The tale of Punxsutawney Neutrophil and his friend, Punxsutawney Stemcell
Monday 9th July
Early start from Derby to arrive at Nottingham City Hospital for around 0800. The haematology day case unit opens at 0815 and I join the queue to report my presence. Name, date of birth, first line of address ritual completed, I’m shown quickly into the stem cell unit and introduced to Pooh, the centrifuge. However, they need to check my blood first for red and white cells and if they’re at an acceptable level, for the CD34 glycosylated transmembrane protein – it indicates if there are any stem cells to harvest.
Minutes later the initial blood test results come back. They’re not pretty and explain the general lack of energy, breathlessness and grumpiness I’ve felt over the weekend. Almost zero platelets, precious few neutrophils and very low haemoglobin.
They don’t bother with the CD34 test and instead I’m given my first ever blood transfusion – two units of the finest irradiated A+ from Sheffield plus a bag of platelets. This is then followed by a double dose of Lenograstim.
I’ve packed an overnight bag ‘just in case’, so I decide to stop in the Hospital Hotel. A good choice – I manage to get a decent amount of sleep, even if it’s impossible to get more than beans on toast or a very well done jacket potato anywhere on the hospital campus after 6pm.
Tuesday 10th July – Groundhog day
After breakfast in the hotel (cornflakes, orange juice, toast and marmalade, tea) I walk the 10 minutes back to the haematology unit. Name, date of birth, first line of address ritual. Bloods taken.
This time the results are better – Punxsutawney Neutrophil(*) sees his shadow as the count is above 2.0, I have platelets but I’m still too anaemic to be put onto a centrifuge. They send off for the CD34 score anyway – it comes back as 2. 10 is the minimum required for the harvest.
Time for another two units of blood and another double dose of Lenograstim and home.
Wednesday 11th July – Groundhog day
The light traffic on Nottingham’s roads after the England World Cup defeat to Croatia means that I get to the unit more than half an hour before it opens. At 0815 the name, date of birth and first line of address ritual plays out again. This time my blood test results are very good (and I can’t believe how well I now feel compared to Monday), but the CD34 indicator is only 5.9.
Home early with another double dose of Lenograstim.
Thursday 12th July – Groundhog day
0815. Name, date of birth, address. Blood tests. Everything excellent – but the CD34 count is 9.66 – 0.34 below the level required for me to go on the centrifuge. The big guns are called out in the shape of a Plerixafor injection (cost to the NHS – a snip at £4,900) that has to be given at 5pm. Oh, and another double dose of Lenograstim injections for good measure.
Jane and I head off into Nottingham for lunch. It’s the first time I’ve been in a big crowd of people for weeks and it feels slightly disorienting. Lunch at Bistrot Pierre is a novelty – I enjoy my Boeuf Bourguignon followed by crème brûlée (I am a child of the 70s) but Jane’s salad is pronounced disappointing. Back to the hospital for the Plerixafor, with a side dish of double Lenograstim.
Punxsutawney Stemcell will definitely see his shadow tomorrow. Or today. Time has ceased to have very much meaning this week.
Friday 13th July – Groundhog day
0815. You know the first bit by now. The CD34 count comes back above 25 so we’re good to go. Punxsutawney Stemcell has now also seen his shadow and the wait is over. I’m plumbed into a centrifuge called Jessie (much to my youngest daughter’s delight) via my Hickman line. Around 5 hours later there’s a bag of plasma and stem cells. It’s not quite over as they need to count them – 2 million will make for a successful harvest.
I’m called at home just before 5pm. 2.86 million stem cells have been collected. Groundhog day is finally over.
Now, as they say, comes the difficult bit. But September will take care of itself. For now, I have a few weeks to get some strength back and prepare for the final challenge.
(*) With thanks to Gail for coming up with this pun!