Finally Pheresis!

Today is Tuesday June 15th and I have had my first treatment of pheresis.  The bortezimib is done and the rituximab is almost done...it's been a very long day!!!

I was admitted to the hospital yesterday for this treatment and I thought it would be started yesterday but I guess they wanted to start fresh this morning.  I can understand that since they showed up at 8:30 this morning and I'm still being treated (it's 7:40 p.m.)

So...pheresis is more...and less...than I was expecting.  Phil, The Pheresis Man, arrived at my door with lots of equipment.  He brought blood pressure monitors, and stands for IVs and a huge machine that looked sort of like an sci fi contraption on wheels.  It had a bunch of empty bags hanging down from it.  This is a picture of the machine and Phil during treatment.

This is a "lovely" picture of me with my tubes!  The tube on the far right is my oxygen tube (4L and holding at rest).  The other tubes come from the catheter shown to the left.  It is a good sized tube that they inserted last Wednesday (using really good drugs thank you very much!).  The tube is inserted under the skin on my chest and up until it goes down into my neck...yes, that's as gross as it sounds ;-)

The single tube splits and has an "in" tube and an "out" tube.  This catheter was put in solely for phereses and even though I have this huge thing in my chest, the nurses at the hospital still had to put in another IV for their use - no one messes with pheresis tubing except pheresis people! The wrap around my arm is to monitor my blood pressure.

So my take on Phil's explanation of pheresis is...The big machine sucks in my blood via the "out" tubes.  The blood goes down into a centrifuge and spins it.  The blood is separated by weight...red blood cells against the wall of the centrifuge because they are the heaviest.  Then white cells, then platelets, then plasma.  The plasma is then pulled away and "bagged up" for disposal (it has my nasty antibodies in it!).  Then this yellow stuff called albumin (processed plasma) is mixed back with my blood to replace the plasma that was removed.  The blood is then sucked back into the "in" tube.  It's wrapped around heating coils to warm up and then it enters my body at the catheter site. 

This is a picture of Phil showing Lee the centrifuge in action (there is a glass window to look down into it).  They both thought it was very cool!

A mathmetical calculation determines how much plasma I have in my blood.  It's based on my height, weight, and blood volume.  I had a little over 2,400 ml of plasma.  Phil continued the process until they had bagged all my "bad" plasma and replaced in with "good" stuff.  We Hope!!! 

Here is a picture of me at the end of the process holding my bad plasma!  Lee asked Phil what they did with the plasma they took out of me.  Phil said it depends.  On Wednesday it's for Chicken Noodle Soup and on Thursdays it's for Birds Nest Soup.  Sounds good to me :-)  Actually they just toss it.  I thought they should keep it and try and figure out why my antibodies are different and won't go away!

Anyway, after pheresis (which ended around 11:30)  I was given solumedrol - the "super prednisone" that gave me diabetes, tylenol and IV benadryl.  Then the chemo nurse came up to administer the bortezimib.  It was one quick shot of drugs into my IV port.  Then...the rituximab regimen started at 2:00 p.m.  It's now 8:45 p.m. and I'm still getting rituximab.  This is a really long day!  All in all, I did really well with the treatments.  I felt a little light headed at times but nothing significant and my blood pressure went sort of low but when I explained that I always have low pressure Phil felt a lot better. 

On Friday I have my next round but, thankfully, there won't be any rituximab.  It should only take around 3-4 hours instead of 13!  That treatment will be outpatient at Duke South Oncology lab. 

Lee and I drove down to Sanford to see Stephen and Vanessa at Dale and Lorie's.  It was really fun.  We enjoyed seeing them and Dale and Lorie were so nice and great hosts!  We visited with Stephen, Vanessa and Amy on the first day and Stephen and Vanessa and Lee and I drove to Pinehurst on day two.  That is a really nice place!  Here are a few pics from our visit...

Lee and Vanessa!  They are so cute together!

And of course here's a picture of Lee taking Missy to Sunny Acres Pet Resort.  She looks really happy in this pic.  Apparently when she got there it was a different story!  Lee said she sunk to the ground and they had to pull her through the doorway.  I say she did that to make Lee feel bad - not because it's a bad place!

We wish everyone a great rest of June and a safe 4th of July if I don't blog.

Love,

Lee, Wendy and Missy