Cycle 1, Day +15: Bone Marrow Harvest Day

This week has been a rollercoaster. Last Friday Steven was admitted to the hospital with fever and feeling terrible.

IV antibiotics got the fever under control and suddenly Steven was feeling really great for the first time, waking up hungry last Saturday morning and shoveling in the food, gaining back the weight he lost during the chemo.

The morning he started to eat, the doctor looked at his 10-lb weight loss and started TPN (total IV nutrition). He was eating so well, better than normal even, I argued to have the TPN removed, not wanting to suppress his appetite when he was doing so well. But once it's started, it's difficult to get them to take it away, it took us until Wednesday night to unhook it.

Thursday, his first day without it, he started feeling poorly again, but still eating, albeit not as well as before. His blood counts were rising, over 1500, up from 300 on Wednesday, which means the bone marrow he received is engrafting.

They told us they were going to keep him in the hospital until Sunday, but unexpectedly came in in the late afternoon and said we could go home. We packed him up and brought him home, he ate a little than said he didn't feel well. Took his temperature-- 100.1.

I called the hospital and they said if he had a fever of 100.4 for an hour then bring him in. I checked him every hour and a half or so all night, but he stayed under the temperature they consider a fever.

Friday we went in for our daily infusion of GCSF, the stuff that stimulates his bone marrow to come back and the stem cells in his bloodstream, and they said his counts were over 5000. They performed another analysis of his blood, CD34 I think, which indicates how many stem cells are present. To do a harvest they want a CD34 of 60 or above, Steven's was at 230.

They said bone marrow harvest needs to happen right away, Saturday (today). In preparation, they give him platelets. We went home, last night his fever was 102.1.

Back to the hospital around 8pm. Because he isn't neutropenic any more (his white blood count is over 500), fevers aren't an automatic admission to the hospital. They culture his blood to make sure nothing is growing, this would stop the stem cell harvest.

Home from the hospital at 11:00 or so. To bed to be ready for 8:00 am appointment to start the stem cell harvest.

This morning they said the blood culture came back negative, so despite the fever they are going ahead with the harvest. Stem cells peak in the blood during engraftment, if they wait too long they won't be able to get as many. They are hoping that during this harvest they will get enough stem cells for the next three cycles of chemo, this will mean we won't have to go through this procedure again.

Steven had a procedure this morning under general anesthesia to place a catheter in his groin for the harvest. The harvest is pheresis, similar to the process for donating platelets, where there are two IV's, one takes blood out and the stem cells are separated out, the other IV returns blood to the body. The pheresis process takes 6-8 hours. Steven's terror of needles is the reason that he got the catheter in his groin instead of an IV in his arm.

At the end of today's pheresis, they will test what they harvested to see if they got enough stem cells. If they didn't, they will leave the catheter in his leg and he will stay overnight in the hospital and go back in tomorrow for more pheresis. If today's amount is enough, they will remove the catheter and we will go back to Target House tonight.

Once the bone marrow harvest is done, there will be no more daily infusions. We're praying all goes well and Steven will have a week without daily infusions before the next cycle begins.

Cycle #2 begins Monday February 2, Steven will be admitted Sunday evening February 1st in preparation for more chemo. One of his chemo drugs was reduced 25% for his first round to see how he did. They think he's doing pretty well, so he'll get the full strength dose next time.

Several people have asked us for our address and phone number, so I'll repeat it. We've got some mail forwarded from Ronald McDonald House, which is where we were staying in November, we are not there right now.

Our address is:

1811 Poplar Avenue #226 Memphis, TN 38104

Our phone at Target House is: (901) 545-0118

- Kathleen