenko will be present for virtually the entire time. The next day the process will begin again until close to 4-5 million cells are collected.Occasionally a third day of collecting is required. The number of stem cell collections needed largely depends on the patient’s weight and response to the G-CSF and the apheresis procedure. Blood work will be done prior to apheresis to determine counts.

Immediately after the apheresis procedure is completed, specimens are obtained from the bag of collected stem cells. These are immediately sent to a special lab where the sample will be studied and the actual stem cell count will be determined. Results of this analysis will usually be completed by 4:00 pm that same day. Once the actual count is known and reviewed by the doctor, you will be notified as to whether more stem cell collections are needed on subsequent days.

 

Processing the Stem Cell Collection

In order to preserve the stem cells, they will need to be frozen by cryopreservation. Shortly after the stem cells are collected, they are sent to a the lab called the Cryogenic Lab, where they will be concentrated and a preservative will be added to protect the cells from the freezing process. They will then be stored in a special freezing vault until the time I need them.

And now you ask, why the “5” for my features image? My good friend Pat sent me that, a type of good luck sign. I am the 5th American to undergo this procedure in Moscow, and the oldest at that…but lets not go there. On Friday, the 5th of July, I will begin high doses of chemotherapy to ablate all T and B cells. In fact almost the entire immune system will be wiped out, and then reset. So, “5” is a big number for me (and I was born on the 5th)!

 

Goodnight Moon,

Lisa

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2 Responses to “Surprise!”

  1. Pat Gallagher

    Good night moon! happy bday in isolation, hope you got cake!
    Pat Gallagher

    Reply

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