A is for Apheresis

Memorial Day 2008

A is for Apheresis, how the stem cells are spun
B is bruises, boy, do I have one
C is for (oxy)codone and going from "Ow" to "Wow"
D is for delirious, I better quit right about now.

Yes, good guess. It's been a very long day. Strapped down in a hospital bed for more than four hours, both arms ramrod straight, each with needles and plastic tubes and bandages, all connected to a strange-looking clickty-clack machine that somehow sucked out my stem cells from my right arm, spit them into an empty plastic bag and then returned my own blood through my left arm.
It didn't hurt, at least not at first.
And even when it did begin hurting about two hours into the collection
(okay, more like a slow burn, piercing stabbing pain suddenly pulsing from the huge intravenous needle in my left arm) once the bright red liquid began trickling into the stem cell collection bag, hope helped me cope.

With my brother, Tom, his wife, Mary, and daughter, Gilly, looking on, the process called apheresis spun red liquid through a blood cell separator, in and out and up and down various tubes. Black round dials on the machine clicked and clacked around and around as the centrifuge separated the heavier stem cells from the platelets, white cells and red cells.
While the bright red stem cells came out of my right arm and slowly filled the hanging plastic bag, the "leftovers" from the process -- platelets, white cells and red cells -- made their way back into my system via my left arm.
Periodically, a blood pressure cuff wrapped around my lower leg would squeeze another pressure reading to add to reams of read-outs and blinking measurements.

Apheresis, by the way, is a Greek term, meaning "taking away."
(This concept did not, though, apply to my bladder, which was forced to KnockKneesis, a Kindergarten term, meaning "hold it in.")

All was going fine until the sudden burn in my left arm. A kink formed in the line, followed by swelling and sudden bruising in the crook of my elbow. Michelle, the nurse, stopped the machine and the flow, repositioned the I.V., then reversed the flow so my left arm now extracted the blood and my right arm received it back. The clickty-clack slowed down to a clack-clack-clack for quite some time before it returned to a faster clip.
Actually, it really didn't matter how fast or slow the collection occurred because I couldn't do anything either way. Apparently, I was misinformed about what activities I'd be able to do lying flat on my back for the afternoon. I dragged in a bag of books, newspapers and magazines to catch up on my reading.
How funny.
Because the first thing Michelle, the very attentive nurse, told me: "Now after I wash down your arms and prepare them for the I.V., you can't bend or move your arms."
Which makes it rather hard to hold any reading material.
Never fear. After my mother and sister, Anne, showed up, I made them turn the pages of The New York Times Magazine and prop it just so on my bent knees so I could read a cautionary tale about being a blogger (which is sort-of-why a profile and photos have yet to appear on this here blog, at least for now.)
The strange stem cell pain in my back and hips subsided, as had been predicted, with some help from pain-killing prescriptions the clinic gave me. However, I continually ran a fever, all day, from the time I received another round of growth-factor shots at 9 a.m., all during the apheresis and into the night as I swilled continuous glasses of water and juice to replace lost fluids.
My temp. never got higher than 100.4 degrees but it kept me sweating all day and night.
This is also a reaction to the growth-factor shots as the body reacts to being flooded with white blood cells. Much like putting up its dukes to fend off the flu, my body's usual disease-fighting mechanisms -- such as sweating to cool down -- were on alert.
Only it turned out to be a drill. Had this been an actual emergency....

Even though I craved coolness, Michelle the ever-smiling and helpful nurse kept piling white fresh-out-of-the-warmer blankets on me.
"It's to get your veins warmed up and pumping," she said.
I nodded a bead of sweat.
She then stepped out of the room and returned with a bright multi-colored double-sided double-lined fleece blanket, asking: "Would you like this?"
I thought, she's was so nice, but not so perceptive.
"No thanks, I'm really warm."
"Oh no, I mean to keep," she laughed. "These are made by our volunteers to give to the donors."
Well, in that case.....
The blanket swirled in colors of blue, orange, yellow, red and green looking like a rainbow of kelp swaying in the ocean. A fringe of delicately-tied knots connected the bright sea side to a plain yellow side of soft fleece. Very soft, very comforting. And within minutes of my brother and his wife admiring it, Michelle presented Tom with a blanket of the same design and material only with a lining of blue.

"Wouldn't you like to lay down for a while," she then asked my brother, picking up on the weariness and fatigue of his constant unwanted companion,
non-Hodgkins Lymphoma. And with that, my brother took a nap in the bed beside mine, matching blankets at our feet, the red flow of life silently seeping between us.