It's feast or famine on this blog. I went all last week without a post, and here is the third one in three days. Well guess what? Believe it or not, I'm back at DFCI for a third day of stem cell harvesting. Rats! It's a long story, so bear with me here.
I didn't get a call from Muriel last night because she couldn't get through to my cell phone (I have to call ATT about that...it's happened before) and I also gave her the wrong number for Gretchen's cell. If she called the house phone, we may not have heard it if it was late and we were in bed.
So this morning, she called and asked why I wasn't at DFCI! I took some umbrage at that, and asked why should I be? She explained that they only collected 2.2 million stem cells yesterday, bringing my total to 8.6 million, still short of the target. My CD-34 blood test count (measure of available stem cells) was really low yesterday, so they had assumed they wouldn't collect enough. Furthermore, she thought I had been told by the nurse yesterday that I would have come in today. I told her that nobody told me that. Oh well...breakdown in communications. At that point, I told Muriel that I didn't really feel like coming in again, and that 8.6 million stem cells seemed like a lot to me. I said I was going to call Dr. Richardson before going anywhere. (In my frustration, my Irish temper was starting to show.) She asked me if I wanted her to call him and I said, "No, I want to talk to him myself."
I then paged Dr. Richardson. When he called me back, he had been forewarned by Muriel. I give the guy a lot of credit. Not only is he a great doctor, but he has great people skills. He started the conversation by saying, "I know why you called, Bill, but first, I have great news!" He then told me that the selection has been made for the random arms of the stem cell transplant clinical trial, and that I have been selected to have a single transplant, followed by RVD consolidation therapy and then Revlimid maintenance therapy. He said that he thinks this is absolutely the best of the three arms of the trial. That is good news indeed! That is exactly what I was hoping for.
Now I ask you - how pissed off could I be after hearing good news like that? We then talked about the shortfall in stem cell collection. In his view, 8.6 million are not enough stem cells for two transplants. He likes to do a minimum of 5 million for a single transplant! He told me that based on my age, the chances are that I will only be able to get one, so I have the option of stopping the collection now. In that case, he would re-infuse all of my 8.6 million cells next week. If I did choose to come back in and get the count above ten million, he would then give me half of them next week and save the rest for a possible future transplant. My choice. Well, when he put it that way, the decision was a no brainer, so here I am, hooked up to the apheresis machine once again. I am still marveling at the way Dr. Richardson was able to get me back in here and have me actually feeling good about it.
Today may not get me there though. The CD-34 count is a rough indicator of the expected number of cells they may be able to collect on that day. On Tuesday, my CD-34 count was 64, and they collected 6.4 million. Yesterday, it was 21, and they collected 2.2 million. Today, the CD-34 count is only 9! I need 1.4 million more cells collected. This could be close! I have been informed that today is my last day here, regardless of how many stem cells they collect. Since my CD-34 count is dropping so fast, they might not be able get enough tomorrow anyway if they don't get enough today. So this is it. They will go with what they get.