From 7 to 10 days after a big chemo blast, blood cell counts hit what the doctors call “nadir” — their very lowest points. That happened for me 2 days ago (for my white blood cells, readings of 200, 200, 500, and 900 per uL from 7/7 to 7/10) and yesterday (for my platelets, readings of 30,000, 16,000, 9,000, and 16,000 per uL). These are expected, if scary-dangerous, readings. The low WBC danger is mitigated through my having to wear a HEPA mask if I go outside, doses of antibiotics, a strict diet, and crazy amounts of hand-washing. The low platelet levels required me to go into Kaiser yesterday for an infusion of platelets, which bumped up the count to a less-critical level today.
Since I’m taking three injections daily (thanks Suzie!) of a drug called Neupogen that stimulates the bone marrow to produce both white blood cells and the stem cells that will be collected at Stanford for use in the transplant, these counts should continue to improve daily.
(As an aside, while our experience at Stanford has generally been excellent, we did discover this weekend that we’d been given incorrect information about the dosage of the Neupogen I was supposed to take. We’d been given syringes in two different doses, 300 mcg and 480 mcg, and told to get a shot of each (or 780 mcg, the dosage written down on our medication chart). But we noticed that we’d been given twice as many of the 300 mcg syringes, which implied that the dose should be 1080 mcg (i.e., [300 * 2] + 480). We called to verify the correct dosage and, as we suspected, the correct dosage was the higher 1080 amount. This may have resulted in a slower blood count recovery, although that’s not entirely clear.)
The low counts made me feel very lethargic and blah the two previous days. I’d feel somewhat OK for a few minutes and then awful again. I’d get extremely lightheaded anytime I’d stand up. But today is much better. I wouldn’t say I’m chipper, but I’m not suffering like I was during the past two days.
To go along with the cue ball picture, I thought I’d share a picture of me in the HEPA mask, which I have to wear whenever I leave the condo. It makes me look like a freak, and it scares little kids when they see me. It’s disturbing to people because they can’t see whether you are smiling at them or snarling at them; it deprives them of visual cues as to my intent, and makes them uncomfortable. It may scare and discomfit you, too (although actually I look pretty docile here, not at all like a man who eats young children):
Once I get called down to Stanford again and complete the stem cell harvesting process, I’ll have a week of no procedures, a week of relative freedom. But then comes phase two of the process, which is the worst, two days of chemotherapy back to back, a complete destruction of my bone marrow, to make way for the new one to be built by reinjected stem cells. So while I’m apparently on the other side of Nadir No. 1, a second, deeper, harder nadir looms. Knowing how hard the “lightweight” version has been, I’m dreading the real deal.
Categories: Blogging