Is it working?

 

BOX SCORE
Element	Current	Std. Range
Hemoglobin	11.5	13-17
Platelets	23	140-375
ANC	750	1800-8300

Sometimes, when I take medicine, I can't really tell that it is working. A case in point is Tylenol. Some people swear by this most popular of pain relievers. I take it for, say, a headache, and I find my pain doesn't decrease. Now, for me this is a problem. "Why not take aspirin or ibuprofen?" I hear you saying. Well, here's the thing. Part of my blood problems, aside from leukemia, is that I  have been diagnosed with Deep Vein Thrombosis (DVT). In other words, my blood clots too easily and causes clots in my lower legs. For this, I take a "blood thinner" (anticoagulant) to prevent a clot from forming and then breaking free and going directly to my lungs, what is called pulmonary embolism. If that should happen, it is entirely possible that I could expire, because the embolism would plug the blood vessels in my lungs, and my blood would not be able to circulate through my lungs to pick up the oxygen my cells need. 

Yada, yada...get to the point, Tom. because I am on a blood thinner, taking aspirin or ibuprofen, which are also mild blood thinners, can lead to my blood being too thin. In other words, it doesn't clot adequately to prevent serious bleeding in the event of an injury. This can lead to the opposite problem from pulmonary embolism: too much bleeding, and if I should have a blood vessel start leaking in my brain, I could end up with a stroke. For more information about blood clotting (and so you will be prepared for the quiz next period!) see Did you ever have a nose bleed?

Don't you just love background information, when you are not sure where the author is going? Yeah, I know! Today, I had the first of my twice weekly blood draws for this week. You can see the results in the Box Score above.  Take a look at the platelets in particular. You will notice that the normal range is 140-375, whereas my count today was 23. Yikes! What this means is I don't have enough platelets to allow adequate clotting. Remember I am taking a blood thinner, so this is a double whammy. What to do?

My instructions are to stop taking the blood thinner when the platelet count goes below 50. So, no more Pradaxa for me, until my platelets rebound. In addition, the HemOncs have set a threshold of 30 as the indicator I need a transfusion. So, now I will need to arrange for a transfusion tomorrow. All well and good, except I am supposed to be in Portland at OHSU tomorrow for a consultation with the transplant oncologist. My immediate plan is to call oncology this afternoon and see what they recommend. I picture  a couple of possibilities. 1) I cancel the consultation and stay in Dallas for a transfusion, or 2) I go to Portland in the morning and return for a transfusion in the afternoon. That will be an exhausting day. 

One thing I do know is that the chemotherapy medicine is working. Dropping blood counts are exactly what is supposed to happen after a round of chemo, which I finished this morning. It would be ever so much more convenient if my counts went down according to the calendar, instead of on God's timing. In the meantime, we need to keep my blood where it belongs, inside my blood vessels. 

Another thing I know is that my God-given body is a miraculous machine that has been doing what it needs to do, while I am in treatment. As the Psalmist wrote, "I am fearfully and wonderfully made." And I know that there is a time and a purpose for everything under heaven. So, it's still one day at a time!