I’m not going to lie. the Neupogen shots can cause bone pain. It’s not pleasant. I have percocet to take, and have had a few today. This bone pain isn’t like anything I’ve felt before, except when I had those 10 days of Neupogen shots before. It’s the result of the crowding of the bone marrow. One nurse told me that this is the kind of pain experienced by some leukiemia patients when their white cells are proliferating out of control.
The apheresis process causes a reduction in platelets, so I’m going to get some before I’m sent home for the day. I’ve never had any blood products before. I just received 2 Tyelnol caplets and one Benedryl caplet. The platelets will be here in about 10 minutes. I’ll take a picture so you can see what they look like.
This will be my last day of apheresis. We’ll end up with just enough stem cells for one transplant, instead of two, which is what we were shooting for. I will have spent 18 hours in the chair and some more hours waiting for lab results.
One thing I noticed yesterday was that the check in procedure is slow. That’s not so bad for people like me, but what about the people who are trying to recover from transplants? Making them wait any amount of time seems inhumane.
This stem cell collection process really makes me tired! I could nap right now.
We shot some video of dressing changes to help me remember all the steps. I can put them on the web if anyone’s interested in seeing them.
Yesterday was my birthday, so I came home to a clean house, and had cake & everything! My sister even brought dinner, part of which I ate. It was good!
More soon.
I’m here at Duke, waiting to see if I’m ready to start apheresis today. I had my blood drawn at about 7:30. At 9:30, they’ll have some counts back. If they’re high enough, I can start. If not, I go back home and come back tomorrow. I don’t have as much bone pain this time as I did last year, but I don’t know how important that is. The nurses said, the more miserable I am, the better. Last year I had 10 days of neupogen shots. This time, I’ve had 5 days of leukine and 2 of neupogen. One of them was just at 5 AM, so it may not count.
It’s been inexcusably hot here lately. This picture is from yesterday afternoon. Today is supposed to be better, although the forecast still indicated a high of 101 F. I don’t know if it will get that hot though, because it’s only 88 F at 1:00 PM. Temperatures are supposed to be in the 90s after this, for the next several days. We need rain!
This post has a picture I took of the outside temperature indicator in my car on Tuesday.
Martha let me know that there were only 5% plasma cells in my bone marrow, according to the report generated from the bone marrow aspiration done on Monday. That’s the lowest I’ve had since dx. It was 60% then, and was 6% in May when I was at the Mayo Clinic. Before that, the lowest it had been was 20% about 2 years ago.
I’ve been injecting Leukine in preparation for stem cell collection. As is usual for me, I’ve searched the web for as much information as I can find about it, and found this comment from the Non Hodgkin’s Lymphoma Cyberfamily web site to be disconcerting:
Leukine (Sargramostim) Similar to Neupogen, Leukine also stimulates the production of Neutrophils, but it goes one step further and also promotes the macrophages. Therefore it is called GM-CSF (Granuloctye Macrophage-Colony Stimulating Factor) Recent studies have shown that for the purposes collecting enough CD34+ Stem Cells for transplant, Neupogen is more effective than Leukine, and Neupogen plus Leukine offers no additional benefit, but the cost is significantly higher. For more information about Leukine click the link below: http://www.leukine.com
I plan on looking for the studies mentioned, so I can ask my doctor about the choice to use Leukine (5 days) and Neupogen (3 days).
On Thursday, when I started, I went to my local oncologist’s office, where one of the nurses showed me how to prepare the injection. Before, I had pre-filled syringes. I thought I was paying attention, but yesterday it became apparent that I hadn’t been. I remembered Andrea telling me to use a different needle to puncture the vial and withdraw the fluid, which I did. The needle is dulled when it goes through the top of the vial, so the injection hurts more. I can vouch for that. I had a heck of a time getting the Leukine into the syringe. It felt like there was a vacuum in there, and I got nothing but air. I ran over to my neighbor’s house to ask for help (she’s a nurse), but she wasn’t home. Her husband got her on the phone, and she told me to try taking the syringe out and putting it back in and injecting air into the bottle before trying to extract the med. That kind of worked. I was able to get some of the Leukine into the syringe. Some of it bubbled up out of the top of the vial. The needle wasn’t long enough to get it all out it seemed. I think it has something to do with the vacuum effect, and I just didn’t have that bit mastered. I gave myself a shot, and then managed to stab myself in the left middle finger when I was putting the cover back on the needle. I should have pushed the plunger in case there was any Lekine left in the syringe, but all I could do was swear and jerk it back. Anyway, my neighbor said she would help if I needed her. I could ask her to load the remaining 3 syringes for me. The injection part is really easy.