After my fifth GCSF shot on Wednesday, we had an appointment
to see if I had enough stem cells in my blood to start collecting them. We
waited for my blood results in the four-bed haematology day stay ward room. For
the next two hours the beds filled up with bald women on IV drips. I overheard
that the nurse could not get a needle into one woman’s arm. She asked another
nurse to try. My arms crawled with the pain of stabbing needles as I listened
to them. We finally got word that I did not have enough stem cells to collect.
I was told I was a “two” and needed to be a “ten”. I didn’t know what that
meant but it was clear they weren’t going to be collecting any cells today. By
6pm that evening I felt pain in my lower back. It came in waves. The pain
reminded me of when I slipped on the ice and landed on my back about twenty
years earlier. I couldn’t straighten or sit properly because my lower back
wouldn’t bear the weight. It was a sign that the GCSF was taking effect.
The next day my
result was fourteen. I was ready to harvest. The corn crop was in. First I
needed a central line. A vein assessment I had on May 8th at the New
Zealand Blood Service in Epsom determined that the veins in my arms would not
support the volume of blood that would leave and re-enter my body during the
stem cell collection. From all the trouble I experienced with getting blood
taken and having needles inserted, it was no surprise. We waited for hours in
the family room in the haematology ward. We turned on the 6pm news.
Shortly afterwards a man walked in and sat on a sofa near us. It was hard to
tell how old he was. He was bald, wore a hospital gown and was attached to an
IV pole. He watched the news with us and made amusing comments at the current
events. We laughed with him. When he stood and left, slowly moving out the door
dragging the IV pole behind him, I saw that he had no fat on him at all. I
wondered what his affliction was. I thought how unfair and how sad that this
was his world, this ward, these hallways, while others moan about such trivial
things in life. I know it’s a cliché to say it makes you think but it does. It
made me sad and hopeless that the giant foot stepped on so many nice people. It
also made me realise that would be me soon. I would be that bald-headed patient
attached to an IV pole, dragging myself down the hallway with a backless gown
on.
At nearly 8pm I was finally wheeled to the surgery ward on a gurney where a South
African anaesthetist introduced herself. She asked me some identity questions
then wheeled me to another area of the room. A young doctor walked up to my bed
but kept his eyes on a clipboard. He spoke a little nervously:
“I will be happy
to put in your central venous line.”
That seemed a
little odd. It sounded like: “I will be happy to be your waiter tonight.” But
then an older man approached with much more confidence and an easy smile and I
realised this was a learning session. They instructed me to turn on my side
with my head to the left. A large blue plastic sheet was put over my head. The
anaesthetist made a tent out of it so I could see towards the wall. Every
couple of minutes the older man and the anaesthetist put their head in the tent
and asked me if I was alright. After a local anaesthetic the procedure began.
It felt like the top of a pen being forced into my neck, followed by another
one. Once the “pen tops” were in I could feel them being manipulated and pushed
into place. It was uncomfortable as hell but when the older doctor put his head
in the tent, I smiled and nodded to show I was fine, as you do. When they
finished, two plastic tubes, about 12 cm (4 inches) long each, hung from the
incision in my neck and dangled on the top of my shoulder. The young doctor
wrapped a tan elastic bandage around my neck but left the tubes hanging on the
outside.
The older doctor
and his protégé left my side. The South African woman stayed and a British man
in scrubs walked over. I didn’t know who he was but he made some good jokes. I
thought maybe the hospital provided a little light relief to relax the
patients. The tubes bobbed on my shoulder when I laughed. It turned out the
funny Brit was the partner of the anaesthetist. I guessed he entertained her
patients to impress her. He could have done stand-up. But then maybe he liked
the idea of a captive audience. You couldn’t get more captive than being flat
on your back with two plastic spouts sewn into your neck. I waved goodbye as I
was wheeled back down to the haematology ward. I had left Alex waiting for an
hour. He didn’t grimace when he saw the half-machine they had turned me into.
In fact he got it completely right. He didn’t react at all. It was 9pm by the
time we got out of the hospital. Alex volunteered to go get the car and pick me
up but I wanted to get away from there as fast as possible. He had parked a few
minutes’ walk away on Grafton Road. As we walked towards the car the two
plastic tubes banged up and down against my shoulder. I must have looked like
an alien with feeding tubes hanging out of my neck. I was glad it was dark.
I woke up on May
18th to another shot of GCSF. After seven days, Alex was an old pro.
His hands no longer shook. He was so good, he began to wonder if he missed his
calling and should have trained for a job in the medical profession. I wasn’t
sure if there was much call for a middle-aged stomach subcutaneous injection
specialist, but you never knew.
It was stem cell
collection day. It was the last item on my peripheral blood stem cell
collection schedule. At the blood service in Epsom, they were ready for me. I
was put in a bed in the corner of a large room. I had a curtain pulled across
the end of my bed but the rest of my bed was exposed. There were lots of lazy
boy type chairs throughout the room for blood donors. The chairs filled and
emptied throughout the day. No one stared for too long at the strange woman in
the corner with tubes coming out of her neck attached to a machine the size of
a refrigerator. The refrigerator was called an apheresis machine for those who
like such detail. I was told the number of stem cells needed for a transplant
was two million per kilogram of body weight. The target for me was to collect
five million. I was willing my body to make it happen.
I couldn’t turn
my head much because of the tubes hanging out of my neck so I just had to lean
back against the pillows and wait patiently for the five hours it took for the
blood to leave my body through one tube and return through another. Plastic IV
bags hanging from the top of the machine were filling up with a pink-tinged
liquid and I was hopeful that I was doing well. The only strange effect was
when my blood pressure was taken. Every time
the automatic arm cuff of the blood pressure machine tightened, my hand would
get an extreme bout of pins and needles. I mean so extreme it was like I had
put my hand into an electric socket and left it there getting zapped with 240
volts. One time the machine misfired and pumped the arm band up twice as hard.
I felt like my hand was going to explode. I wanted to scream. But since I
didn’t want to disturb the good people donating blood around me I gritted my
teeth.
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