The Merits of the Case

Today Matthew told me about a cartoon in an issue of Nick Magazine that depicted two vampires. One of them looked really dejected and when his fellow vampire asked him what was wrong, the sad one told him that he failed his blood test. This was definitely an appropriate cartoon for Matthew to read today--I also failed my blood test this morning.

During one of my first visits to the oncologist’s office they ran lab tests on my blood to get a baseline reading of my white and red blood cell counts, among other things. They gave me a copy of the lab report at the time so that I could use it later to compare future lab test results. The report that I received today looks dramatically different from the report I received back before chemo began and certainly explains how awful I’ve been feeling for the past few days.

The normal range for white blood cell counts is between 3.6 - 10.0 units. (I’m not going to get all technical and actually write down the unit of measure here…you’ll be able to tell from the numbers how low the count is.) In June my white blood cell count was 8.4—right in the middle of the range. My lymphocytes (one of the white blood cells they track) were at 24.4 out of a normal range of 29.5 – 51.1, so they were marked as LOW on the report. My granulocytes, another white blood cell they track, were 5.8 out of a normal range of 1.4 – 5.5. I seem to recall that I thought I might be fighting off a cold on the day that was done, which explains the high granulocyte count and low lymphocyte count. They are both infection fighters, and their levels were off because they were busy protecting me from the cold (which I never got). Today my white blood cell count was at 0.9 (again, the reference range is 3.6 – 10.0). My lymphocyte and granulocyte counts? Both at 0. (Reference range is 29.5 -51.1 for lymphocytes and 1.4 – 5.5 for granulocytes.)

What this all means is that despite the Neulasta shot my blood cell counts are not recovering from the chemo treatment. It explains why I am feeling so tired and it means that I have absolutely no defense against illness right now. The nurse scared me sufficiently about illness today that I ran (okay, I didn’t really run…I walked very slowly) to Target to buy Chlorox wipes and Purell. I have banned poor Blake from being anywhere near me (he has a cold) and I have been washing my hands constantly. I’m a germophobe anyway…this just plays right into all my OCD germ behavior.

The nurse did tell me that I am probably at my nadir, or lowest point, and that they expect the counts to climb again before next week’s treatment. If they don’t, however, I think the treatment might have to be delayed. (I’m not positive about that, but seem to remember the doctor or nurse telling me that.)

While I was at the doctor’s office today I spent about 15 minutes talking with another breast cancer fighter whose treatment schedule is exactly one week ahead of mine. I met her briefly at my first appointment last week and was happy to see that today, the day of her second round of AC, she looked great and seemed to be feeling pretty good. We compared side-effects for awhile, and it was wonderful to talk with someone else who experienced so many of the same things that I did in the past week. She gets kudos from me for her grit, however; the Saturday after her first treatment she attended a family wedding. I couldn’t even get up off the couch on Saturday. She did tell me that she thinks she paid for it over the next three days, but I am still duly impressed that she even attempted it.