2014/12/18

Thursday, 18th December

Day 17 - Stem Cell Transplant

Since today is going to be a very long day I have decided to do updates throughout the day and then post them all this evening.

We set the alarm for 4am and I got up to give Jimmy his Neupogen injection.  He actually asked me if I could give it to him without waking him up.  I told him there was more chance of me giving him an injection without waking up.  One thing is for sure....he has never lost his sense of humour.

09h30
Jimmy has had his bloods taken and just as we were told, his white blood cell counts have more than doubled to over 20 since yesterday.  His vitals have all been taken, as well as weight and height.  An interesting side effect of Multiple Myeloma is loss of height and Jimmy has already reduced from 1.67m to 1.63m.

The harvest procedure today takes place in the Chemotherapy Clinic.  There are 2 beds behind a wall that doesn't go up to the ceiling with curtains, like in a normal ward.  Dr Fine has just finished inserting the PICC line in his groin under local anaesthetic so they should start the whole harvesting process soon.  I had a good laugh this morning when Patsy sent me a message saying she hopes those stem cells are all swimming around screaming pick me, pick me, pick me......so do I.

 
The Chemotherapy Clinic

The 2 procedure cubicles at the rear of the chemo clinic


Jimmy rearing to go

13h40
Gosh, this is a very slow process.  By the time they had Jimmy's PICC line in and he was hooked up to the aphaeresis machine it was 10h24.  So it has been just slightly over 3 hours.  I can see the stem cells in the bag but we have no idea how well or slow he is doing.  About 30 minutes ago Olivia came to get a syringe full of the stem cells to give to Dorothy who measures and works out how many are being collected and at what rate.  The rate of stem cells per ml of blood stays constant, although different for each person, so when we get these results we should be able to get an idea of how long this is going to take.  Jimmy has to lie completely flat on his back and can't move much before the aphaeresis machine and BP machine's alarms start going off.  The PICC line also has much thicker pipes going into his groin this time round so this is a little uncomfortable.  The one pipe is for out and the other for back in again.  It's amazing how this aphaeresis machine separates the stem cells and then everything else goes back into his body.

The aphaeresis machine

Jimmy's PICC line


The screen of the aphaeresis machine

Blood circulating through the aphaeresis machine




14h50
This is getting even more fascinating now.  Jimmy's body has approximately 4.5 litres of blood in it, which is quite average.  At 14h30 Olivia came to tell us that 10 litres of Jimmy's blood has circulated through the aphaeresis machine and Prof wants 14 litres.  We still don't know how many stem cells this produces but according to the nurses he is doing extremely well and we should be finished harvesting at about 16h30.

The stem cells
16h50
Dorothy has just come to tell us that Jimmy has been as absolute super star.  They are going to turn off the aphaeresis machine at 17h00 as they have managed to collect 15 million stem cells which is enough for 3 transplants.  Once the aphaeresis machine is turned off and all the pipes and tubes are removed, Jimmy has to lie still till 17h30 to give the main vein chance to clot nicely.  Olivia will then remove the PICC line and apply some pressure for a while.  We received his blood counts back from this morning and his white blood cell count was as high and 27.2.



17h45
Olivia has now removed the PICC line and Jimmy is still lying flat to make sure a nice blood clot forms.  I will have to wheel him out in a wheel chair and the only walking he is allowed to do is to the toilet until tomorrow.  They have also done another batch of blood tests and his white blood cell count has now gone up to just over 30 (normal is 4 to 11).  This will drop down again in the next few days to what is Jimmy's normal which will be around 2.5 to 3.  He doesn't have to have any more of the many pills he has been taking for the last 10 days in preparation for today nor any more injections and I have to admit I pretty relieved about this.  After something close to 30 or 40 injections it still doesn't come naturally to me.

What would normally happen now is Jimmy would have been admitted to F4 Isolation Ward in the next 3 or 4 days for another heavy dose of chemo to kill everything again prior to stem cell transplant.  The nice thing now is that Jimmy can actually relax till mid to end January when he will be admitted.  We are hoping that Prof will be able to confirm what date he is going in before they all close for 2 weeks because we think he only comes back on the 19th of January but he has assured us that Jimmy will be included in the 1st batch going in for transplant during January.

Homeward bound after 10 hours

Today was a big step and a whole leap closer to Jimmy's recovery and I am very happy that it went so well.  Much better than we had anticipated.  A special little thank you to Jane Pederson (who works at UCTPAH) for popping in to check up on Jimmy xx










1 comment:

Anonymous said...

Bryan and I are so glad to hear that everything went better than expected. We are praying for Jimmy's full recovery. Vivienne you are also a true inspiration. It cannot be easy. God bless you both. Bryan and Sharon.

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