This past Sunday and Monday my white blood cell counts were bouncing along the bottom, so I was dismissed from IPOP pretty early both days. But by Tuesday they had recovered substantially, so even though I was still not ready and was again sent home early, I received a phone call from one of the IPOP nurses early in the afternoon warning me that there was a significant possibility that the harvest could take place Wednesday, if the trend continued. I was instructed to prepare myself for a longer day.
Sure enough, by 9 A.M. Wednesday morning I was hitched to the apheresis machine. Both lumens of my catheter were fully engaged, and I was getting a very strong saline solution added to the return leg -- strong enough to cause an unpleasant metallic taste in my mouth. Obviously a machine like this does many things automatically, but the nurse running the show still had a great deal to do for the three-and-a-half hours the procedure lasted. For starters, shortly after getting the machine started, she announced that she was unhappy with the outbound flow rate; this was remedied by pausing the machine and switching all the tubing between the two lumens. As the machine did its work, she made adjustments to certain of its parameters. Every thirty minutes, she took blood from a branch on the outbound leg and sent it off for analysis, to make sure the cell counts and certain other numbers continued to be satisfactory. She measured and recorded my "vitals" (body temperature, blood pressure, heart rate, and dissolved oxygen) nearly as frequently. When I began to feel cold, as often happens in the course of this procedure, she covered me up. When I began to feel some tingling in the ends of my fingers, she backed off the outbound flow rate a couple of percent. She kept me supplied with drinks and cookies. And when the saline solution and drinks eventually filled my bladder, which happened a couple of times, she took care of that as well (and that's all I'm going to say about that).
Eventually time passed and the procedure completed; the "product" was declared to be of top quality. This consisted of a bag of straw-colored plasma, and another bag of blood colored a dull dark red. This second bag consisted mostly of stem cells, but also some red blood cells and platelets that had escaped the machine's filtration mechanism. Before being frozen, the contents of this bag would have to undergo a second round of filtration, which I did not observe.
Often apheresis costs the patient enough platelets that it is necessary to wind up with a blood transfusion to replace them, so I had to hang around and wait for the results of the last set of tests to determine whether this should be done in my case. Fortunately my only problem turned out to be a potassium deficiency; I was given a few pills to take and was sent home. So, unless I have some sort of delayed bad reaction overnight to something or other, I would have to say that the stem cell harvest went about as well as could be hoped.