Monday, May 27, 2013

Donor's Perspective part 2; Apheresis

Backing up a little, I found the email exchanges between Duke and myself and Laurie, and reprint edited versions below.  Chris
--------
Feb 6th

Laurie, 
Hey , I am NOT too old to get a transplant, and you are NOT too old to be a potential donor . Duke Adult Transplant Program wants a sample of your  HLA, and will send a kit.


Please email he duchess@duke.edu with your mailing address, and SSN,  Reference my Duke History # .
If you are a match ( 25% chance) we will fly you into Raleigh/Durham for the procedure. 1 in 4 , but hey, we may get lucky, and a matched sibling is preferable to a matched unrelated donor, which they call a MUD.

Will keep you posted, and Thanks..

CB 
 --------------
Feb 28th

Hello Mr. Siegel,

Thanks for checking in.  It sounds like you are agreeable with proceeding to transplant.

We just received the report for your sister's HLA typing late yesterday.
Congrats, Laurie is a perfect match for you!
This means we can start planning any time.

You may tell her yourself, or I can do that for you, either is fine with me.

We will also need to make plans for your sister to visit.  She would need a 1-day visit for physical exam, labs, EKG, & Chest XR, then return at least 5-6 days later to begin the stem cell mobilization process.  This requires 5-6 days of shots to stimulate her stem cells.  On the 5th day of shots we start the collection.  Collection usually takes 2-3 days.  If she prefers not to make two trips, we can coordinate her visit about 10 days before you start so everything comes together at the same time.  This means she would need to plan to stay in the area for about 2 weeks.

We can talk more about this next week, and of course, when you return.

Have a great weekend.
We look forward to seeing you soon.
Kind Regards,
The Duchess

------------

After many phone calls to schedule all the tests we both needed prior to transplant, the dates started to firm up. 
Laurie flew in on March 20, and stayed with old friends in Chapel Hill. Anne and I secured the apartment through Duke and their arrangement with Blue Cross/Blue Shield.  The target date of April 1 had been set by March 5th with  my Day of Ttransplant to coincidewith our father's bbirthday. We wound up  missing it by only one day.


I posted about this here My Sister is A Match! Countdown Starts.

Anne and I moved to temporary quarters in Durham as recorded here Moving Day .

We met up with Laurie on March 24th, less than a Month after getting the news that she was a match. Looking back, and hearing about how some recipients don't find a donor match for Months and Months, and then the donor is from afar, or even abroad , it has been really blessed the way that this whole procedure has come together - Feb 6th Laurie's sample to April 2 transplant, call it two months. And now I am at about 2 months post transplant.  A third of a year. 

OK, back to Laurie's account.

Over the Jump


The soundtrack:

Can't beat Gospel Organ.


aphe·re·sis   noun 

There seems to be some question as to the correct  pronunciation.

\ˌa-fə-ˈrē-səs\

[uh-fer-uh-sis for 1;  and  af-uh-ree-sis for 2]

So I  went to the Oxford Dictionary, and of course there is a variant spelling, (like hematology and  haematology)  aphaeresis.

Syllabification: (a·phaer·e·sis)
Pronunciation: /əˈferəsis/

At Duke many of the nurses just say free-cess.   Rhymes with recess, the a is silent, in fact it rolls off the tongue like Freezes, so when in Rome...


I knew about the linguistic application of apheresis,  or "taking away", like the silent K in knew. There is a medical meaning too, that means taking away, and is classified as an extracorporeal or "out of body" therapy, similar to dialysis.




The process of apheresis involves removal of whole blood from a patient or donor. An instrument that is essentially \a centrifuge and series of filters and semi-permeable membranes, separates the components of whole blood.. The separated portions that are needed are withdrawn and the remaining components are transfused into the patient or donor. Those components which can be separated and withdrawn, include Plasma, Platelets, Stem cells and Leukocytes.



Me hooked up to the machine with two IVs

Here I am, relaxing at the clinic, I lay still while my blood was taken out, spun around , filtered, and then put back in me. This procedure was only a few hours over the two days preceding Chris's transplant. It involved two IVs as you can see in the picture. I watched a movie on my Kindle Fire during the apheresis process.



my stem cells on the right

The next day they infused Chris with my stem cells. I stayed with Chris and Anne for another week until it looked like he was out of the woods, and then flew back to Maine to finish up my semester and exams.
Even with the interruption in classes, I was able to pass my finals with almost flying colors, and the college wants me to speak to the nursing students next year about the whole transplant process.

 It was a spiritual experience for me and I have had my faith increase by this amazing process.

I must not fail to mention the hundreds of people praying for this procedure to be the help that my brother needed. I was humbled and exhilarated to be an integral part of my only sibling’s life. To conclude that I would do it again is an understatement, I have one more year to donate and hope I will get that call. Anyone can be a match. This took a short fraction of my time and hopefully will make a greater difference in the wonderful man I call my brother.

Be the Match  is the link for the National Marrow Donor Program. Consider it.
It is interesting that after Robin Roberts of Good Morning America had her stem cell transplant ( her sister was her donor too )  that the donor registry increased dramatically. Unfortunately,  not everyone who volunteers and is found to be a match comes through. Some get cold feet, and others have scheduling problems. Even though both Chris and I were a bit on the old side to qualify as both donor and recipient, they took us because of the sibling match.


 Go to  Red Cross to find the nearest place to your location to donate blood.
I just checked by zip code for Waterville  Maine, and there are 17 opportunities in the next month!

Laurie







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