Saturday, August 18, 2012

Killer Cooties

I'm just gonna come right out and say it:  Science is amazing.  Ah. Ma. Zing.  I'm a big proponent, and often wax poetically about the vastly under appreciated efforts of scientists. (I am also a gigantic nerd in case there was any doubt)  Which is why I'm a little embarrassed to admit how deeply I recently doubted the abilities of one particular scientific marvel:  Neupogen.

Let me back up a bit.

About ten days after receiving my last dose of chemotherapy, I (predictably) began to go into nadir - which as you may recall is the time when my immune system is at its lowest.  I'd been through it before and had developed sores in my mouth and ended up taking antibiotics for a bladder infection.  Not fun. But I'd taken it in stride and eventually the symptoms cleared and I got stronger.

But this was different.  Over the weekend I began to spike temperatures of 101 - which isn't terribly high except that any fever is significant when you have a defunct immune system.  My body ached, my lungs felt heavy, I'd developed a cough and it became an effort to even get dressed in the morning.  But worse was the feeling of somehow falling into an abyss - it was the feeling of non-specific "impending doom" that they always warn you about in nursing school. 

Luckily, I have very good doctors who preemptively called in a round of antibiotics without requiring me to go to be seen.  Monday I trekked into the office to have labs drawn.  Turns out there was a reason I was feeling so crummy.  My hematocrit and hemoglobin - (the oxygen carrying components of blood) were low which means that I was a little on the anemic side which could account for the low energy level.  But what earned me a slightly panicked phone call from my nurse was this:  My white blood cells (the part of the blood which fights off infection) had dropped to an abysmally low 1.3.  This was particularly significant because before treatment they were 18 (a little on the high side). Worse, my absolute neutrophils (mature white blood cells) were at 0.1 - this was a number I had seen before - but only by hospitalized patients.  I was neutropenic.  And scared.

I'm not very experienced with knowing what it is like to be really sick.  I've had colds before, the flu of course and once I broke my pinky toe (that hurt like a muther!)  But I've never experienced anything like this and it was eerie to glance over a lab sheet - knowing full well the implications of those numbers - and reading my own name at the top. And the really crazy part about all this is knowing these lab results are all part of the goal of chemotherapy.  Remember, the game plan is to kill off everything we can while still keeping me alive.  Well, we went a leetle too far this time.

Sooo...enter Neupogen.

Because my WBC levels were so low my oncologist prescribed a total of five days worth of neupogen shots in order to boost me up enough to be able to tolerate another round of chemotherapy next week.  The medication works by targeting the bone marrow to produce more white blood cells - sort of speeding along the process that would occur naturally.  The shot itself was small and injected into my abdomen - but within hours it caused the glands in my throat to swell, I developed a low grade fever and my bones ached enough that I was glad I still had some vicodin laying around.

So here's what I did for the next five days:

I avoided the grocery store, farmers market and every public space where unknown strangers could spread their brand of nastiness.

Barley - the worlds best nap partner.
I dolled out hand sanitizer like it was Halloween candy.

I chloroxed every surface in our house.

I chastised my son for initiating the "ten-second-rule" and eating a grape off the floor.

I glared at our fat Labrador while he silently drooled on the carpet.  (To be fair, Barley is also blind so he probably had no idea I was sending him daggers from the couch).

In short, I turned into a neurotic, paranoid mess.

Which was probably unnecessary because in spite of my efforts - I don't live in a bubble.  There is no way to protect yourself from every single cootie.
And I needn't have worried anyway.   My oncologist knew what he was talking about.

Yesterday I had my last injection and my lab work was re-drawn.  My white blood cells were 22.  So even though it was terrifying to have my labs go down that far - it was also pretty reassuring that I can be brought back again too. And with the next dose I will be given a shot called neulasta - which works similarly to neupogen except it is long lasting - so hopefully I won't drop that low again in the future.

But for now I'm back on target for chemotherapy this Thursday - and finally starting to feel a little better.

Hooray for Science!