Apheresis Day

The dark clouds in the Oklahoma sky threatened to let loose a deluge upon us at any moment all day yesterday but never delivered on the threat. With the tall windows of the James W. Smith, MD, PhD Center for Apheresis and Innovative Therapies behind me, I was only slightly aware of how dark the sky grew from time to time. The LPN who took care of me, DeAnn, invited me to sit down in a recliner next to a machine with a panel of knobs of various sizes and a monitor above it. There were IV poles and long tubes that I knew were meant to attach to the lumens, or pigtails, of my CVC. DeAnn began to explain the process and what she would be doing, and then she expertly set upon her tasks. In short order, my blood began to flow from one pigtail attached to a tube, into the machine where it was funneled through a centrifuge that was situated inside the front of the machine. White blood cells containing the stem cells were separated into a bag that hung from one of the IV poles while the remainder of my blood, including red and white blood cells and platelets, was returned to me through another tube attached to the second pigtail. This process would take four hours, and DeAnn would monitor me carefully the entire time and respond to any sensations or side effects I might experience.

Working along side her with other patients were nurses April and Peggy. Like the team of nurses who cared for me at The Woodlands, they were focused, highly-trained professionals who also possessed that special essence of character that renders seemingly endless patience and compassion for the patients they treat.

“Who’s your doctor?” DeAnn asked as she gently connected tubes and checked settings on the apheresis machine.

“Dr. Selby,” I responded.

“Oh, he’s a great doctor,” she said, and the three nurses began talking admiringly of the doctor who was in charge of my care.

One of them remarked, “You’re lucky to have gotten him. He’s getting ready to retire.”

As they chatted about Dr. Selby’s impending retirement, a thought formed in my brain, and before I could stifle it, the words slipped past my lips. “I sure hope he doesn’t have short timer’s syndrome!”

If there are two things I feel confident about, it’s Dr. Joudeh and Dr. Selby, who have advised me every step of the way, ordered whatever treatment I have needed, answered all of my questions with patience, and given me confidence and courage to face the challenges to come. I’ve managed to do so with a hefty measure of humor along the way, something my mother believed in deeply. Strive to find something to laugh about every day. Laughter is definitely good medicine.

I am including here a short video that DeAnn was so kind to create for me so that you can have an idea of the setting on Tuesday and the amazing machine that plays such a vital part in my potential longevity. I am also always mindful that the machines don’t operate by themselves. It’s the unsung heroes like DeAnn, Peggy, and April whose meticulous skill and knowledge make it possible, and they do it all with a warm compassion and positivity for the patients they care for.

The only issue I experienced that was a concern was double vision. It was one of the strangest sensations I have ever had. There were three very brief episodes where it seemed as though I was looking through a prism. The first spell was the longest, lasting perhaps five or six seconds. DeAnn decreased the flow of the anticoagulant that was added to my bloodstream to keep my blood from clotting. She had explained at the beginning that it was most often responsible for unpleasant side effects that some patients experienced. The two preceding episodes were even shorter.

“Have you ever had a patient who experienced double vision?” I asked. DeAnn responded that she hadn’t. She told me she wanted to consult with the doctor about it, and a few minutes later, she came back with liquid calcium, which she added to my line through a giant syringe. The remainder of the session proceeded without incident.

The best news of all is that we were able to get the quantity and quality of stem cells that I need for the transplant in this first four-hour session. It usually takes at least two and up to as many as six. It also meant that I was done with the Filgrastim shots.

Unfortunately, I woke up this morning with nausea and no appetite. I stayed in bed until well after noon. As long as I was horizontal, I was okay; but as soon as I sat upright or stood up, the nausea would come in waves. Ugh. I wanted to write! The news of getting everything in one apheresis session was too good not to share. So, I am keeping this post shorter than I might have if I were feeling better.

The worst part so far has been the CVC. It has been exceedingly uncomfortable and it hurts! Sometime during the night last night, the pain finally subsided, but I have yet to shower today, in part because I have to keep the bandages dry, and contemplating how to do that is daunting. The nurses have given me some good tips that I will try. Wish me luck!