In the nearly three weeks that I have been out of the hospital, my white counts and red counts have been like rollercoasters… http://photos.tandlphotos.com/blog/2016/11/stem-cells-dont-multitask
Tag: stem cells
Hospital Day Nine — Day One
Today starts day one for counting days to recovery. The stem cell re-infusion was day zero… http://photos.tandlphotos.com/blog/2016/10/hospital-day-nine-day-one
Hospital Day Eight — Out of the Ashes
The stem cell re-infusion went well with… http://photos.tandlphotos.com/blog/2016/10/hospital-day-eight-out-of-the-ashes
Plugged-in, Unplugged
You can see more photos and read more about stem cell harvesting at http://photos.tandlphotos.com/blog/2016/8/plugged-in-unplugged
Harvest
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.
Bad Cells & Stem Cells
In February I went to the doctor about some tell tale symptoms I’d been having for a couple of months. I’d had these same symptoms in 2008, two years before my first bout with cancer, but I didn’t know then they were anything more than muscle, back and joint pain for exercise and getting old. All my blood work and vitals were normal, but after the GP told the oncologist about my symptoms, they ordered a PET scan. I got the images from the PET scan the next day, and when I compared them to the last PET scan I had in January 2013, I was “hot”, but nothing like the PET scan from June 2010, when I was starting stage 4 lymphoma.
After my oncologist reviewed the PET scan and radiologist’s report, he ordered two needle biopsies, one from a lymph node, the other from a bone, and they both came back indicating two different types of Hodgkin’s lymphoma. At that point the doctor decided I needed to have a lymph node removed and biopsied to get a complete and definitive diagnoses. The most logical “hot” lymph node to go after was under my clavicle, so I went to visit a surgeon to see about getting the lymph node under the clavicle removed.
The surgeon reviewed the scans, felt around my clavicle and said he couldn’t feel any swollen lymph nodes, and it was too risky to try and remove a lymph node from under my clavicle. He told me he wouldn’t do it, and sent me back to my oncologist. My oncologist ordered a CT scan, and send me back to the surgeon after they got the images and radiologist’s report from the CT scan. The surgeon told the radiologist thought he could get at the lymph node from above the clavicle and after poking and prodding around the surgeon decided that it was a less risky route, and we scheduled surgery to have the lymph node removed on June 18th. That surgery was successful, and the surgeon removed a large lymph node for the pathologist to biopsy.
I got the results on May 27th, and I have a Hodgkin’s type lymphoma that is slow but aggressive, and while it will respond to a treatment like I had in 2010, my doctor does not want to do a treatment like I had before, because he said the cancer will just come back again in 3 to 5 years. Instead he is going to do a very aggressive chemo with stem sell replacement that will begin on June 6th.
The treatment is outlined as follows:
1) Chemo will be administered every day for four days in a row over a period of nine hours each day.
2) Twenty-one day recovery period
3) Another round of chemo like the first round.
4) Check to see that I am in remission
5) Start the process to extract stem cells from my body
6) Extract stem cells, process them and freeze the stem cells
7) Another round of intensive chemo
8) Whatever tests to see that I’m ready for the stem cell replacement
9) Replace the stem cells they removed before the last chemo
10) Twenty-one day recovery while the reintroduced stem cells take hold
If the treatment works has planned, I should be completely cured at the end of my stem cell recovery. In a normal population, the chance of being cured is 50/50. Since I am otherwise healthy, active and determined, we are hoping my chances of being cured are even higher.
I had not told many people about the recurrence of cancer before this post, because I wanted to have a definitive diagnoses and a treatment in place before I broke the news to everyone. It has taken over four months since my first visit to the doctor, until we got a diagnoses and treatment scheduled. In the time between biopsies, I got all kinds of tests and preparation for treatment including “re-ported”, so that once we got a diagnoses I would be ready to go. So all the prep, testing, and extra surgery to have the new port installed were time well spent while working on how to get a lymph node out.
For anyone who’s noticed that I don’t comment on your blog as much as I used to, you now know why. After I start treatment, I’ll have to see how I feel each day — while I might not post anything at all or look at other blogs some days, I might just be so bored that I comment on everything and put up lots of pesky posts on other days. Until I see how I will react to the treatment, the amount of posting, reading and commenting I will do with blogs will remain a mystery.
Off Center & Not Even 