Getting Plasmapheresis For NMO

Plasmapheresis is a complex therapy which I’ve undergone four times in my journey with neuromyelitis optica (NMO). Every time I’ve completed a treatment my results are phenomenal.

But what is plasmapheresis? “Plasmapheresis is the process healthcare providers use to obtain plasma from blood. Plasma exchange is when providers use plasmapheresis to replace plasma. The process involves using a machine to separate plasma from blood and then returning the blood to the person receiving treatment.”¹

Is getting plasmapheresis scary?

In my opinion, the scariest part of the whole treatment is the initial part of the process, getting a catheter placement. For me, all four times of getting plasmapheresis, when getting my catheter line were placed on my right neckline/ chest area, it was always a scary experience.

I always thought what if they don’t place the tubing in the correct place or worse, let me bleed to death. I watch too many scary movies.

Catheter placement

I was brought to the operating room and under local injection of lidocaine had a line placed. It took about 45 minutes in total (not counting the cleaning prep work). It was uncomfortable because of the position I was in, but I also felt the itchy, stinging injection of lidocaine. Funny how I get itchy in the wrong spots at the wrong time.

Once the team of doctors found the correct size catheter for the area, then continued some pulling and tugging of the line to put it in place. It’s very uncomfortable.

After the catheter placement I started my first treatment of plasmapheresis. This was done by the hematology department. Before starting the plasmapheresis treatment, a series of paperwork had to be signed and blood work done, specifically checking for hematocrit levels.

Because the line placement was done in of the major veins it was very important to take things very slow. This was to prevent falls or anything that could cause bleeding. Infection and death was a major risk in this treatment due to the nature of the incision, line placement and treatment.

Getting plasmapheresis

When the plasmapheresis treatment started there was a lot of verification of identification that needed to be done between the doctor, nurse and myself. After all, we were replacing the plasma in my blood so mistakes can not be happening. Albumin was going to be used for my replacement because my bloodwork was good at the moment. If there was a time during my treatment that my hematocrit was not at a good level, then they would have used donated plasma.

There was a big machine placed next to my bed with a lot of buttons, a twirl line warmer, hanging hooks on the top, and a digital screen. Before getting hooked up to this machine to get started, the sight and line must be cleaned thoroughly. Blood goes down one line, into to the machine which then separates the blood and plasma, discarding my plasma into a hanging bag, then return my blood through the spinning warmer with albumin.

They constantly asked how I was feeling and gave me Tums for calcium. The treatments lasted about 3 hours with an additional 2 hours of prep and post.

Feeling the difference

In my experience I’ve found that my body reacts better to albumin replacement rather than donated plasmas. Very few times I was given donated plasma because my hematocrit levels were low and by my body needed more time to produce.

In total I had 5 sessions of plasmapheresis on every occasion. Treatment was done every other day. By the third cycle of treatment, I could start feeling the difference. Of course I was tired from what my body was going through, but I could feel the change in me. I was going from weak to strong. I measured this through my strength when getting up from a chair and the strength in my legs.

Goodbye old antibodies

At the end of every treatment, I always take a picture of my old plasma as a reminder of my fight with NMO and then throw it away in the trash. It feels good to throw away those old, bad antibodies and know I’m on the road to recovery.

I understand that plasmapheresis is temporary fix to this incurable disease, and I’m reminded every time I do this treatment. My response is always along the lines of, until there is a cure for NMO I will always fight for quality of life.