Collection

     Today started very early, driving to Huntsman while the moon was still up and the sky was still dark.   Often while making the drive my thoughts wander and I try to focus on being grateful instead on on some of the other things.   Today in the dark with Chris silently sleeping beside me I turned to where we were headed.  I'm amazed at how lucky we are to have a top notch cancer center, that just so happens to specialize in his rare cancer nearby.  Being treated by a myeloma specialist is important in his key to his survival.   While the drive is often filled with traffic and usually takes an hour, it's a blessing that most don't have.  Today we learned that the older man in the bay next to us had to come all the way from Oregon.   With all of our appointments so far this year, we've driven about 1,000 miles, I can't fathom the logistics of trying to coordinate everything even if we still lived in St. George.  Being able to sleep at home, and just visit the doctors in the hospital is a blessing.  Collection was delayed from the original plan of February but we grateful that he's being able to do the process as it's an important one in his treatment.

      Today marks the first potential day of actually collecting.  We've driven here several days already to receive Nupogen shots to tell his body to over produce stem cells so that we can collect them.  We weren't sure how quickly the shots would kick in, but shortly after getting them the bone pain kicked in.   Strangely Claritin can help, so he's been taking that and Tylenol to try and keep the edge away.   They only take the edge off, I'm so grateful that I'm able to be with him as sometimes the simple act of human touch is the greatest for pain relief.  The pain tends to come in waves sometimes in his hips, sometimes his shoulders or his legs or arms.   Often in multiple places at once.  He's described the pain a few ways.... like his bones trying to get out of his body, like someone is taking a chisel and hammer to his bones and also like a vice grip on his bones.   The pain ebbs and flows in each area and he's been a champion and handled it pretty well.   I'm touched with his thoughtfulness as each day he's thanked me for being with him and for being patient with him.   He's going through a lot, yet he still things daily of how it is for me.

      Yesterday in addition to the Nupogen shots, he also had a line placed for the collection.   This one is very similar to the line he had for dialysis but with an additional catheter.  It usually sticks up out of the patients neck but we were able to request that they tunneled it down through his skin instead. 
     
     Yesterday was an unusual day at Huntsman.   While in the waiting room waiting to be taken back to IR we were both surprised to see two young little toddlers.   Being treated at a cancer treatment is strange because unlike a regular hospital, you know that everyone there is either being treated for or is there to support someone with cancer.   We usually feel so out of place with so many around us the age of our parent's or grandparents.   Having a toddler walk by and say "bye-bye" and wave sweetly brought a smile to both our faces. 

      As well, after they wheeled Chris back and I was sitting waiting for him to come back they wheeled another patient into the curtain next door.   His voice sounded very young and I could tell he was alone, it made my heart ache and I nearly peaked around the curtain to introduce myself.   About that time a visitor stopped by and I learned that his indeed was very young, likely about 19.   He had just until recently been serving an LDS mission in California.   He, like us, was grateful to be in good hands with his diagnosis. 

      Most people don't collect on their first available collection day, but the preliminary numbers testing for the number of cells in his blood stream looked good so instead of having to wait 3 1/2 hours for the blood tests to come back, they were able to get him started a little bit early.   Chris has been very optimistic that this will go smoothly so being able to collect some today was a win in our book

     They usually process 15 liters of blood in a session of apheresis and the speed that they do so can vary the time that it takes.  Today's session was about 3 hours.  They collected about 175mL of stem cells and 200 mL of plasma. 

      As well, there is approx 250 mL of blood in the tubing, but at the end of the process they put most of it back in, usually returning about 230mL.

     To prevent his blood from clotting in the machine and tubing, they add an anti-coagulant as part of the process.   This anti-coagulant binds to calcium which can cause his calcium levels to drop which can cause tingling in your lips and extremities.  Because his calcium was low before even starting this morning they started a calcium drip shortly after they got him all hooked up.   Because it can mess with your other electrolytes (potassium, sodium, etc) they run additional labs to make sure he's OK to go home. More waiting for those to come back, but they all turned out good and he was given the OK to leave.   About 9 hours after we left this morning we arrived back home and both took a nap. 


      The tech today said it's really hard to estimate but that his best guess would be about 1.2 million.  We're now getting ready to head back up to the hospital for a new nightly shot.    This shot, called mozobil, tells the stem cells to "get out" of the bone marrow and into the blood where they can collect it.    This also is pretty common and something we expected.  He will continue to get the Nupogen shots in the morning as well. 

    While hanging out in a hospital hooked to a machine isn't fun, and brings back memories of doing dialysis, we know this is a good thing and a step in the right direction.  We also are touched by the support and thoughtfulness of others.   Our friend Rachel stopped by for a visit, wearing her Team Chris shirt.   We're getting to know all of the nurses, techs and support staff but it's always nice to see a friendly face and reminisce about her recent trip to Hawaii.   Also, we returned home to a delivery of groceries on our porch from Smith's.   Our good friends from St. George had promised Chris a Dr Pepper and had Smith's deliver a case along with a whole bunch of other goodies and essentials.   I had started a small list of what I knew we needed and planned to try and go to the grocery store sometime this week but they saved us. While I'm sure there are several who would have picked up groceries for us if we had just asked, we weren't quite sure what this week would be like so having it just show up when it was needed to me was a tender mercy and someone following a prompting.   So lucky to have such good friends! 

      Off we head to Huntsman again, but at least we get to return home again tonight to sleep in our own bed!