September 19: Just On Hold

Well, I was stunned to find my blood counts down again. Yesterday, I trotted up the hill to the mailboxes. That's not very far, only about 30 or 40 yards, but there's been days during this chemo when such a jog was very difficult or even impossible without a walking warmup. Yesterday it barely affected me breathing.

That was pretty exciting, so later in the day I took a risk that I was violating Dr. Strickland's orders and went jogging.

Now, keep in mind, I didn't know that I was violating his orders. In fact, I was pretty sure I wasn't. Dr. Strickland told me not to jog if my platelets were below 75. They were 91 on Thursday, and I had significantly more energy yesterday than I had on Thursday.

So I ran. I was thrilled enough already that I could just leave the house running. Since that first round of chemo, I've normally needed a significant walk to make my legs work right for jogging, but yesterday they felt great right out the door.

My hope was to make straight through for a mile, but the last quarter mile was uphill and I didn't want to overdo it. I quit at 3/4 of a mile, which wasn't even all that hard. I was excited. I swung by the fitness center, did just a few exercises, then walked enough to hit 2 miles for the day.

I felt great, even after, so I was excited about seeing good blood counts this morning.

The very first count on the list is my white blood cells. They were 1.7 (or 1700; they get expressed both ways). That was the same as last Thursday. My heart sunk a little, and I immediately went looking for the neutrophil count: 600.

Watching a play in Centennial Park with a mask

That's not quite low enough to be officially neutropenic, at least not here in the U.S. A Blastic Plasmacytoid Dendritic Cell Neoplasm patient in Ireland who's been emailing me tells me that under 1000 is officially neutropenic there.

Neutropenic means that your immune system is so depleted of bacteria-fighting cells (the neutrophils) that you're at extreme risk of infections. A lot of safety measures kick in when you're neutropenic.

I was at 850 last Thursday, but we began practicing those safety measures anyway, especially because we knew my blood wouldn't be checked again until today (Monday).

So, 600. We'll be continuing those safety measures till Thursday at least.

What was most surprising, I think, was my red blood cell counts. I'm at 30% hematocrit, down from 35%. Normal is about 45%, so I've only got about 2/3 of the oxygen carrying cells that I should. Hemoglobin, the actual oxygen-carrying molecule in the red blood cells, are equally down, at 10.2.

So why was running yesterday so easy? Weird.

The one that was really off, however, was the platelets. Those stop you from bleeding. My platelets are down to 15. Normal is at least 135, and people's platelet counts are commonly over 300. So 15 is real, real low.

So I'm sitting here in a room waiting for platelets as I type this.

They actually have me a choice. They don't automatically give platelets to hematology patients unless they're down to 11 or actually have a bleeding problem. But I won't be back for blood counts until Thursday, so it's not wise to wait 3 days without checking.

Apparently, though, Meg is willing to wait 2. She's the nurse practitioner for my case, and she told me I could get platelets and come back Thursday or turn them down and come back Wednesday.

I chose the platelets.

However, it's now 10:50 and the platelets are arriving as I type this. The nurse just checked my armband in the middle of the last sentence. I gave them blood at 8 a.m. This seems unusually slow for them.

Not that there's a problem. This is probably what I'd be doing at home, anyway.

Rats. IV is acting up. I have to type one-handed now until it's done. Few more minutes, then I go home. So ... till later!