Every Day is Marne Gras

When you donate bone marrow, you might have a liter or more of fluid pulled out of your body in under an hour.  Post-op, you will probably become 1. anemic and 2. dehydrated.  The breathing tube they stick down your throat exacerbates your thirsty feeling, and it feels like you have strep throat and cotton mouth and you feel like a raisin all in one go.  Also, you have IVs in both arms (full of ‘rehydrating fluids’) that make it very hard to bend your wrists and elbows, so someone is probably sitting next to you the entire time with a cup of juice with a straw dangling out of it for your suckling pleasure.  Also, if you are a anesthesia lightweight, you are high as a kite and it feels like you have been beaten by a gang of enthusiastic teenagers wearing steel toed boots.  Your sore little body will refill with the rehydrating fluids and juice like a little chicken breast being pumped full of saline and phosphates, and when you realize you have to pee, it will be about fifteen seconds before you literally explode.  Having to pee when you are being intravenously pumped full of fluids is like falling asleep with sleeping pills; you never feel it coming, it’s not natural, and you better be in the right place at the right time.

When I find the words to express this, my nurse, who has received advanced training in bumping patients off her ward as quickly as possible,  suggests that I try getting up out of my gurney and walking to the toilet (a half dozen steps behind me) all by myself.

Under normal circumstances, I would take this moment to laugh hysterically and sarcastically and shame this woman for her ridiculous suggestion, but I am discombobulated and instead I try to tell her I can’t but I find myself listening to her ‘this is how we get up out of the bed’ instructions and nodding.  I’m there but I’m not.  There’s a ten second time delay on my thoughts.  I know that this is about to end in disaster, but there I am, grabbing the nurse’s elbow, grunting, and attempting to sit up.

It actually all goes according to plan (I know I’m talking about this like I’m Indiana Jones entering the Temple of Doom, but bear with me.  The toilet might as well have been in Kolkata.)  and I somehow find myself sitting on a toilet, sore and surprised.

But when I am peeing, something happens.  I break out of my drunken post op cocoon of warmth and anesthesia loveliness and the little bit of blood left in my face drains out and I suddenly want to throw up, and I realize I am freezing, I realize I have a migraine, and I realize that four holes have been drilled into my back and they are on fire.  My nurse mostly drags me back to my bed, and I shiver violently until they can find some more heated blankets to throw on top of me.  Maybe that was a little too soon, my nurse cheerily mentions at some point.  I don’t answer, because I am consumed with not dying.  I am chattering so hard I can’t speak and my head feels like a bowling ball and my mind is the metaphorical equivalent of a not especially impressive dustbunny.

I need a blood transfusion.

This was mostly expected– the woman I did this donation for needed a large donation, larger than what I could safely give, and so I was slated to donate the maximum possible amount of bone marrow my body could reasonably be expected to part with (given my body weight– around 1100 mls).  The marrow is retrieved by drilling into the hip bones, through the bone and muscle, and the bone marrow is extracted with a hollow needle inserted into the cavity.  The recipient will then receive my marrow, which is full of my kick-ass healthy, normal stem cells, intravenously.  The general concept is that yours and my stem cells can become any kind of cell, and once they enter this woman’s body, where her bone marrow has been nuked out of her through high dose chemo and radiation just prior to the transplant, they will realize that they need to become blood cells, and they will multiply like they do, and give her new, awesome, healthy blood/bone marrow, etc.

The high dose chemo and radiation can kill the recipient (it wipes out her entire immune system; the recipient is quarantined while this is happening, and the slightest infection can turn into pneumonia and become fatal).  No one is allowed to tell me if my recipient has made it far enough along to receive my donation.

This procedure makes a donor anemic.  In anticipation of this moment, the donor is asked to bank a unit of blood for themselves prior to the surgery.  Two weeks ago, I visited the Puget Sound Blood Center and expelled a unit of blood to be put back into myself at this moment.  Donating for yourself is called an autologous donation; when you bank a baby’s cord blood in case the baby becomes sick in the future, this is an autologous donation; you can use your own healthy stem cells to fix yourself.  This is ideal.

I am so dizzy and cold and migrained that I can’t focus on anything when my surgeon comes in to tell me that they’re retrieving my unit of blood from the blood bank.  They are going to put it back in me.  It should help.  I am fevering.  I am freezing.  In the meantime, I ask for socks.

When I arrived at the hospital before surgery I was wearing a sweatshirt, a pair of flannel pajama plants, and a pair of plain, black trouser socks that I usually only wear with my fancy shoes when I have a job interview.  The socks belonged to an ex of mine who left them at my house by mistake, and when the nurse finds them and puts them on my feet for me, I try to think about a few good memories of the girl who came with the socks to ease my fears about the fact that I am now convinced that I am actually dying.  I have never had major surgery before, and I am a worrier and a hypochondriac.  Where is my blood? Maria holds my hand.

(The next few times I have to go pee, they give me a bedpan, a yellow, plastic, flimsy thin that is laughably nowhere near the size of my posterior.  I know it should be embarrassing but I feel nothing but relief for this nurse who is so gentle and responsive, and that is when I realize how sick I feel, when someone else helping me pee is something I am grateful for rather than upset by.  At one point I pee on my socks and my nurse, who has been very kind if a little overzealous, peels them off of me and moves towards a trash can with them and I find it in me somewhere to scream at her and tell her that my peed-on trouser socks have ‘emotional meaning’ because I can’t remember the slightly less creepy phrase ’sentimental value’ and don’t even think about throwing them away, please.  She puts them in a plastic baggie and gives them to Maria.  A week later when I can finally go up and down stairs reliably again, I wash them.)

Eventually the unit of blood arrives and it makes me feel less panicky and eventually the blood begins to return to my face.  Somewhere between three and five hours go by, and eventually my blood pressure creeps back up into almost normal territory and I feel more human than apparition.  The migraine, fever, and chills that began with my bathroom trip have not abated, but I am no longer convinced that I am fading away.   I have reached something resembling stabilization; the nurse informs me that I am ready to be shipped off to a private room, where I will get a door and a tv and privacy in exchange for not getting an individual nurse all to myself.  Because I have had a transfusion, I need to stay overnight for observation (it also doesn’t help that I can’t yet walk, having refused to get out of my bed since the bathroom incident several hours prior)

The few times I have been in hospitals prior to this stay, it is because someone close to me was dying.  I had never experienced hospital smells or tastes or noises or hospital people at great length until my grandparents died and it felt every bit as terrible as people who hate hospitals told me so.  When I am wheeled into my new private room for the first time, however, I feel like I have won the lottery.  Everything is bright and clean and friendly and beautiful and this private room is so much nicer than the recovery room that I want to cry with happiness.  The nurse who accompanies my transport tells me that when I’m feeling up to I can order whatever I want off the room service menu.  This hospital room is the best thing that has ever happened to me.  Every part of it glows.

Ten minutes after I am moved through the winding hallways and elevators to my own room on a high-up floor with big, beautiful windows that overlook pretty things, a nurse comes in to tell me that there’s been a mix-up and as an anonymous donor (meaning a National Marrow Donor Program patient), I cannot stay in my room because there are other transplant patients on this floor and confidentiality blah blah blah and I start to cry.

I cry because Maria has gone to run some errands and I am afraid she won’t be able to find me in this big gargantuan scary place when she comes back if I have been moved again.  I cry because they want to move me to another recovery room like the one I just left, the kind with curtains instead of rooms, where you are basically a patient in a bed in the middle of a floor of nurses, like a big cat on display at a zoo.  I cry because I am in a lot of pain and the whiteness and cleanness of this room is instantly comforting and all I want in the world is to sleep in this room on the high up floor and order orange sherbet when I wake up.  I cry and cry and cry and the nurse who delivered this news to me, the head nurse for this floor, sits next to me on my bed as I sob, taking in the whole scene.  She says that people are often weepy after the anesthesia.  Do I think I am weepy because of the anesthesia.

I am thinking a long string of expletives, and this woman is not going to leave my bedside before I figure out how get a few of them out of my mouth.  Finally, in between huge, uncontrollable waves, I practically choke on “I AM CRYING BECAUSE I DON’T WANT TO MOVE ANYMORE.  LET ME STAY HERE”.  And then I cry and cry and cry some more, and it is damn convincing because it is not an act, even though I know in my head that this scene is probably helping my case quite a bit, and the head nurse disappears to ‘talk to the surgeon about this’, and she comes back a minute later to tell me that if I am very quiet and I do not talk to the other patients on the hall (meaning I do not tell them that I anonymously donated bone marrow to a leukemia patient), then I can stay.  I cry in a happy way now.

The head nurse leaves and I turn on my private tv and rest in my private bed until Maria comes back.  I am three quarters asleep when she walks in, as Michael Phelps is winning yet another gold medal on the tv.

Later in the evening I use my room service privilege to order Maria a three course dinner with soup and crackers for me.  Maria has been watching tv and me for hours upon hours now, holding my cup of apple juice up for me, fluffing my pillows, phoning in reports to my mother, and generally functioning as another nurse. In my pathetic, space cadet voice I cajole her into calling another friend of ours because at 8pm I think it would be a fantastic idea to have a party in my swank, private room.  I look and feel terrible, but I am arguably beginning a slow and steady climb back up.