Wednesday, August 09, 2006

An Unwanted Journey: Day 0260 - Neutrophils, Blockages, and Delays

Yesterday I visited the cancer centre to get a simple blood sample, have it analyzed, and then meet with the medical oncologist, fully anticipating that today I would be getting my fifth chemotherapy treatment. Unfortunately, that's not how it turned out.

The cancer centre nurse was unable to draw blood from the PICC line, even after several attempts. That meant I had to be scheduled for chest X-rays to ensure the PICC line was not looped somehow in my body. In the meantime, we took blood the old-fashioned way.

While waiting for the X-rays to be scheduled, I met with the oncologist who noted that my blood counts were lower than she would like, although not all the counts would be in until later in the day. She commented on how good I looked and how well I seemed to be doing in general.
The chest X-rays showed no problem with the PICC line itself. This was good news. I really didn't like the idea of having the existing line removed and another put it. So that left a blockage of some kind.

Settling back into the recliner, I waited while the PICC line nurse injected an alteplase solution into the line and left it for 30 minutes. We tried again without success. Then she tried a stronger dose of the same drug. We waited almost 150 minutes after which we were finally able to draw blood. She then changed the dressing. I was pleased to see that the irritation around the PICC line insertion point was less angry even though it seemed to me that the area of irritation was larger than before and that there were more pin-prick marks. Nonetheless, I was pleased to finally get out of the centre and go home.

Late in the afternoon, my supportive care coordinator called and left a message with my wife that my neutrophil count was far too low to go ahead today with my chemotherapy. They want to delay my fifth treatment until next week.

Neutrophils are a special kind of white blood cell that targets inflammation. They constitute as much as 70% of all white blood cells and only live for a few days. I have watched the trend downward for my neutrophil count over the entire year. What this means is that no matter how good I might look, appearances are deceptive. My body is highly susceptible right now to infection.

In addition, I have noticed a general increase in fatigue, even during my good days. Today, for instance, I had to sleep several times and still feel very tired.

So, while we are getting closer to the end of chemotherapy, there are still hurdles to get over. I am disappointed in what happened this week, but I can adapt. I can work from home most days, if necessary, and get rest whenever I require it. By December, most of these delays and problems will be a dim memory.
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