Neupogen

I hated the sight of needles growing up. I would always turn my head away as the sharp metal went under my skin for a vaccine shot. Even as a 24 year old, Nurses would have to remind me to exhale as I would unknowingly hold my breath during a routine blood draw. About 2 years ago, there was an incident at an injection clinic when I almost fainted. The room got very dark and my ears were ringing. I had to lie down and drink some water for a few minutes. I wouldn't say that I was deathly afraid of needles, but there was just something unnerving about the whole process that would cause an elevated beat in my heart, cold sweat to form in my palms and my mouth to dry up like I had just swallowed a spoonful of sand.

(Side note: I totally understand why people who are afraid of needles refuse to register to become donors. I never said it was easy to become a donor. It is a huge sacrifice and a very serious commitment. However, if you could overcome your fear of needles, YOU COULD SAVE SOMEONE'S LIFE....)

Never did I imagine that I would one day have to give myself daily needle injections.

This entry is about how I give myself shots to boost my white blood cell count. It's been about 2 months since my last shot of Neupogen (10/30/07) so I want to write down my notes in case I ever need to give myself one again. It's pretty amazing how fast I forget things these days. I'm just writing this down for myself. Maybe it will help some other patient who wants a refresher from the training he/she received in the hospital, but please note, I am not an expert. This is what I learned during my training session and I would recommend using the instructions your doctor gave you. I was considering taking pictures of me giving myself a shot, but I didn't want to gross people out.

How Michelle shoots up -
1. Get all of your supplies ready. I take my vial of Neupogen out of the fridge for about 15 minutes before my shot because I heard it can sting when the medicine is cold. Open up about 3 packets of alcohol pads for cleaning. Also open the package that the syringe is in. Lay the syringe on the package until you are ready to use it.

2. Give those hands a good scrub with antibacterial soap. When you are done try not to let the water run down your fingers. Stick your hands upward so the water runs down your arms. Dry with paper towels NOT cloth towels because the cloth might carry bacteria.

3. Remove the cap of the Neupogen vial and use an alcohol pad to rub the rubber top. Rub for about 30 seconds.

4. Take the syringe, with the cap on, and make sure that the needle is secured tightly on top. The needle I use is a twist-off so make sure it's on tight by twisting the top part with the cap on clockwise.

5. Remove the cap on the syringe. Draw the syringe plunger back to fill it with air equivalent to the same amount of neupogen you will be administering. I get 2mls per shot.

6. Pierce the rubber top of the vial at a 90 degree angle with the needle. It's okay if the needle doesn't go in perfectly straight. Just don't bend the needle.

7. Push the plunger so that the air in the syringe gets pushed into the vial. This will cause air pressure so that the medicine will easily flow into the syringe.

8. Turn the syringe upward (the vial will be upside down). Pull the plunger back so that you get 2mls of the neupogen. While you are filling the syringe make sure the needle is always submerged in the liquid to avoid air bubbles. To do this, you will have to slowly move the needle downward.

9. If you get air bubbles flick the side of the syringe with your fingers so the bubbles go to the top. Push the plunger to push the bubbles back into the vial. Continue the pushing and pulling until you get the right amount of the medication. You may not be able to get all of the air bubbles out, but try your best.

10. Pick an area about 2 inches away from your belly button. Clean your skin thoroughly with an alcohol pad.

11. With one hand, pinch your skin with your thumb and index finger. With the other hand, hold the syringe like a dart. Insert the needle into the skin at a 90 degree angle. Sometimes the needle may not go in at first, you may need to add a little force. After the initial puncture it should slide in easily. Only push it until the needle is completely inserted into your skin. Don't push it too hard.

12. Let go of the pinched skin and then slowly push the plunger inwards until all of the medicine goes in. I've noticed that doing this slowly reduces the amount of bruising. (At this point, remind yourself to breath!)

13. Pull the needle straight out of your skin. Do not put the cap back on (so that people know it's been used). Disposed the open needle in a coffee can or yogurt container.

14. If the area is bleeding, gently wipe with an alcohol pad.

Seems like a lot of steps, but it becomes quite routine after the first couple of times. It takes me only 2 minutes to perform the whole process now. I still have to get myself mentally fired up everytime I give myself a shot, but it's a piece of cake.

Tami Le

I wish there was a switch. A switch that you could flip at the end of your life when you are ready to go. A switch that ends all of the pain and suffering. A switch that stops the destruction the cancer is doing to your once healthy, strong and beautiful body.

On December 29th, 2007, my boyfriend's dear aunt, Tami Le, passed away at the young age of 57.

Co Tam was diagnosed with breast cancer 10 years ago. She persevered through a tough treatment plan and even had to undergo high dose chemo and an autologous stem cell transplant (a once-popular combination therapy that fell out of favor as a treatment for breast cancer). Co Tam successfully kicked cancer in the ass and enjoyed the next 10 years with her daughter Michele, her two adorable dogs (Rocky & Rolly) and countless friends and family.

Unfortunately, the cancer slowly creeped back in and a few months ago she was diagnosed with Stage 4 cancer as it had spread to her lungs and intestines. Over the last couple of months her health quickly deteriorated. The space around her lungs filled up with fluid making it very difficult to take in a full breath. What was once the most natural and automatic process of the body, became the most exhausting and frustrating struggle. Her energy was completely used up on the strenuous exercise of breathing which made it difficult to do all the things she loved most (dancing, singing, playing with her dogs, etc). Nevertheless, she remained hopeful and would never turn down our requests to visit her.

My boyfriend Van and I spent the day before she passed at her bedside with all of her many loved ones. We sat there in silence and watched her. Though you couldn't read her closed eyes and she was much too weak to even whisper a single word, we could sense the enormous amount of discomfort she was in by observing those frowning brows across her beautiful skin. We wanted the pain to end and were telling her that it was okay to let go. We thought she was going leave us that afternoon, but being the fighter that she was, she clung on until 11:03pm the next day to spend just a little more time with her loved ones. It was heartbreaking to see her go, but I feel relieved that she is no longer suffering.

This past year I felt extremely connected to Co Tam because she was one of the few people that really understood what it is like to be in my shoes as a cancer patient. She was extremely supportive and shared her own experience with me so that I could become a smarter and stronger patient. I always admired her for her determination and perseverence and I will continue to look to her as an inspiration to never ever give up.

Happy Belated Turkey Day!

Not much to report. I am still just hanging out. Thanksgiving was spent with my family and Van. My younger Big brother Michael did all of the grocery shopping and Melanie and I helped him cook. I have much to be thankful for and it meant a lot to me to spend Thanksgiving with the people that matter most. I am looking forward to many more turkey dinners to come.

My white blood cell counts are finally stabilizing. With my new and improved immune system, I have decided that I need to get out of the house and be productive. My first idea was to start training Marshawn to become a therapy dog...you know the pets that visit senior citizen homes and hospitals. I think Marshawn would do a fantastic job because he is very sweet, friendly and smart. Plus he definitely brings sunshine into my life and I would love to share that with people who need a bit of cheering up. Unfortunately dogs have to be atleast 1 year old. :( Luckily I found a couple of other volunteer opportunities to keep myself busy.

I am tutoring at John Muir Elementary School in San Francisco on Thursdays with the Tzu Chi organization. We help the kids (1st - 5th grade) with their assignments. I've always loved working with kids and this was a great program to join. The kids really enjoy the one-on-one attention they get and some of them need a lot of help because they are quite behind on the fundamentals.

I also just started working at the AADP to set up a more structured volunteer/internship program. Hopefully we can get people to volunteer regularly at drives. I've noticed that most drives are run by the patient's friends and family, but it would be nice to have a core team of volunteers to work at any drive when needed.

It makes me really happy that I am able to dedicate myself to some great organizations. (Now I don't feel so guilty about all of my hours spent watching the Food Network channel and my new favorite reality show Jon & Kate Plus 8.) Please let me know if you want to join me! Both Tzu Chi and AADP can use all of the help they can get.


Love,
Michelle

P.S. Our new donor count is 1945. Big thanks to KPMG SVO, Most Holy Trinity Church, Great Exchange Church, Kaiser and Wat Buddhanusorn Thai Temple for all of the support and amazing results!

P.P.S. I'm running out of locations to host bone marrow drives. If you have a venue in mind please let me know!

Drives in So Cal

**Quick update on things..I went to see Dr. X on 11/2 and he said that my blood counts need to stabilize a little more before I can get the bone marrow biopsy done. He believes that it'll be at least 2 more months before I will get the biopsy. Hopefully shortly after that I can get the groshong catheter removed. I'm a little bummed because I was hoping to get both of these procedures done last week. (I can't wait to take a normal shower without having to worry about the catheter in my chest.) I'm going to spend the next 2 months building up my strength and energy so that I can ease back into "normal" life.

Most of the drives that we have organized have been with the Asian American Donor Program in the San Francisco Bay Area. However there are many other donor recruitment organizations throughout the US that you can contact to get registered if you don't live in the Bay. The organization in Southern California is called Asians for Miracle Marrow Match (A3M). This month they have planned many drives in So Cal and Houston to help me find a match. If you or your friends and family are in So Cal or Houston, please check out A3M's upcoming drives!

1) 11/11/07 From 12 pm to 3 pm at Vietnamese Baptist Church of South Bay - 2051 W 236th Street, Torrance, Ca 90501
2) 11/13/07 From 10 am to 3 pm UCI Campus, Irvine, CA
3) 11/13/07 From 10 am to 3 pm UCR Campus, Riverside, CA
4) 11/14/07 From 10 am to 3 pm UCI Campus, Irvine, CA
5) 11/14/07 From 10 am to 3 pm UCR Campus, Riverside, CA
6) 11/14/07 From 9 am to 3 pm UCLA Health Dpt, Los Angeles, CA
7) 11/15/07 From 10 am to 3 pm UCI Campus, Irvine, CA
8) 11/18/07 From 8 am to 12 pm Our Lady of LaVang Church - 288 S. Harbor, Santa Ana, CA 92704
9) 11/20/07 From 10 am to 3 pm UCLA Campus, Los Angeles, CA
10) 11/21/07 From 10 am to 3 pm UCLA campus, Los Angeles, CA
11) 11/23/07 From 8 pm to 12 am Our Lady of Lourdes Festival, Houston ,TX
12) 11/24/07 From 10 am to 12 am Our Lady of Lourdes Festival, Houston, TX
13) 11/25/07 From 10 am to 12 am Our Lady of Lourdes Festival, Houston, TX

Hooray to Lend a Hand!

Lend a Hand did an awesome job organizing the drives in Houston this past Sunday. LAH volunteers created posters and flyers and spoke on local radio stations. All of their hard work really paid off because they ended the day with 244 Vietnamese people registered! A Gulf Coast Blood Center recruiting coordinator sent an email afterwards and wrote "I wanted to see what the Houston donor center has done in the past. Houston has registered a total of 542 Vietnamese, since 1991. From Jan. of 2006 to Jan. of 2007, we only registered 97. Needless to say, you all were very successful this weekend!"

I am ecstatic about LAH's success! In just one day, LAH increased the Vietnamese donor count in Houston (that took about 16 years to build) by almost 50%. LAH is not stopping yet either. More drives are in the works and LAH is hoping to get hundreds more to register.

Bravo LAH. One of these days I would love to meet you and give you all big bear hugs!

Isn't it amazing what people can do when they come together to fight for a cause???

P.S. Project Michelle has helped register 1524 people total! :D

Cal Drive Great!!

Although my last entry was a bit of a downer, I do have some really good days that lift my spirits. For example, our Cal Bone Marrow Drive was a huge success. Over the 2-day drive we got 344 people registered. Additionally, over 75% of the people who registered were ethnic minorities. These are amazing results! I am so grateful to the student volunteers that spent hours under the scorching sun to flyer (I haven't sweat that much in a long time). I was impressed at how effective the volunteers were at explaining the process and alleviating people's fears about donating. Everyone did an amazing job.

Thanks to all of the volunteers and people who got registered. Special thanks to Tony Tran (Lambdas), Chen Lu (Engineers Joint Council) and Brandon Hogstad for their extra hard work. Lastly a gigantic thank you and hug to Glenna Lee from AADP for helping me spearhead the event.

This event really showed me that the success of a drive depends on good marketing, good location and most importantly good support from the sponsor group. Who else is excited about Cal Bone Marrow Drive Spring 2008???? :D

P.S. Please check upcoming drives on our calendar. We are going to have a busy November. Additionally, there are a bunch of drives this coming Saturday, November 4th, in Houston hosted by the Lend A Hand VYO, Inc. If you can't make any of these, check out AADP's website for a full listing of upcoming drives in the Bay Area.