Every little cell in my body is happy, every little cell in my body is well!
Although I had been told that I would be unlikely to get a reaction to the Malphalan immediately I didn’t entirely believe it. But approaching 4 days on and nothing really yet. Maybe another couple of days they say. Somehow it all seems so protracted like a sword of Damocles hanging over my head. I almost want it to fall now so I can get on and face what is coming, though I am sure I won’t say that when it happens!
The day after the Malphalan, in came the Dalek with the stem cells, not saying ‘exterminate’, but restore. I had been a little suspicious of a storage container lying around for days unconnected to the electricity. How could it keep the plasma and cells frozen? I need not have worried. All blood and plasma products collected from patients are managed by an off-shoot of the Blood Transfusion Service. It is all part of the NHS. I had thought my cells were stored here at the QE but I was wrong. It is far more industrial than that and so instead of being rushed in by the nurse, collected from the blood fridge for urgent use, they arrive in a dustbinlike container. Very strange.
Anyway that Sunday morning, the sun was shining when the show started. In came 2 nurses, wheeling in the container and a heating trolley to warm the cells to body temperature, called a Sahara.
In came poles to hang the bags and lots of small packs of saline for intermittent flushes. Plasma is very gloopy and will stick without a little extra saline flushes if required. I felt quite relaxed and calm and very interested. I had not observed on collection day how small the bags were, but in fact they held little more than 100mls of stem cells each in plasma to keep them flowing. There were 3 precious bags with more stored back where these came from, for a possible future transfusion at a later date. Stem cells are infused under gravity because being alive they could be damaged if pumped in. An adequate size gauge tubing is also essential. They need to arrive in the blood stream in as pristine a state as possible to be the most effective.
When the tub with container of Nitrogen was opened the boiling gas swirled out in a white mist. Nitrogen is liquid at an extremely cold temperature and does not boil until it reaches -195 degrees C. Very cold. The little bags of stem cells are not only frozen solid but extremely fragile. If they would be dropped on the floor they would shatter and be permanently destroyed. Fortunately that did not happen. One of the nurses put on thick protective gloves and got the bags out one by one to get them ready.
All medical folks reading this will know what a catheter bag looks like when the patient has a nasty urinary tract infection. The urine is thick with dead bacterial cells and the colour of wheat beer, with a hint of rosé. Fortunately, when I saw the plasma/ cell liquid flowing, although it looked similar, I could actually see the individual cells flowing, so knew I had the right stuff.
Everything proceeded uneventfully and Martin arrived early afternoon having missed the matinée. I was grateful that all went well. The cells infused without too much fuss and soon the whole procedure was over. I had no ill effects. The reason for my admission to hospital was completed. All I had to do now was wait for the effects to emerge.
(Emma is writing this now – Bridget hasn’t really got the energy to focus on it. She is dictating some bits and the rest I am making up myself!)
Day 5: I felt fairly well, and ate well. Just before visiting time ended, my Emma arrived. She has come from Greece to keep me company during this long period of being in hospital. She always has a lot of work to do but luckily it can all be done from right here in my room. She has established herself in my comfy chair, and despite initial complaints about internet speeds, has been happily tapping away ever since. It is nice for me to have her here.
Day 6: another reasonable day. Our lovely neighbours (S & P) came to visit which is always nice. They reminded me that I should probably stop hugging and kissing people as I am now close to being neutropenic (my immune system is now very low). I reluctantly agreed it was probably a good idea.
Day 7: appetite beginning to tail off. Nausea definitely an issue, although ginger beer and the various medications on offer help. This is my first truly neutropenic day. Emma got a lot done as I spent a good part of the day asleep or on the loo with the other very common not-so-pleasant side effect of the treatment.
Day 8: Ugh. No appetite and decidedly queasy. Emma and Martin told me I also looked very pale and translucent. Doing anything takes enormous amounts of energy. Getting enough fluid down is a challenge. I didn’t fancy anything to eat until late afternoon, when Emma went down and raided M & S food for anything that might tempt me. I managed nearly a small tub of couscous which was delicious, and even a few crisps. Emma and Martin were lucky enough to be invited over to the neighbours (S & P) for dinner.
I have now been in hospital for more than a week, the longest ever for me as an in-patient. Most of the time I can occupy myself with a book or online Scrabble but occasionally life gets a little tedious. I get plenty of visitors which is very diverting and at other times when I am fed up with sitting I continue to walk the corridor and complete at least one mile a day. My appetite has been very capricious, affected I am sure by the Dexamethasone I have been taking again. I have spent several days longing for a sweet/sour pork. Not the anodyne ones bought in the supermarket and zapped at home later. No, the ones from a good take away, crispy pork balls, not over lean and a rich piquant sauce full of vegetables. Yum, yum, yum. I really love spicy hot food and look forward so much to being well enough to eat lots of it. A lamb saagwala is also high on my list of favourite food.
Day 9: more nausea and exhaustion. Didn’t want any of the Sunday roast which is normally my favourite food. Then I had a look at the trolley and thought I might be able to manage a couple of roast potatoes and gravy. I could. I even sent Martin running down the corridor after the dinner ladies for more gravy. They had to get the trolley back from the service lift – all that fuss for me. Some good friends are coming tonight and I am looking forward to seeing them.
All in all, it is going as well as can be expected so far. Fingers crossed it will continue this way. I will update you again in a few days.