Stem Cell Transplant Journal Day 9 – Wednesday 9 December 2015 (Cancer and Me 50)
Thoughts from yesterday.
Today is the anti-climax really, rather than yesterday. No chemo, no stem cells. Just sitting around, trying to keep occupied in some way, but really just waiting for the inevitable deterioration that is due to happen in a few days.
I slept well, relatively, last night.
Heidi brought Tom and Anna with her this morning, having agreed with school to give them the morning off to see me. Realistically there was no other time to bring them before the weekend, and at the weekend I probably won’t be up to having visitors.
I’ve passed the remaining time reading a book I was kindly given, dozing, listening to music, doing exercises and doing some Bible study. It’s still not 8pm as I write, and I think it may be a case of watching a few more episodes of “The Walking Dead” to kill a bit more time!
Blood counts are going down as expected, but it will be a few days before they ‘trough’. I’ve been asking the nurses to write down the four key ones daily for me when the results come back:
- Hb (Haemoglobin) – indication of red blood cells
- Plt (Platelets) – cells to aid clotting
- WCC (White Cell Count) – broad immune system indicator
- Neut (Neutrophils) – particular type of white anti-infection cells
At the moment all my levels are still within a normal range, except platelets, even though they are all trending downwards. And I think the platelets are only low because I am being given daily injections of anti-coagulant so that I don’t get clots in my Hickman line. Once my platelet count naturally deteriorates I won’t need those injections.
My WCC was 4.5 this morning, against a ‘normal’ range of 4-11.
Neutrophils were 4.3, against a ‘normal’ range of 2.0-7.5.
Hb was up against yesterday and well within the normal range. But I think that may be because some red cells are caught in with the stem cell harvest, so the red cell increase may have been a bi-product of getting some of those yesterday.
Because my disease is lymphoma, this affects the white cells. So the aim of the high dose chemo is to reduce the WCC and neut counts to zero – yes, absolutely nothing. Other blood cells do suffer as well – hence the risk of bleeding/bruising (low platelets) and the exhaustion (anaemia) – but not as critically. And then the new stem cells will busily be engrafting and generating new cells, so that within a few days of reaching zero the counts will be picking up again. (I heard somewhere, but could be wrong, that they will allow me home when my WCC rises above 0.5, I’m not on IV antibiotics and I’ve returned to eating and drinking without assistance.)
But while the WCC and neut counts are zero I am expected to pick up infections, and it’s really just a question of how bad and how many. That’s why I’m in isolation with strict hygiene control. The first signs of that blood count ‘trough’ will be mouth ulcers and diarrhoea, coupled with “feeling generally like not talking to anyone”.
Hopefully that helps people to understand why I look and sound fine right now. It’s just because even though the treatment itself is done, the worst is yet to come. Can you tell it’s playing on my mind a little?!