Just the stem cell facts, ma'm

My stem cells hurt.
That's a sentence I never thought I'd say.
But they do. Whatever they are and whatever they do, they hurt.
In my back, my hips and my head.
The pain woke me up at 6 this morning out of a sleeping pill-induced slumber.
Sharp darting pain in and out of my lower back.
I'd had two rounds of a shot meant to jump start my stem cells into overproduction and round three was scheduled later that morning at the Seattle Cancer Care Alliance.
I fumbled my way to a cupboard and took two of the allowed pain killers, non-aspirin acetaminophen, then rocked and rolled into varying positions until sleep found me again.

But what the heck are stem cells and why are they building up inside me like a river about to flood its banks?
Here's the quick explanation:
Stem cells are starter cells, baby blood cells so to speak.
They are formed in the bone marrow, the soft sponge-like lining found in the bones.
Stem cells mature into one of the three types of blood cells: white cells, which fight infection; red blood cells, which carry oxygen; and platelets, which help the blood to clot.
Hematopoietic or blood-forming Stem cells are NOT embryonic stem cells, which can develop into any cell in the body. (These are the cells under research for disease-curing potential and mired in religious, ethical and political controversy.)
Blood stem cells, on the other hand, have been quietly and successfully saving lives and curing cancers for decades.

Three sources of blood stem cells are:

Collecting them directly from the bone marrow by cutting them out of the bone; collecting them from the bloodstream; collecting them from the umbilical cord after a baby is born.
Previously, cancer patients receiving a new immune system using stem cells underwent a bone marrow transplant. In that procedure, a donor underwent the painful removal of bone marrow from the hip bone using a large needle. The bone marrow was "harvested" to remove blood and bone fragments
Now, using new procedures pioneered at the Fred Hutchinson Cancer Research Center where my brother is receiving his medical care, stem cells are collected directly from the bloodstream using an easier process with much smaller needles!
Nurses tell me the procedure is still often referred to as a bone marrow transplantation (BMT) even though 90 percent of the time patients are actually undergoing a stem cell transplant, technically known as peripheral blood stem cell transplantation (PBSCT).

White Cells: Going Up, Going Down

While I'm undergoing four days worth of shots stuck into my stomach (they don't hurt at all, just take a long time to empty) containing a growth factor to stimulate my body's stem cell production, my brother endures the opposite. This past week, he received daily doses of chemotherapy to further kill off cancer cells and destroy his cancer-plagued immune system. Hours before he receives my blood, he undergoes a final full-body radiation.
While his white cells continue a precipitous drop, mine are climbing off the charts.
After just one round of the shot called Neupogen -- containing what's known as Granulocyte Colony-Stimulating Factor (G-CSF) my white cell count tripled.
My first dose was Friday. It's now Sunday, or Day Three of the Neupogen shots and my white cell counts have climbed from 7,000 to 35,000.
The body usually produces only as many new stem cells as it needs to continue the miraculous daily balancing act of living, breathing and sorting out good and bad germs.
Now stem cells are literally spilling out of my bone marrow into my bloodstream and "pooling" in the spots where they grow in the greatest number -- hips, lower back, parts of the head. Which explains my pain.
But that pain will subside once the stem cells find a place to go. And they will tomorrow when they are collected and separated using complicated machinery and a process called apheresis.
But more on that after I experience it.

In two days, May 27, 2008, fresh, new and pure stem cells are to be transplanted, or infused, into my brother so they will grow into a new immune system while fighting off any remaining cancer cells. The start of the process, known as engraftment, seems easy. Similar to a blood transfusion, a plastic bag full of bright red liquid -- my stem cells -- will slowly drip into my brother intravenously.
It may only take 30 minutes to an hour.
But it's the beginning of a very long and nerve-racking 100 days called engraftment.
There may be many bumps and bruises along the long road. But I'm confident of the end result: A Cure.
The countdown to Day Zero -- my brother's New Birthday -- is almost over.