So today I started round 6 of my chemotherapy -- finally. Each round is a month and is comprised of a chemo treatment, followed by a week off, follow by another chemo treatment and then another week off. In total, each round has 2 treatments and 2 off weeks. So in short, what that means is that I had my 11th treatment today. Doing some quick math (and with out a calculator), if my total treatment protocol was 12 treatments, and I've completed 11, then I only have 1 remaining. (oh boy, it looks like I've been reviewing too much elementary school math homework lately).
I must admit I was a bit apprehensive today, prior to my blood test results. My fear was that my white blood counts had tanked to a level where it wouldn't be safe to administer the next chemotherapy infusion. It's been a very long ride so far, so I dread the possibility of any further delays.
Fortunately, even though my neutrophil count dipped a staggering 1600 points in the past week, to 760, it was just high enough to allow for chemotherapy today. So the good news is that I had chemo today and we're getting closer to the finish line. The bad news is that I had chemo today and FEEL like I had chemo today, a bit toxic and nauseous. But this is old hat by now and will eventually dissipate.
I will still have to be extra careful as we enter flu season to keep my distance from anyone with the sniffles or otherwise and be sure to continue with my dietary restrictions to limit any possible exposure to food-borne bacteria.
For now, my immediate goal is to stay healthy enough for next couple of weeks, so we can wrap up with the last treatment on October 8th. Then I can focus on the more important issues at hand, like what I'm going to be for Halloween this year!
That's it for today. Thank you for reading. I'll write again when I have some new information to share. As always, please go out and do something positive today, hug a loved one and count your blessings.
Glenn
Thursday, September 24, 2009
Saturday, September 12, 2009
It's All in the Numbers
From the time we are very young, we are focused on numbers. During our early years it's about school grades and test results, MCAS scores and SAT results. As we get older it's about college entrance exams, GPA's and starting salaries. Once we begin to settle into our adult lives, the most interesting numbers become, tracking Tiger's strokes upon the leader board during the latest tournament, how the Red Sox are doing in the standings and whether the Patriots will have enough wins this season to take it all and regain the Super Bowl title. For the most part, these are all fun numbers to track.
Well, for cancer patients, the focus can be slightly slanted on a new set of number...blood counts. For me personally, my weekly focus is on my White Blood Counts. The chemo therapy I've been receiving has done a good job of killing off the cancer cells, however it's also done an equally good job of killing off the healthy white blood cells, especially the nuetrophils, the unique white cells that protect me from infections.
Over the last several weeks, I've experienced some depleted "numbers" due to chemo's unrelenting assault on my white blood cells. A healthy person will have a total white blood count in the range of 4,000 - 10,000 with the all important neutrophil count (the cells that fight infection) in the range of 2,500 - 5,000.
Throughout chemo therapy my counts have been a bit lower, with my neutrophil count commonly dipping below the dreaded 1,000 range, triggering "Neutropenia" and requiring special precautions including a restrictive diet and every effort to avoid exposure to bacteria and potential infection.
A few weeks ago I hit a new low. It started on my normal weekly visit for blood labs on Thursday, August 27th. My neutrophil counts had dropped to below 700, so I was officially neutropenic. The problem with taking a static blood count is that the doctors don't know in which direction my counts were going...was I recovering and my counts going up, or was I continuing to crash and becoming more vulnerable to every sneeze, cough and germy hand shake in the outside word?
So the doctors asked that I return on Monday for another set of blood tests. The results were staggering, my neutrophil counts had plunged to 30 -- "boy in the bubble status". I was instructed that if I were to go anywhere other than home then to wear a mask and wash my hands constantly.
For treatment, they injected me with a drug called Neupogen. As I mentioned in an earlier posting, this medication stimulates the blood system (bone marrow) to make white blood cells, helping you fight infections. I was then given the option to either learn how to inject myself with another dose of neupogen the following day, or come back for another visit Tuesday and have a nurse administer the drug. Well, my aversion to needles, coupled with the sheer thought of gearing up mentally to induce pain upon myself, made it an easy decision. I opted for the 90 minute round trip to engage the services of a trained professional.
It was actually a good thing that I went back to the hospital on Tuesday. Prior to the injection, they ran another set of blood labs. My neutrophil count has risen from 30 to 200, so the neupogen was doing it's job. But we were still very far away from the moderate safety of the much cherished 1000 count. So it was decided, I would return once again the next day, on Wednesday, for a third daily injection of neupogen. Hopefully, this would do the trick and boost my counts to 1000.
Another delay I was encountering, due to the low neutrophil counts, was that my Oncologist could not proceed with my next round of chemo. With my white cells so low, the chemo would just further depress my immune system and then who knows what...so yet another obstacle prolonging my journey...
The plan was to skip my scheduled chemo for Thursday September 3rd, because based upon drug protocol, there has to be at least 72 hours from the last neupogen injection until chemo is administered. So the plans were to resume treatment right after Labor Day on Tuesday, September 8th.
So, I arrived on Tuesday for my blood labs to check my white counts and then anticipated receiving chemo treatment #10. Alas, very much to my surprise and dismay, there would be no chemo on Tuesday. My total white counts had done a drastic turnaround and now were at a whopping 22,000. For me, I thought this was great news. If the average total white counts in a healthy adult can range from 4,000 to 10,000, then the neupogen must have done a spectacular job in making my white counts super healthy. Unfortunately, the doctors, who are trained to be far more analytical in their evaluation of cause and effect, didn't quickly agree with my diagnosis.
They explained that the effects of neupogen usually only lasts 3 or 4 days and it had been 6 days since the last injection, so they were looking for other causes of a high white count, like infection, more specifically another pneumonia.
Although, clearly not a doctor, I refuted their hypothesis. Without the presence of any symptoms, no fever, no coughing, no pain (other than the one in my ass for the past six months -- but that's just how I characterized my cancer in general from the beginning), I found it hard to believe that I had an infection. But nonetheless, my doctors, who are extremely cautious and proactive in their care, ordered some more tests, urine samples, more blood cultures and another chest CT scan.
On Wednesday, I was invited back for the results and yet more blood labs. This time my total white counts were down to 15,000 from 22,000 the day before. All the tests from Tuesday were negative, no signs of any infection. It looks like I was correct, the neupogen just had a delayed yet profound effect on my white blood count. I was cleared for Chemo and received infusion #10 on Thursday, September 10th, (by the way, had I not hit the bumps in the road earlier along the way, that was the date I was expecting to finish up).
But now my important numbers, include "1000", the neutrophil count needed to stay out of "trouble"; " 2", the total number of chemo infusions left; and "10/08/09" , the date, provided all else goes smoothly, that I will be receiving my 12th and final chemo infusion.
Funny how your perspective can change. so quickly. I just hope that soon enough my focus can go back to the more fun numbers like those of the Red Sox, Patriots and Tiger.
Until then, I will just keep my attention were it needs to be for the moment.
Thanks for reading, I will write again when there is more excitement to share. In the meantime, please go out and do something positive today, hug a loved one and count your blessings!
Glenn
Well, for cancer patients, the focus can be slightly slanted on a new set of number...blood counts. For me personally, my weekly focus is on my White Blood Counts. The chemo therapy I've been receiving has done a good job of killing off the cancer cells, however it's also done an equally good job of killing off the healthy white blood cells, especially the nuetrophils, the unique white cells that protect me from infections.
Over the last several weeks, I've experienced some depleted "numbers" due to chemo's unrelenting assault on my white blood cells. A healthy person will have a total white blood count in the range of 4,000 - 10,000 with the all important neutrophil count (the cells that fight infection) in the range of 2,500 - 5,000.
Throughout chemo therapy my counts have been a bit lower, with my neutrophil count commonly dipping below the dreaded 1,000 range, triggering "Neutropenia" and requiring special precautions including a restrictive diet and every effort to avoid exposure to bacteria and potential infection.
A few weeks ago I hit a new low. It started on my normal weekly visit for blood labs on Thursday, August 27th. My neutrophil counts had dropped to below 700, so I was officially neutropenic. The problem with taking a static blood count is that the doctors don't know in which direction my counts were going...was I recovering and my counts going up, or was I continuing to crash and becoming more vulnerable to every sneeze, cough and germy hand shake in the outside word?
So the doctors asked that I return on Monday for another set of blood tests. The results were staggering, my neutrophil counts had plunged to 30 -- "boy in the bubble status". I was instructed that if I were to go anywhere other than home then to wear a mask and wash my hands constantly.
For treatment, they injected me with a drug called Neupogen. As I mentioned in an earlier posting, this medication stimulates the blood system (bone marrow) to make white blood cells, helping you fight infections. I was then given the option to either learn how to inject myself with another dose of neupogen the following day, or come back for another visit Tuesday and have a nurse administer the drug. Well, my aversion to needles, coupled with the sheer thought of gearing up mentally to induce pain upon myself, made it an easy decision. I opted for the 90 minute round trip to engage the services of a trained professional.
It was actually a good thing that I went back to the hospital on Tuesday. Prior to the injection, they ran another set of blood labs. My neutrophil count has risen from 30 to 200, so the neupogen was doing it's job. But we were still very far away from the moderate safety of the much cherished 1000 count. So it was decided, I would return once again the next day, on Wednesday, for a third daily injection of neupogen. Hopefully, this would do the trick and boost my counts to 1000.
Another delay I was encountering, due to the low neutrophil counts, was that my Oncologist could not proceed with my next round of chemo. With my white cells so low, the chemo would just further depress my immune system and then who knows what...so yet another obstacle prolonging my journey...
The plan was to skip my scheduled chemo for Thursday September 3rd, because based upon drug protocol, there has to be at least 72 hours from the last neupogen injection until chemo is administered. So the plans were to resume treatment right after Labor Day on Tuesday, September 8th.
So, I arrived on Tuesday for my blood labs to check my white counts and then anticipated receiving chemo treatment #10. Alas, very much to my surprise and dismay, there would be no chemo on Tuesday. My total white counts had done a drastic turnaround and now were at a whopping 22,000. For me, I thought this was great news. If the average total white counts in a healthy adult can range from 4,000 to 10,000, then the neupogen must have done a spectacular job in making my white counts super healthy. Unfortunately, the doctors, who are trained to be far more analytical in their evaluation of cause and effect, didn't quickly agree with my diagnosis.
They explained that the effects of neupogen usually only lasts 3 or 4 days and it had been 6 days since the last injection, so they were looking for other causes of a high white count, like infection, more specifically another pneumonia.
Although, clearly not a doctor, I refuted their hypothesis. Without the presence of any symptoms, no fever, no coughing, no pain (other than the one in my ass for the past six months -- but that's just how I characterized my cancer in general from the beginning), I found it hard to believe that I had an infection. But nonetheless, my doctors, who are extremely cautious and proactive in their care, ordered some more tests, urine samples, more blood cultures and another chest CT scan.
On Wednesday, I was invited back for the results and yet more blood labs. This time my total white counts were down to 15,000 from 22,000 the day before. All the tests from Tuesday were negative, no signs of any infection. It looks like I was correct, the neupogen just had a delayed yet profound effect on my white blood count. I was cleared for Chemo and received infusion #10 on Thursday, September 10th, (by the way, had I not hit the bumps in the road earlier along the way, that was the date I was expecting to finish up).
But now my important numbers, include "1000", the neutrophil count needed to stay out of "trouble"; " 2", the total number of chemo infusions left; and "10/08/09" , the date, provided all else goes smoothly, that I will be receiving my 12th and final chemo infusion.
Funny how your perspective can change. so quickly. I just hope that soon enough my focus can go back to the more fun numbers like those of the Red Sox, Patriots and Tiger.
Until then, I will just keep my attention were it needs to be for the moment.
Thanks for reading, I will write again when there is more excitement to share. In the meantime, please go out and do something positive today, hug a loved one and count your blessings!
Glenn
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