The second phase, or I should say 3rd since the lab work to separate the stem cells from the marrow happened between Monday and today, is probably the most complicated and last year definitely the most painful for Dave. First, they have him curl up into a ball as tight as he can so that the lower-lumbar area of the back is curved. This opens up the spaces between the vertebrae as wide as possible. Then they insert a long, thin needle through the gap and into the sack around the spinal cord where the spinal fluid is at. This needle is again very much like the type you may have seen used for IVs, with the removable insert for after the needle is place. They then remove a small amount of spinal fluid, one drop at a time. 
Once this step is done, they fill a syringe with the now concentrated stem cells – remember the apx 175 ml from Monday? It is now around 4ml. They used a bit of the removed spinal fluid to “swirl” around the container with the stem cells to make sure that 1. They have all of the stem cells in the syringe (or at least as many as possible) and 2. To make sure they have as close to if not exactly the same amount of fluid that they just removed. This second part helps to keep the disruption to the pressure inside the spinal column to a minimal.
Finally, the mixture is VERY slowly pushed back into the spinal area and again yes, just a bandaide to cover the injection site. The hard part last year came about 30 minutes after the injection, when the headaches started to hit. Last year, Dave was in quite a bit of pain until the evening of the day following the injection and the ibuprofen that they had given him did not help much at all. This year we asked as soon as the procedure was done, if he could have the Ibuprofen to make sure that he was at least ahead of the pain enough to keep it under control. The second miracle of the day happened, it is now 4 hours post-injection and he has not experienced ANY pain. No, I did not forget how to count . . .
The first miracle of the day was just before the injection. We met with the doctor just before Dave hopped on to the table. Remember Monday, when I told you about how they were able to get the extra marrow this year compared to last . . .wait, let me back track a bit . . . sorry for the suspense. Usually when they do a stem cell injection, they are looking for 2 things. The first is the stem cell count. They aim for a count of about 2 million stem cells in the injection, average is around 4-5million. The second is the viability of the stem cells that are present. Last year Dave’s were around 98%, which is very good, which is why he did so well even though he had a lower count than desired. Ok, here is the miracle part. This year his cells were 94% viable, which is still really good, but the count was . . . ok, are you sitting down? . . . actually, maybe you should be standing up, sitting down is awfully cliché . . . I mean really, usually when people hear something exciting and they’re sitting down, they just jump up anyway, so why not just start there . . . which reminds about this time . . . just kidding . . . his count this year was 11280000 . . . don’t count out the missing commas, I’ll spell it out . . . that’s 11 MILLION, 280 thousand stem cells! Kind of worth the suspense, eh? Well, I enjoyed it anyway. I mean look at your face!
My creative writing teacher would be so proud. Anyway, we are back in the room. Dave is taking a nap and still no pain, which means we will actually have an extra day (tomorrow) to do some sight-seeing. We are trying to plan something exciting since we didn’t think we’d be able to do them this visit. I know, again with the suspense, but I’d hate to ruin the surprise. Besides, it gives you something to look forward to read tomorrow!
Thanks to all of you for reading our blog and keeping Dave in your thoughts and prayers. They are working!!!!
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