Bill’s Tale of Two Cancers #10

Harvest time.

I live out in the country, and that phrase usually means getting the crops to market etc., but in this case I was both the crop and the market.

The next part of my treatment was to prepare me for the process that would extract my stem cells from the rest of my blood in order to use them to help my body heal itself from both the cancer and the treatment that would hopefully eradicate the last, stubborn diseased cells in my back and hip. In order to get enough stem cells to work with, I was to receive another variety of chemotherapy, along with a blood boosting drug called neupogen that makes your bone marrow go into overdrive producing white blood cells. White blood cells are the body’s defence against disease, and your body produces them whenever it senses infection or injury, and within these cells are stem cells. These little babies are our body’s ultimate healers as they can make themselves into whatever kind of cell has been damaged, replacing what has essentially become a damaged part.

The chemo was administered to me over a three day period, and from my experience was nothing really new or shocking, although I still brace myself for the unexpected any time I’m being given something as toxic as these drugs. On the third day of chemo I was also given an injection of 30 ml of neupogen. During my previous treaments involving chemotherapy I had received the same drug for a series of injections over the leadup to each session in order to keep my white cell count at a level that allowed me to stay on schedule so that the treatment had the best chance for success. In that period, the dose was 1 ml per day for 5 days. When the drug went to work, I experinced a continuous and dull pain in the long bones of my body, because as the bone marrow goes into overdrive it literally expands within the center of your bones, stretching them outward. With each series of teatments the pain lessened as my body grew accustomed to the ebb and flow of my marrow. I thought the radically increased dosage would be terribly painful, but I was happy to realise that my body still knew how to deal with the drugs, making the effect less unpleasant than it might have been had I not been down this road before.

This little drug also came with another side effect, one which was financial rather than physical and threatened to throw the whole plan off the rails.

You see, each ml of neupogen came with a pricetag of  $797.35, in 1999. By 2004 I don’t know what the exact price was, but the 30ml dose was going to cost something over  $24,000, and neither my public or private health care plans was willing to cover the cost of the neupogen as it was deemed to be part of an “experimental” procedure and therefore not insurable.

Well fuck me gently. Here I am, halfway through the preparation for what I need to do in order to save my life and I’m running into this kind of shit. In Canada. And here I was, thinking I lived in a place with universal access to health care, following what some of the best people in the field called the only viable option to keep me alive, and I’m running into a wall because of insurance companies and their actuarial tables.

Fortunately for me, I also had an amazing nurse in my corner who cut through all the bullshit and got me my neupogen. Surreptitiously she gathered enough unused and returned neupogen that I wound up circumventing the authorities and staying on schedule for the harvesting of my stem cells.

Also fortunately for me, my body happens to process neupogen very effectively, because I’m pretty sure I set a record for being harvested.

In order to harvest your stem cells, here’s what happens : After the three day chemo and neupogen combo platter have been administered, you’re hooked up to a machine via tubes that have been surgically implanted into your heart and are sticking out of your arms and neck. Very Frankenstein. Once you’re hooked up, you sit still in a specially made recliner for four hours while the machine you’re attached to takes blood out of your body and runs it through a centrifugal pump that separates your blood into white cells, red cells, plasma and stem cells. It then pumps the red and white cells back into your body while keeping the plasma and stem cells for the final phase of treatment.

Normally the harvesting takes 2-5 days in order to have enough stem cells to continue treatment. Some people don’t produce enough stem cells to keep going, as was the case while we were touring the treatment rooms. A woman who had been coming back for something like 6 or 7 days was in for what was the last day she might be able to be harvested, as her husband told us. While we were there, she was told there was no chance her body was going to make enough cells for the transplant to continue, and that she wasn’t going to make it. Her husband was devastated, as was she, and Caroline and I looked at each other as the gravitas of our situation became even more palpable.

With that backdrop in place, I was hooked up to the machine. As with the chemo lounge, the process was weird but not painful or anything like that. It’s a bizarre sensation to watch your blood come out of yourself, get thrown through the spin cycle and then be pumped back into your body. And a bit tiring. But not all that bad, for me, and when we were getting ready to leave for the day, the technician/nurse told me that they had about double what they needed to go ahead with the stem cell transplant and that I should start getting ready for the final part of the treatment.

Right Fucking On.

The next thing I had to do was go see the dentist. I thought this was a bit odd, but the doctor explained that any teeth that had cavities or could provide an area for bacteria to gather and develop into an infection had to be taken care of before I could proceed because once I was in the isolation phase of my treatment I would have no immune system to fight off infections. In fact, they said, if you develop a fever of 1-2 degrees Celsius above normal, they basically call in the priest/rabbi/whatever because you’re a goner.

What this meant with respect to the dentist was that I had to have three wisdom teeth and one molar removed. Normally this would have filled me with dread, but at this point it was just another detail to deal with so we arranged a time for the next week and went ahead with it. As it turned out, my brother-in-law, Greg,  drove up to Peterborough and took me to the appointment, saving Caroline yet another task of drudgery and offering us an opportunity for comedy in the most unlikely of places.

Keep in mind that when I went in for the appointment, I was still taking heavy doses of muscle relaxants (2 kinds) and morphine pills. Yummy. Not to mention the stuff I was smoking in order to take away the chemically feeling that all these drugs were providing. Once in the chair I was given some lovely nitrous oxide as well as some general and local anesthetics, and my teeth came out with little of the effort i’ve heard about from so many people. As he was finishing up, the dentist asked if there was anything else I would like, and I said that yes, I would like some more of the nitrous, so he put the mask back on me and told me to let him know when I”d had enough. Guess what ? It took a while.

He then went and got Greg, telling him he might want to give me a hand as I was probably going to be wobbly from all the drugs he had given me, but Greg and I just started giggling as I got out of the chair while Greg told the dentist that I’d be just fine and that he had probably just given me the best day I’would be having for quite awhile.

Greg was right. In addition to feeling no pain, I didn’t give a fuck about anything that day.

I happen to like opiates and they seem to like me, too, and the rest of that day was spent in a blissful, druggy state, and Greg and I just laughed our asses off on the ride back to Peterborough.

Now all we had to do was wait for my gums to heal and then it was time to go back into the hospital for the actual transplant.


~ by Rocky Green on September 28, 2007.

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