Day Zero

Day Zero is the day the collected stem cells are returned, a new birthday for my bone marrow and all the blood cells that are made there. For me, that day was today. We started at 5:15 AM (these hours!), and finished at 3:00 PM or so. On the surface, it is a pretty restful day, in which I lie in bed (and Liz has a reasonably comfy recliner) and have fluids dripped or pumped into the central line. The only interruptions being frequent trips to the bathroom because of the high volume of fluids. The nurses treat the cells gently, thawing in a water bath and using gravity to feed them into the line, which runs slightly pink because a small percentage of the specimen consists of red blood cells that do not survive the freeze-thaw process. The stem cells survive in part because a preservative called dimethyl sulfoxide (DMSO) is used that buffers the cells from the rigors of freezing and thawing.

Besides the cells and massive doses of saline, I'm given tylenol, benadryl, and cortisone to prevent any short term allergy-type reactions (mostly, it seems, to the DMSO). We are also told that the DMSO, presumably because of its sulfur content, can produce bad smells and tastes that come right out of me, but are noticeable and unpleasant for those around me, too. Combined with the deodorant ban, this could be a difficult period, although minor in comparison to the nausea, vomiting, and diarrhea that I'm promised.

So far, none of this has come to pass. Mostly I'm just tired, as my red blood cell counts drop toward anemia, and at the same time the engraftment process will start to make use of the suddenly-depleted energy-delivery mechanism.