Stem cells infused successfully!

Yesterday I got my new immune system! As promised, they arrived around 4pm. Holding the cell-bag in my hand was a great experience. They didn’t look like much—like a watered down tomato soup—but they were sure important and represented so much. I was surrounded by family, with my parents, Briana, Peggy (Briana’s mom), and Alpen. It was nice to share this momentous and symbolic occasion with them. The cells had been filtered out of my donors blood some 16 hours previous, put on ice, and hand-couriered from Europe to Seattle. A logistical triumph indeed. Fresh cells meant no issues with any frozen preservatives so I was happy about that.  Like other patients I have talked to or read about, I felt a huge hit of gratitude for my donor. Just goes to show that even in a time when political borders are tightening-up, the human-human bond remains strong and people are out there willing to help. For me it meant a stranger in Germany went out of her way to jump through some hoops, get a temporary central line installed, donate some blood product, and get nothing physical in return. Well not exactly a complete stranger: a closely-related-genetically stranger.  I wonder how much the genetic component factors in to a person’s decision to altruistically help a stranger psychology/sociology PhD project anyone?.  As was emphasized when I took Intro Ecology and Evolution, there is no case of true altruism in nature. Some researchers thought they had found it in a colony of ground squirrels, but only to realize that the assumed-altruistic hawk alarms (for the good of the colony, but endangered the alarmer) were actually dependent on how many relatives the alarming squirrel had in the colony. 

It took about two hours to infuse the cells through my central line. Nothing out of the ordinary, just like receiving red blood cells or platelets. They take 2-3 weeks to engraft or solidly nestle in to my bones. Once there, they will start producing all the components that make up blood: RBCs, platelets, plasma, and the white blood cells. Since the blood cells made will have a different genetic signature than all my other cells (they share some markers, but not all), the white cells will probably recognize my organs as foreign and start attacking them. The next year is all about figuring out where this is happening and trying to suppress it. My first suppression starts on Sunday, when I’ll get an old chemo favorite, cyclophosphamide, infused which is suppose to re-orient the early t-cells from my new immune system. It sounds crazy to give chemo on day 3 and 4 after a transplant—I thought it sounded crazy when I heard it—but the Hutch did a recent study that GVH outcomes were just much better when the cyclophosphamide was administered on days 3 and 4. So that’s the next step for now. I’m feeling OK otherwise. I have a little bit of mouth issues, but not too bad yet, and my GI tract seems to be holding up OK.  My hair is still present, but should be falling out later this week. I was told from an experienced transplant nurse last week that to have a successful hospital transplant I will need to 1. Rinse my mouth with saline all the time (10-12 times is good, but more is better)  2. Take at least three walks a day 3. the bed is not a couch, so get to the chair during the day. So far, I’m sticking to his advice and its going good.

In regards to the previous post and the last two days of TBI: I never did find Waldo in the Troy scene, but we switched it out and I found waldo in the Old West, Hollywood premier, and the Franco-Moroccan war. The TBI did increase my nausea, but I was able to mostly manage it (only one vom session) through “around-the-clock” Zofran pieced with 3-4 Ativan doses as needed.   

New cells, transplant day Nov 16th 2017

Sounders game pre-transplant