Vulnerability

My white blood cell count has plummeted, a few days more quickly than anticipated. Yesterday I felt great. A lot of energy. My head was clear. I went to the Avon Cancer Center for a CBC (Complete Blood Count) check - just a quick finger prick for blood and to check in with Dr. Dailey.

The lab tech filled my vile and dropped it into the blood cell tabulating machine and I hear a big groan.

"This things going to give me a heart attack. Ugggghhhhh. Come on."

She's banging the thing, running the sample again, saying she may have to stick me again. She gets on the phone with the Hartford Cancer Center and I hear her on the phone telling them that it's showing a white blood cell number that's impossibly low and that the breakdown of types of white blood cells isn't even showing up.

Turns out it wasn't the machine. The reading was in fact correct. My white blood cells are 0.4. So low that the machine doesn't even to bother to calculate the percentage of granulocyte and neutrophils present. I'm told that I will be at 0 after the stem cell reinfusion. I didn't think I would get this low after infusion one of the ICE chemo.

Dr. Dailey, always calm and assuring, wasn't overly concerned.

"So your counts are very low," he said calmly, balancing out the frantic nature of the lab tech.

He had expected them to drop to about 1.0, but probably not until the weekend. But he said that he was still glad that we hit it hard and I now realize how harsh these drugs really are. I guess that's why the nurses have to wear protective gowns and gloves when handling the IV bags full of the chemo.

As a precaution he put me on a antibiotic in anticipation of any infection that might arise. I now take this Levaquin once a day and I need to take my temperature a few times a day to be sure that I'm not spiking a fever. If I hit 100.5 I need to call him immediately and he'll very likely admit me to the hospital where I can receive IV antibiotics. So far, no fever. This is good because I do not want to be in the hospital any more than I have to be.

I am what is called "Neutropenic" meaning that my body's disease fighters, neutrophils (a type of white blood cell), are nonexistent so I have to be very careful with what I expose myself to. No shaking hands and kissing babies. No getting anywhere close to sick people. I have to be super diligent with food safety and ridiculous about hand washing. So, I haven't left the house since I got back from my appointment yesterday. Well, besides to get outside for some fresh air.

Though Dr. Dailey doesn't think I have to be overly paranoid about it, I thought it best to lay real low - no grocery store, no movies, no restaurants, etc. This is what they told me I'll have to do when I'm living down at Yale so I figure it's best to take those precautions now as well. I do not want to land anything that will delay this treatment course or will send me back to the hospital. I go back tomorrow for another CBC and hopefully the counts will begin to climb, though I'm told I can expect to be this low for several days. Soon, though, the Neulasta shot will kick in and that's when my marrow will start creating new cells to get me ready for the next chemo whop.

For the past several days I've been blowing bloody tissue out my nose. All of the delicate tissue in my sinus tract and within my nasal passages is fried, so it's filling my sinus cavities and I wake up with awful sinus headaches. Once things get moving I fell several tissues of bloody phlegm and internal tissues. It is not a pleasant site, but it feels so much better when the daily collection is out. There can't be much more left so it's got to end soon. My gums are so fragile and raw I can feel every bristle of the tooth brush and I worry that they're not holding tightly enough to my teeth. I also have quite a deep cough that comes up at night. Dr. Dailey says that this is also because of some of the rawness in my bronchial tract. A lot of that tissue is delicate tissue is burnt off so it's irritating my chest.

But I'm not going to play my fiddle. It's all par for the course. I just have to keep telling myself that if it's causing this havoc on the good cells in my body, then it's frying those cancer cells just as hard.

Yesterday I had so much energy I was dancing around to MJ's "This Is It" DVD that my mom had rented for me. Today I am exhausted beyond belief but can't sleep. I woke up a completely different person. My body is so restless and there are so many things that I want to be doing but I can't. I just can't get the physical strength. I've gone through this before and I know I need to listen to my body, but it doesn't necessarily make it any easier, so far doing it for a second time seems harder because I know what's coming.

This afternoon I just sobbed. Choking sobbed out of pure exhaustion. Thank God for Sammy. At my first crying hiccup she was nuzzled on my lap and sat, chest out next to me while I cried it out. She kept giving me her stuffed dog, her new favorite toy. She went and got it off her bed and would toss it over to me for comfort. It's smelly and spitty but exactly what I needed. I buried my face in her fur and wailed and then she was nuzzling my face so much and shoving her toy at me so hard that I just started laughing and laughing and everything was better. I love that dog.