T + 470 Panic in Detroit - it's Robocrap.

Well sitting here in my Spitfire pilot outfit sucking on the old Ricola nebulizer - thought I might as well update.

Haemoglobin finally stayed up at 10 today so off across the ghetto to Guys for another photo-pheresis (PP) session. Transport did not screw up today and were only an hour late. The driver told me that they have 90 minute window on times quoted so I'll have to factor that in next time. Only a half hour wait for the lift back so none too shabby all considered.

It was plain to me earlier this week that my blood content had dipped, usually it’s a rich ruby red colour (when goodish) but looking at it going through the plastic tubes it looked more like raspberry juice. I asked one of the nurses to take some pics at Guys today to better illustrate what happens at PP. I've already put the pics up on Facebook, but for those of you who can't see my page I've reposted below.

The first stage is when a dirty big needle is inserted in the biggest vein of each forearm - the right hand tube feeds into a centrifuge, you can see it just below the monitor screen, which spins off the White Blood Cells (WBC) from the rest of the blood content. This takes between 60-80 minutes depending on levels of hydration and vein condition. The optimum extraction rate is 50ml per minute and 90% of the time I’m up to this – you really need to plough through the liquids the day before to boost hydration. I've got two decent veins left on the inside fleshy part of each elbow which I save for PP, because if they put the #14 needles in smaller veins, an element of discomfort is experienced (hurts like fuck).
Being a typical male twat, if I'm hooked up at the same time as a fellow patient, it's instantly a competition to see who can finish first. Fun comes in small packages these days...

At the end of stage one the PP machine will have processed approx 1500ml of blood yielding about 300-350ml of WBC, you can see the bags at bottom left and right. It is at this point the nurse injects a photo-sensitizing solution into the WBC bag (cue to don sunglasses) before it is fed into the long curved module at bottom centre of the unit.

Look at all my lovely GORE!

This contains a clear plastic maze a bit like an ant farm with UV lights on either side through which the blood is fed to be exposed. The thinking behind this is that the T-cell component in the WBC is reduced by being damaged or killed during this procedure. T-cells are the aggressive little bastards that have been causing GVHD in various parts of my anatomy. They do apparently calm down and assimilate of their own accord eventually, but the timescale on this is uncertain and PP is seen as a good way to accelerate this. Once the UV exposure is complete, both bags are transfused back into the left arm which takes about 15-20 minutes. I’m scheduled to be at this twice a week every other fortnight so it’s fingers crossed for some meaningful change soon. I'm pretty sure my mouth is improving incrementally with each visit. The only real downside I've experienced from these sessions is fatigue for a couple days after.

In spite of leaving details with all and sundry of my meal choice if I was not back in time to order it, this somehow slipped everybody's minds and the stuff that they had in reserve was grey mince school dinner style or beef stew and dumplings. Those of you who read the blog last year when I was in for the transplant may remember that I found a sodding toenail in my mouth when I was halfway through my last KCH beef stew, so that's coming nowhere near me for starters.

Fortunately a new franchise has opened in one of the restaurants so I packed down a hot Steak and Monterey Jack Sub like a python hoovering up a puppy and then bought a bunch of crap from the other hospital shop, lovely what you can get away with eating when you look like shit anyway.