Last time I donated cells I took Neupogen for 5 days prior to the donation. Neupogen stimulates your bone marrow to produce extra cells. It's primarily used in cancer patients but is needed for the people donating stem cells prior to bone marrow transplants as they need to be able to collect more immature stem cells from the donors than they would normally have floating around in their bloodstream.
Anyway, this time the infusion Daron will likely receive is a little different. Instead of infusing immature stem cells that have to take over Daron's bone marrow, they need to infuse mature lymphocytes (fighter cells) that can target Daron's leukemia and kill it!
The neupogen does not increase the number of mature lymphocytes (just immature cells) therefore it wasn't needed for this collection. I was happy about that as artificially stimulating my bone marrow makes me a little nervous.
Given the fact that I didn't have to take neupogen prior to this donation (it causes bone pain), everyone anticipated this collection would be easier.
That wasn't quite the case! In order to collect stem cells peripherally (via blood rather than directly from the bone marrow) they insert a large bore steel needle (rod) into one arm and an IV in the other arm. The site with the large steel needle in it collects my blood using "vacuum- like" suction. The rod hurts a little, but the suction does not.
Unfortanately, my blood vessel was very unhappy with this "suction" action and decided to spasm, a lot! I could actually see and feel my blood vessels spasming (didn't hurt but was quite fascinating to watch). They gave me Ativan which is supposed to help your blood vessels relax but it didn't help. (It did help me relax and I took an excellent nap!) They also tried positioning the needle differently, different vessels, etc. Nothing worked. They did attempt to collect cells for 3 hours and were only able to get 1.9 units of lymphocytes and they wanted 15.
So, that meant I needed to get a catheter placed in my neck as it much easier to collect the cells that way. (To collect the stem cells/lymphocytes they cycled all of my blood through this large machine 4 times, pulling off lymphocytes each time. The machine can separate out specific cells based on weight. Pretty amazing!)
How does one place a "neck catheter"? I've seen this done but now have first hand experience.
At 6 PM on Friday night (11 hours after getting to the hospital that day) I was sent to interventional radiology. By now the Ativan had completely worn off and I was quite nervous about the catheter placement.
It's hard to believe but they place these neck catheters while the patient is completely awake with no drugs at all except local anesthesia (lidocaine). The lidocaine really helps with the pain but not the anxiety of having a large catheter stuck in your neck. Ha!
They had me lay down on a skinny metal table and then covered my from head to toe with a surgical drape. They leave you a small hole to look out of on your left side but they that's it.
After sterilizing my neck the radiologist numbed my neck with lidocaine. Then using a scalpel made a small incision (1/2 inch) in my lower neck exposing my jugular vein. Using floroscopy to guide him he then inserted a fairly large catheter into my vein, put in a couple a stitches and sent me home.
The next day I went back to the hospital for the stem cell collection which went well. Shortly after the collection they removed the catheter and after about 60-90 minutes of laying flat with pressure on the site they let me go home. It is still mildly sore and I have a lump where they put in the catheter but that's it.
The thought of the catheter being in your neck is really worse than the actual procedure. That being said, it is something I hope not to experience again in my life! Of course, it is super tiny sacrifice to make and I hope this story doesn't stop you from being a bone marrow donor! Please sign up! Your donation truly could save a life.
Catheter in place
Pre-collection blood draws
Stem cell collection in action
The catheter!
The long skinny tube was in my vein, the two short ones were
what they used to access and return my blood during the collection.
Post collection I feel completely fine, aside from being a little more tired than normal.
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3 comments:
Yikes. Yikes, yikes, yikes.
OH MY! Sounds like quite the experience.
I think i just puked a little. You're brave. Like you said, it's a small sacrifice...but still...it gave me the heeby-jeebies.
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