Monday, November 9, 2015

Roll With the Changes

So the live blogging is on delay.

I hope everyone is excited to learn things today, because I'm going to be science-y and explain-y. For me as well as for all of you. Today's lesson will brought to you by the letter "S." I have chosen this one because "Science," but also mostly because of "Shite." Because -- Yay! no chemo treatment today, but also -- Shite! no chemo.

First thing on the agenda when you show up for chemo day is they take blood work to make sure your system is in good order and track changes from session to session. Apparently my white blood cell (WBC) count is practically nil today. The ideal range is 4.5 - 11.0 and mine is 1.7. Not only that, but my Neutrophil count is 0.2 when the range should be 1.8 - 7.7. Neutrophils are the most abundant and mature of the white blood cells and the first immune cells that move to infectious sites -- first line of defense. Not so abundant in my system today however.

This means that I am severely immunocompromised and likely at least moderately neutropenic. Remembering that chemotherapy is a full-scale system poisoning... it's not something they will do when your system is compromised past a certain point. The kind of fraked up thing about chemotherapy is that they are attempting to kill the cancer in your system without actually crossing the line into killing you and the rest of your bodily systems. It's a difficult balance to maintain sometimes.

This changes the whole way we approach my chemo treatment this course. (Quick reminder since I'm being super explain-y today: a course is 6 infusion treatments done every other week, takes about three-ish months.) During my first two chemo courses back in 2012/13, I had low WBC counts and neutropenic issues right before session number 5 each course. The first course they delayed that fifth treatment by a week. I had it in my mind that this course would be similar to the first two and we wouldn't run into the WBC count issue until session number 4 or 5 again. But here I am having to roll with the changes that keep coming with this recurrence.

The silver lining is that no one was awfully surprised with the news. It is not an uncommon thing when cancer patients have had prior chemotherapy that their system has a hard time keeping white blood cells up with a new chemo course. Apparently my body just isn't bouncing back and my bone marrow isn't producing quickly enough. Luckily there is a work-around. And I always love me a work-around. There is a drug, Neupogen, a protein form that is a colony stimulating factor which will encourage/force my body to create immune cells. They gave me a shot of it today, and I'll go back for a second shot tomorrow. Then, on Wednesday morning we will do a new set of blood work and see if my system has a decent set of WBC. If it does, then we go ahead and do chemo treatment number 2 Wednesday morning (fingers crossed everyone!).

Since we are having the WBC count problem so quickly this time, they will treat me with Neulasta (a longer lasting version of Neupogen) the day after each chemotherapy session. It should help my system bounce back each time so that we don't have any more delayed sessions. They may also decide to lessen the dosages of some of the chemo drugs in future sessions. Roll, roll, roll with things.

That's a lot to absorb, and maybe more details than needed. I've never been afraid of a bit of verbosity. And I'm certainly the type of person for whom details and knowledge bring empowerment. So for those of my friends who are the same (and I know you're out there!), this is all right up your alley. If all goes well this week then there could be super-not-exciting live chemo blogging happening on Wednesday. And if not, then there will at least be another update here. 

It's been a dual dueling working laptop afternoon on couches with my sister all afternoon. We've both been working and chatting in the spaces between and soon off to get some take-out and a movie for a relaxing evening in pajamas. Not such a bad end to a compromised day.


  1. Very glad they are mindful of being careful not to "cross that line" - Erica

  2. Isn't it funny the dichotomy of feeling that occurs in this situation? to get it over with vs getting a pass? Your outlook as always inspires me to approach my less complicated life with equanimity. Love you my dear.

  3. Quick note: as your body assimilates the EPO and GM-CSF, you're probably going to feel *really* good for a while--the new red blood cells that come along as part of the package of stimulating your lymphogenesis will carry much more oxygen and you may also feel like you can eat for days. This can be a little... heady. (I got to experience this living in ABQ and then coming back down to sea level, felt like I could run over mountains... even when I hadn't exercised in months)

    Also, good luck! *hugs*

  4. Keeping track, love you, Aunt Lenora