2nd ASCT - Day 0 - May 18 2012

My 2nd autologous stem cell transplant went well today. Here is my transplant team after my stem cells ran in. Me, Han Myint MD, RN Sarah, RN Emily, Stem Cell Technician Cassie. Lots more photos to follow tomorrow showing all the steps!

Advanced Care Partner Emily.

Kemmer waiting in Greeley for me. Thanks Lisa Mathews for the photo.

Day 16 - Dr. Han Myint Appointment - September 29 2011

Jan Martin drove me to my first out-patient appointment since the Stem Cell Transplant with Dr. Han Myint on September 29 2011. My appointment was scheduled for 3 PM and they actually had us in an exam room right at 3 PM.

However, we sat and sat in the exam room for more than hour before Nurse Practitioner Denise came and showed me the lab work results from this morning and asked me a few questions. Denise noted my serum protein and albumin levels and was impressed that Jani had maintained my diet so well since discharge - making sure I was eating adequate levels of protein each day despite my continued nausea. If you look at the values over time chart below, you can see, I never ate enough protein while I was hospitalized with the Protein value ranging between 4.8 and 5.1. Now 2 days post hospital discharge, my protein level still is not in the normal range of 6.4 to 8.3, but much closer at 6.2.

Around 4:30 PM, Dr. Myint came in and said I was doing fine. He decided to give me a Neupogen injection to stimulate my new bone marrow into action since my white blood cell count had dropped from 2.8 on Day 14 to 1.3 on Day 16.

I'm scheduled for a bone marrow biopsy on November 2 2011, just prior to my Day 60 when the decision will be made on whether I will require a tandem (2nd) stem cell transplant. If that bone marrow biopsy shows any abnormal cytogenetic (DNA changes), I will need the tandem transplant. If the cytogenetics are normal and I'm in the top 3 categories of remission, then I would not require the tandem stem cell transplant. If I need the tandem transplant, it would be done right after all of the bone marrow biopsy results are done and finalized. My insurance company, Anthem, has already approved the tandem stem cell transplant.

We were still waiting for the neupogen injection when the nurse poked her head in the room and said they were waiting for insurance approval. Neupogen costs about $250 per one 300 g dose. Not long after, an obviously pregnant nurse came in the room with the neupogen and I asked her if there was a another nurse who could give the injection. The nurse looked so hurt and said, "Yes, there is." I quickly told the pregnant nurse that I had shingles and then she understood. The 2nd nurse came and gave me the injection and I took a Claritin tablet that I brought with me.

Now 5:00 PM, we went downstairs to schedule future appointments. Jan Martin waited at the desk with the scheduler and I went through a door to the Apheresis Department which has temporarily moved to the 1st Floor while the new space is being remodeled. Jessica Jones from Apheresis was there and we had a good visit.

With appointments in hand by 5:35 PM, Jan Martin drove us back to The Timbers. I told Jan that if I had to wait all afternoon by myself at the University of Colorado Hospital Outpatient Cancer Clinic - it would have been miserable - but visiting with Jan was wonderful and the 2 1/2 hour appointment didn't seem that LONG~

I collapsed into the bed for a 2 1/2 hour nap. Jan Martin made me mashed potatoes, fried chicken, and canned spinach for dinner and I ate it all - so yummy and loaded with protein.

Stem Cell Harvest Day 2 of Cycle 2 - September 7 2011

I drove myself to the University of Colorado Hospital this morning for my 2nd Day of stem cell harvest in this second attempt to get better stem cells for transplant. When I arrived, I found out that I yielded 5.28 million stem cells yesterday which is quite good.

My blood revealed that I was more anemic than ever this morning with a Hemoglobin of 7.8, so they decided to give me 2 units of A+ Positive blood. First, Martin, RN had to give me 2 bags of magnesium, because my magnesium was low too. I've never had a blood transfusion before ever - so, this was new to me. Their protocol at UCH is to give Benadryl and Tylenol just prior to any blood transfusion and I talked Martin, RN in to giving me about 1/2 of the Benadryl since I needed to drive home later. Sure enough, the Benadryl put me to sleep for well over an hour!

My doctor, Han Myint, MD came in to see me for a few minutes with my partial bone marrow biopsy results from the procedure done September 1 2011.

All of the chromosomal changes that I had in my 2nd bone marrow biopsy are gone, but I have a barely visible new one. However, Dr. Myint feels I am ready for transplant and can use the stem cells that I collected yesterday and today.  They are predicting that I will collect 13 million stem cells today based on on my CD34 count of 120 today (which is soaring). Compare to my previous stem cell harvest dates below:

Finished up the stem cell harvest before my 2nd unit of blood was in. Martin RN writing all the numbers they need for the stem cell collection.

After my 2nd unit of blood was finished, Martin RN changed my Trifusion Hickman Catheter dressing. I had quite a few "crusties" that needed to be cleaned off today - but, the site looks good.

Second Round stem Cell Harvest - September 6 2011

University of Colorado Hospital Apheresis Center September 6 2011

 jm and Jessica Jones from the Apheresis Center September 6 2011

 jm and Transplant Coordinator Dana Godec, RN September 6 2011

My wonderful sister, Jani September 6 2011

300 cc of my blood which hopefully contains LOTS of stem cells September 6 2011. Won't know the count until tomorrow.

Stem Cell Harvest Day 3 - August 18 2011

Again up at o'dark thirty for the 70 mile drive from Greeley, Colorado to Aurora, Colorado. The distance is further because I am paying to take the E470 Toll Road which adds about 10 miles but, cuts traffic DRAMATICALLY~

I arrived at the University of Colorado Apheresis Department shortly after 7 AM. Jessica Jones and Martin Bromley got me hooked up to the machine after they drew my blood from my Trifusion Hickman Catheter.

 jm and Martin Bromley at the UCH Apheresis Department August 18 2011

Day 2 of Stem Cell Collection yesterday yielded an actual value of 3.68 million stem cells. So, we hoped to collect 3.30 million today which would bring the total value to nearly 8 million stem cells.

My electrolytes were somewhat off and Martin hooked me up to additional potassium and magnesium which ran over several hours. My bones ache from the Neupogen and I'm a tad tired, but really I was fine~

Apheresis machine on left with potassium and magnesium running via IV Pump on the right

When my time on the machine was up, Cassie from the stem cell lab ClinImmune came to pick up my stem cells. She is always right on time and very nice. She told me that she had processed my stem cells from yesterday and they were safely in their freezer.

Martin Bromley and Cassie with my stem cells August 18 2018

Jessica Jones gave me Neupogen 780 mcg (2 injections) before my apheresis session was up and signed me up to return tomorrow for Day 4 Stem Cell Harvest to complete the 10 million.

Stem Cell Harvest Day 2 - August 17 2011

Up at o'dark thirty again and I drove myself again this morning from Greeley, Colorado to the University of Colorado Hospital at the former Fitzsimmon's Army Post location in Aurora, Colorado for my 7:30 AM appointment in the Apheresis Department (2nd floor of the Anschutz Cancer Pavilion).

Jani packed my rolling personal assistant again today. The bottom cooler has cold drinks and yogurt. The middle cooler has bread and snacks. And my laptop computer and with cooling fan tray grace the top. Works very well and I have everything I need throughout the day as I'm tethered to the stem cell machine.

At the Apheresis Department, I was greeted with smiles by Jessica and Martin. Jessica got me started on the apheresis machine. She drew blood first, but we didn't have to wait for the results like yesterday to get started - so, by 7:30 AM, I was hooked up and collecting stem cells. However, the blood test results came right back. My Stem Cell CD34 value was down to 41 from yesterday's 56.5.

My white blood cell count was up to 35.9 from yesterday's 28.8

 My blood type is A Positive.

Unfortunately, the prediction of between 4 and 5 million stem cells during yesterday's Day 1 Stem Cell Harvest turned out to be only 3.01 million stem cells. So, I have a ways to go to get to 10 million~

jm at UCH Apheresis Department Day 2 of Stem Cell Collection August 17 2011

I had a slight reaction after I was hooked up to the machine this morning. My lips tingling and my eyeballs felt jittery. I told Martin and he immediately gave me a bolus of intravenous calcium and very soon after, I felt fine.

Dana Godec, RN spent a long time with me going over the Stem Cell Transplant inpatient guidelines. I felt like I was in school again~

I was surprised with a visit from my cousin, Diane Dynia Miller, today while I was donating my stem cells. She is the oldest daughter of my father's youngest sister (both still living). We had a nice visit and she made me laugh which is imperative in this adventure. I missed getting Diane's picture because Jessica was giving me 2 more Neupogen injections (780 mg total) in my left arm.

By 12:20 PM, my stem cell collection was over for the day. Jessica looks pleased with the collection - won't know the number of cells until tomorrow morning.

Cassie arrived from ClinImmune to take possession of my stem cells and transport them to the lab in the cooler.  Cassie told me that my stem cells from yesterday are now safely frozen at their facility. Cassie is so nice. Jessica and Cassie have to read a lot of numbers and verify everything before Cassie leaves with the stem cells.

Cassie packed my stem cells in a blanket with a thermometer to make sure the temperature is maintained on their way to the lab.

I'm returning for Day 3 of Harvest tomorrow morning.

Stem Cell Harvest Day 1 - August 16 2011

I drove myself to my stem cell harvest appointment at the University of Colorado this morning. I had to be there at 7:30 AM, so I left Greeley, Colorado just after 6 AM. First, they drew my blood to determine if I was ready for stem cell harvest. My white blood cell count was HIGH at 28.8 which is good for stem cell harvest and my platelets were normal at 192 and okay.

My CD34 value was 56.5 which is also good for stem cell harvest. I guess anything over 10 is okay.

Dana Godec, RN came and changed the dressing over my Trifusion Hickman Catheter. The most painful part of the Trifusion Hickman Catheter was the small incision they made in my neck above where you see the dressing below. They glued it together and it itches a lot today.

Jessica Jones in the UCH Apheresis Dept. hooked me up to the Cobe Sprectra Collect Flow Path machine at 10 AM and I got started donating my stem cells.

Jessica Jones, UCH Apheresis Dept.

Jessica also started IV calcium on me. My pre-stem cell harvest calcium level this morning was 1.19 within the normal range.

jm at the University of Colorado Hospital Apheresis Department August 16 2011. My headache improved some through the day while I was on the machine.

I spent about 5 hours on the machine today. If I had to pee, they brought me a port-a-potty since I was tethered to the machine~ I was SURPRISED that I didn't feel one bit different throughout the whole day as my blood went in and out of the machine except for my headache improved some.

I entertained myself with my laptop computer, iphone, and television. I quickly learned that the UCH television consists of about 10 channels only~~ I had plenty of food that Jani packed for me in 2 coolers - one cooler for bread and snacks and the other for cold items like drinks and yogurt. I had enough food with me to stay a week or at least several days - thanks Jani~

My stem cells were collected in the plastic bag in the middle of the picture below (looks sorta like light colored blood).

The machine has a computer that counts the time on the machine, the amount of fluid collected, etc.

Jessica and Martin watched the machine closely and were in and out all day making sure both the machine and I were okay. They are very competent and relaxed about what they do and they gave me a true sense of confidence that I could relax and just let them work~

Martin and Jessica at the UCH Apheresis Department August 16 2011

When my time was up on the machine for today, Jessica calculated that I had probably donated between 4.75 and 5.0 million stem cells. Dr. Myint wants 10 million stem cells, so I will have have to come back tomorrow and maybe the next day to fulfill the 10 million. Jessica gave me another 780 mg dose of Neupogen (2 subcutaneous injections in my right arm) and I took my Claritin. Jessica also drew blood for my post stem cell harvest calcium which was 1.20 (remember the beginning calcium was 1.19, so that was pretty good). 

Jessica gathered my stem cells in the plastic bag and the Cassie from Stem Cell ClinImmune came to take them to their lab.

Jessica and Cassie had to read a gazillion numbers to each other and do careful labeling of the stem cells.

 Then, Cassie carefully put my stem cells in the cooler she had with her along with a thermometer to make sure the stem cells stayed in the right temperature range for the short walk back to their lab for processing and freezing.

Jessica disconnected from the machine and Martin changed my Trifusion Hickman Catheter dressing again.

I loaded up my 2 coolers, laptop computer, laptop computer cooling fan tray and headed for Bart. Drove home via the E470 toll road and made good time back to Greeley. Was home by 4:35 PM.

All and all, it was a great day in my adventure - no hurts and nice caregivers~