Day 3 - a day of rest

Today has been great with no appointments....and not having any reason to be at the hospital. Dad had a nice relaxing day just kicking back and watching tv. I had a great time with my friends from Lincoln, Deb and Lynn, who were so very kind to drive all the way up here so we could have a nice visit and to have a get-away for me while I can still get away! We met at a local restaurant and had a great time visiting. It was so nice to see them. They are two very special people. I'm very blessed to have such wonderful friends!

I brought back a piece of cherry pie for Dad. He'll have that tonight with a glass of milk. Did I mention the fact that they encourage him to start getting as much calcium as he can before the stem cell harvesting? The reason is that during the stem cell harvesting process, socium citrate is added to the blood to prevent the blood from clotting in the apheresis machine. This is the machine that the blood circulates through, the stem cells are extracted, and the rest of the blood is circulated back to the body. This sodium citrate solution causes a depletion of calcium which can cause numbness or tingling in the lips, or cramping in hands or legs. Eating calcium rich foods like ice cream and milk ahead of time, may help. Well, that's all Dad needed to hear. He had a vanilla milk shake from Goodrich last night and tonight the milk and pie. I can see where this is going!

So the schedule tomorrow is 10:00 a dose/drip of rituxin - a chemotheraphy. It is used to purge the harvest of any lymphoma cells. It does this by attaching to any CD20+ cells. Dad's stem cell transplant is an autologous one...getting the stem cells from himself versus a donor. Normally, there are not many stem cells circulating around in the blood therefore they need encouragement to get out of the bone marrow and into the blood stream. There are 2 ways to do this. One is the Rituxin which kills off large quantities of white blood cells, which causes the bone marrow to go into overdrive to replace them. Since there is not room in the marrow for this to happen, it forces the stem cells out of the marrow into the blood stream where they can mature.

Another way is to give an injection of a growth factor...in this case called Neupogen. This drug encourages stem cells to mature very quickly into Neutrophils (a type of white blood cell). Because it causes a rapid increase of neutrophils, the bone marrow is again forced to push the stem cells out of the marrow and into the bloodstream to make room for the new cells. This is all amazing to me. The human body is a wonderous thing! So not only does the chemo Rituxin help reduce the lymphoma, it also forces large numbers of stem cells into the blood stream, making the harvesting process more successful.

Back to Dad and tomorrow. So at 10:00 he gets the Rituxin drip for 1 1/2 to 2 hours. Then he will receive a Neupogen shot. We have a break for lunch and then at 2:00 we go to a catheter care class to learn about his Hickman catheter that he will have surgically placed on Friday. I'll have more information about that tomorrow or Friday.