Stem Cell Collection

I spent about a week in the ICU before being moved to the cancer floor to recover further. I remember feeling so, so relieved to be out of the ICU.  In the ICU, I had so many lines coming out of everywhere that I couldn’t sleep.  I had to use the bathroom under supervision right next to the bed.  There were no windows, and it was incredibly busy and noisy.  Due to covid, the place was overrun and super chaotic.  On the cancer floor, I had a big window to see outside, a private bathroom, and it was very quiet and peaceful.  I remember being so grateful and absurdly happy about having these luxuries back. I was also thrilled to have a real shower with soap and water after a week of being wiped down with wipes. In the ICU, they tested for everything under the sun and couldn’t find any source of infection so they pulled my central line, thinking it must have caused the septic episode. The nurses on the cancer floor were upset about this because they needed it.  They had someone come in and insert a line that went through my forearm, up to my neck, and down to my heart.  This was during the time of covid so I wasn’t allowed to have any visitors, including my mom. My mom hung out at our hotel in Arkansas but checked in frequently over the phone.  It was very lonely.  I was still in a very depressed state as I was still reeling from diagnosis just weeks before.  One of the nurses in particular, Zoeie, would make a point just to come in and look at pictures of the girls and chat for a few minutes when administering medicine.  I would look forward to her visits.  I began having my daily shots of filgrastim to prepare for stem cell collection.  This produces more stem cells and releases them into the blood stream. I spent another 7 days on the cancer floor. I was beginning to feel extremely weak from the chemo. I was encouraged to get up and walk a few times a day to keep up my strength.  I remember taking my first shower and it felt like I had run a marathon afterward.  I was wiped.  My daily walk became a daunting task. My hair at this point was beginning to come out in clumps. I really wanted to do the shaving at home so Charlotte could be involved. I didn’t want to return home bald so I stuck it in a braid and stopped brushing it, washing it, touching it, and messing with it in the hopes it would stay on my head long enough to make it home. After being discharged from the hospital, I went straight to the operating room to get my central line put it in for collection. This line was huge as they need a big tube to go in your neck to collect the stem cells.  They put it in in the operating room but you are fully awake for the process.  I actually had no idea I would be going to the operating room to have this done but I had kind of become apathetic to what was happening next with the whole process.  I felt like my whole existence consisted of being stuck with needles 24/7, being pumped with toxic drugs constantly, and going from one hospital waiting room to the next.  To put the tube in, they numb the area but it is still an unsettling feeling because you can feel it going into your chest.  It felt like my heart was fluttering when they put it in.  Sleeping is very difficult after it is put in because your whole neck and chest area are extremely sore.  You can’t sleep on it either so your only choice is to sleep on your back, without movement.  When it was finally time for collection, they hooked up the catheter on the line to the apheresis machine.  You really don’t feel anything during collection.  It is mostly just a very long and boring day.  My doctor in Arkansas wanted 21 million stem cells.  Most facilities shoot for around 4 million.  This is another example of UAMS shooting for the moon.  You have 3-4 days to collect what you need.  They collect whatever they are able to collect.  There is no way to prepare for it or ensure your body will be able to get the required amount.  Therefore, I was nervous about being able to get what they needed.  The results of the first day were 3 million. This was concerning because the doctor said this was pretty low and the first day typically yields the biggest numbers and then they taper off.  I began to wallow in my misery again.  Could things go right just for once?  I left the collection center and went upstairs to infusion to get my blood numbers and more growth shots. Day 2 yielded 5 million.  The doctor said this was a little better but he was still worried about meeting the goal of 21 million.  Here is where UAMS does what they do best- fight for a plan B. They spent hours on the phone with my insurance to try to approve a shot that is known for increasing collection numbers.  They wouldn’t just accept that I may not reach the goal.  They were going to make it happen at all costs.  It is typically hard to get this shot approved so they had to go to bat for me to get it.  They were finally able to get it approved toward the end of day 2.  I went up to infusion to get the shot to prepare for my last day.  This shot is known to cause some serious bone pain but I really didn’t know what I was in for.  That night, I awoke in tremendous pain and told my mom my ribs were broken.  It was difficult to move in any direction and even breathe.  The next day they had to wheel me into collection in a wheelchair because of the pain.  I told the doctor repeatedly my ribs were broken but he assured me it was from the shot.  That day, I was on pins and needles waiting for the final result.  What would happen if I couldn’t get the 21 million?  Would I be able to have a transplant?  Without one, it was certain death in the state I was in.  He came in at the end of the day and I held my breath.  He started with “You’re not going to believe this” and my heart sunk.  I thought the whole thing was a fail.  Then he followed with “We collected 19 million stem cells today.”  He went on to say he was shocked.  He said they never see a spike that large even with the extra growth shot.  He said it was unexplainable.  I was so relieved I cried.  It was the first time since everything had happened that things went RIGHT.  On top of that, I was finally able to go home for a couple weeks and see my babies.  I had been away for this first round for a total of 24 days.  I would go home for 2 weeks and return for another month.