On Monday of this week I reported to Taussig for apheresis or the less fancy term, stem cell harvest, to capture and freeze my future immune system. This means the removal of blood plasma from the body by the withdrawal of blood, its separation into plasma and cells, and the reintroduction of the cells, used especially to remove antibodies in treating autoimmune diseases. Fun science fact, these are pluripotent stem cells we are capturing, meaning they are cells that are able to self-renew by dividing and developing into the three primary groups of cells that make up a human body.
After my last few harrowing and emotional posts, this update is easy breezy and super science-tastic. What a lovely shift.
A short but impactful day
I arrived early, checking in at 7:15am. My sister and I were told after my initial blood draw, we could leave or wait as it would take up to three hours to receive my blood results from the lab. They were checking several clinical indicators including my white blood cell count and a particular biomarker — CD34 — that indicates how many stem cells are in the blood. Given my general weakness and mobility issues, I was content to wait in the private room on the nice hospital bed. We prepared to wait for up to three hours but were “a go” within 45 minutes. The lab was super speedy and both counts indicated I was ready for harvest. The CD34 number to reach was 20, my number came back 277.
The apheresis doctor came into my room she said, “no wonder you feel like absolute crap!” Apparently my bones and my blood were spectacularly crowded with those magical stem cells. It’s nice when there are clinical indicators that affirm your personal experience. Also, the drugs, side effects and difficulty over the last few weeks was instantly worth it.
They proceeded to “fire up the machine” and align all tubes, coils and piping. Having Inspector Gadget was a godsend. Because of my chest catheter, I was able to sit, stand, use my arms, move around (as far as I was connected to the machine) and remain very comfortable. One lumen of the catheter takes my blood out to be spun and isolated in the machine and a separate lumen is connected for the filtered blood to be returned to my body. The coil pictured above warms my blood before returning it to the body (totally rad, right?). It’s a loud machine that shakes like a washing machine the entire time. My Bose noise-cancelling ear phones were invaluable when my sister and I weren’t chatting up a storm.
I was given a heated blanket, pillows and of course my sister brought snacks. I was hooked up to the machine for about four and a half hours total. This is painless, easy and amazing to watch. I asked ten million questions as they prepared my machine. I watched my blood leave and return to my body. And I stared in fixed wonder as my stem cell bag began to fill. We even documented the first stem cell making its way up the tube and into the bag.
The day is not without its curriculum of body humility. As you are hooked up to the machine, you have to use a bed pan or wear a diaper. At this point, who cares?!? The team of nurses is so exceptional that nothing really seems out of the box or weird to me anymore. I’m just chalking up the use of a bedpan as another experience gained in my wacky life. Plus after not-so-successfully using said bed pan, I got a free pair of hospital scrub pants to go home in. Anyone that knows me, knows I love free stuff.
One of the noted side effects individuals experience during apheresis is tingling. Through the blood filtration process, you can lose precious calcium. This apparently causes tingling anywhere but most notably face, hands and feet. Having MS, I am no stranger to tingling but this was more pronounced than usual. I received two bags of calcium to assuage the tingles during the filtration process.
Burying the lead
I was scheduled for several consecutive days for stem cell collection but was told multiple times that MS patients tend to collect in one day. A physician friend of mine said this is because I have “pristine bone marrow” — what a lovely compliment to receive! We were home before 1pm and waited confirmation from my transplant nurse and the lab with the amount collected.
The number we were aiming for was 5 million stem cells to proceed with transplant in a month.
The last photo I took of the day is me holding my bag of stem cells. It might look like a woman with a newly shaved head holding a bag of blood to you, but to me, it’s hope personified. My body built and produced these magical wonder-filled pluripotent stem cells. Science figured out how to harness them. They will be frozen until I need them in a month. They will be thawed and put back in my body. They will rebuild an entirely new immune system for me. That photo, that bag, this process… is magical, amazing and incredible beyond words.
A note of gratitude
So many of you have reached out via text, cards, Instagram, phone messages, Marco Polo and more. You’ve sent thoughtful gifts and given me 10,000 reasons to smile during the dark days. I’m so grateful for your support, friendship and love.
A doctor’s drawing
During the initial planning appointments I met with a doctor on the apheresis team who explained the process in detail and gave a tour of the unit so I would know what to expect on the day of collection. I couldn’t omit his spectacular drawings below. At the end of the appointment he told me I could keep the paper…and you better believe I did. My sister and I giggle every time we see it.