More blessed?

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	7.2	13-17	v
Platelets	3	140-375	v
ANC	0	1800-8300	-

BOX SCORE
Element	Current	Std. Range	Trend
Hemoglobin	6.6	13-17	v
Platelets	27	140-375	^
ANC	0	1800-8300	-

Whoa! Too many data, Tom; what's going on?  Oh, I'm glad you asked. The top Box Score shows lab results from yesterday. The lower Box Score shows today's lab results. 

You will notice, I trust, that there is a big difference in the two platelet counts. You may also recall that I had two platelet transfusions last week, the second of which was on Thursday. Ever the optimist, I thought, surely I could make it through the weekend, even though the platelet count last week went down from 8 to 6 during the three days between those transfusions, which were three days apart. 

Saturday night I went to bed, feeling as well as I ever feel when I'm  out of blood cells. In the wee hours, I awoke with a very dry mouth. I got some water and swished it around my mouth, only to find there was blood in the water when I spit it out. That was the first time I had had bleeding in my mouth during my jaunt through the world of leukemia. 

"Yikes," I thought, "I wonder if I have any platelets at all." The day I was diagnosed with "some kind of leukemia" in the Salem hospital ER, my platelets were at 4, but I had no actively bleeding lesions anywhere. So, when I saw the blood, I was kind of at a loss for how to proceed next. I knew I needed to go to an ER, but the bleeding was minor, and I didn't want to wake Jill unnecessarily. So I spent the rest of the night mostly sleepless. 

In the morning, Because it was Sunday, I called the Advice Nurse who was very helpful in expediting a visit to the ER. We chose to drive to Sunnyside hospital because it is so familiar, and it is much less crowded than Salem. 

Once we checked in, I got a blood test. When  the results came back, Dr. Schuster came in to report that my platelets were at 3! Wow! Lowest count on record (for me). After my experience in the night, I was glad there were any left at all. Dr. Schuster ordered two units of platelets "stat," as in "right away!"

When Adam, our nurse, came in to set up the IV, he told us that I would receive two units, and it would take three to four hours. "Oh, my!" said Jill. "It only takes about half an hour per unit at the infusion center." I reminded her that with setup and a saline flush afterwards, it's closer to 45 minutes to an hour. Still, the difference seemed odd to both of us. Adam found that information to be new to him, and repeated that the usual time  is about 1 1/2 to 2 hours to transfuse a unit. Jill later remarked that the ER nurses probably do many more RBC transfusions, which by the by take about two hours, than platelet transfusions. Good point. Not wanting to make waves, and since we were just grateful to be seen on such short notice, we acquiesced, and the first bag of platelets was "hung" [on the IV pole] as they say in the biz. 

When the first bag was almost dry, Adam returned and said that the doctor had done some checking and found that platelets could be given at the higher rate. So, the second bag of platelets was transfused in about 40 minutes time. We hoped maybe we had been helpful to these dedicated pros, who I'm sure, do not do as many transfusions as the RNs at the infusion center. 

We arrived home in mid afternoon, with me feeling like a new man. I had a long nap, and slept a full nine hours last night! Hooray for transfusions!

Now on to today's data. The second Box Score shows my hemoglobin dropped from 7.2 yesterday (the threshold for transfusion is 7.0) to 6.6 today. We just had a call from Suzanne, my case manager, who asked about my current symptoms, followed by a call from Lexy, who scheduled a "packed red blood cell" transfusion for this afternoon. I love my care team!

This morning I had an email exchange with a fellow I have been mentoring in his Christian faith, and I had occasion to remind him of what the Apostle Paul wrote in Acts 20:35 -     

In all things I have shown you that by working hard in this way we must help the weak and remember the words of the Lord Jesus, how he himself said, ‘It is more blessed to give than to receive.’ 

I believe that with all my heart...but sometimes receiving is pretty doggone good, too!