T+12 Go team Go! Fight team Fight!

BOX SCORE




Element

Current

Std. Range

Trend

Hemoglobin

8.2

13-17

^

Platelets

33

140-375

^

ANC

0

1800-8300

-         

 

Cheer, cheer for Old Notre Dame,
Wake up the echoes cheering her name,
Send a volley cheer on high,
Shake down the thunder from the sky! *

Thus begins the chorus of the Notre Dame Fight Song, arguably one of the best known college anthems in the US. It's melody and message are a source of joy and encouragement to ND students and alumni alike.

I awoke about 4:00 am today. I had blood drawn for lab tests around midnight, so I decided to check out the results. They are recorded above, but there is another statistic that I don't generally track, and that is white blood cell (WBC) count. Why do I not track this one? Perhaps, it is simply because I was encouraged to keep an eye on Hemoglobin, platelets and ANC (absolute neutrophil count) from day one after my diagnosis of acute myeloid leukemia (AML). 

Neutrophils are WBCs, but there are other WBCs as well, including lymphocytes, monocytes, and eosinophils among others. These various kinds of WBCs each have different functions, but ANC is the best surrogate for tracking immunity, which is very important to AML patients. It essentially tells us when certain medications are required to support the immune system and when they are not. It also gives us guidelines for when we can mingle with other people with relative safety. 

Following chemotherapy, which I have had dozens of times, the WBC counts are greatly diminished. As the marrow recovers from the chemotherapy, it begins to produce more WBCs,  but the cells are undifferentiated, in other words they need to mature into neutrophils, and lymphocytes and so on. So, for a stretch of time the WBCs can be counted, but until they reach a certain level, it is impossible to differentiate the various types of WBCs, because they are essentially stem cells in need of maturation. And that's where I am at this moment in time. 

Prior to bone marrow transplant (BMT), chemotherapy and radiation are used to kill off the patient's (host's) leukemia cells as well as the host bone marrow cells,  Following BMT,  the donor stem cells, along with some immune cells from the donor, begin to destroy any leukemia cells as well as any remaining host marrow cells. As the donor cells take over they must begin producing new bone marrow cells, which in turn begin producing blood cells, including red cells (RBCs), WBCs, and platelets. 

During this transition time between host and donor marrow cells, the patient is extremely vulnerable to infection, which is compensated for by the use of anti-microbial drugs. The WBC count goes essentially to zero. The RBC and platelet counts must be supported by blood transfusions, and then as the donor cells mature and begin producing blood cells, the blood counts begin to rise. When the blood counts begin to rise, it is a sign that the new marrow cells are maturing and beginning to do their job. 

The Box Score above shows that my RBCs (Hemoglobin) and platelets are rising. This is the first day in several that I have not needed a transfusion. What you don't see in the Box Score is that the WBC count is rising as well. There has been a rise in WBC count each of the last three days, but the cells are in the stage where they can't be differentiated as to cell type. So, the hope (and the expectation) is that within a couple of days, ANC will begin to appear again in the Box Score, and when ANC reaches 500, I will be discharged. My day nurse yesterday told Jill that I have already surpassed all of the criteria for discharge, except for the ANC. 

So, with apologies to Notre Dame (and to the tune of her Fight Song), I offer my own fight song:

Cheer, cheer for WBC,
Wake up the stem cells growing in me
Send my ANC on high,
That will sure make me one happy guy!
 
If you are a praying person, I invite you to pray along with me and Jill and dozens of others that my ANC will soon show it's face again and continue to rise enough that I can safely be discharged from the hospital. 

 * source: https://www.lyricsondemand.com/miscellaneouslyrics/fightsongslyrics/notredamefightsonglyrics.html

 

 

Comments

Post a Comment

Popular posts from this blog

Happy Anniversary

Today is our wedding anniversary. Jill has survived 21 years with me. Our marriage is old enough to drink!! In many ways, it seems like only a couple of years since our wedding day, and in other ways it seems as if we have always been us. This, I believe, is what is referred to in the fairy tales as "wedded bliss." Only, in our case, it isn't a fairy tale at all. It's just, well...wedded bliss. How I love that girl! A year ago today, I finished my induction chemotherapy at Club Sunnyside. Jill picked up German food at Gustav's, which is across the street from the hospital campus. She also picked up Bundt cakes from "Nothing Bundt Cake;" a little one for us and a big one for the oncology staff. It was as fine a celebration as we could muster under the circumstances, and one we will never forget.  Today we had a morning clinic visit. This time for Jill's blood pressure, which with the help of a new medication added to her regimen, is perfect, thank you...
Read more

A Dream Come True

Image
BOX SCORE Element Current Std. Range Trend Hemoglobin 11 13-17 ^ Platelets 89 140-375 v ANC 2810 1800-8300 ^ When I was a youngster, probably about 10 years old, my dad introduced me to model making. Mainly we built models from kits, but Dad also taught me how to make a stick and paper airplane from scratch. It actually flew, with the help of a rubber band motor. But one of my favorite plastic model kits was an MG-TD sports car. You may remember this car from your youth (if you are old, like me) or from old movies, or maybe from a car show. It was a little, English two-seater with long sweeping front fenders and a vertical grille. The windshield (well, windscreen, if you are Brit...
Read more

Don' be that guy!

Remember the Mighty Casey? In Ernest Lawrence Thayer's famous poem "Casey at the Bat," he was the pride of the Mudville baseball team. We join the story in the 9th inning:  The outlook wasn't brilliant for the Mudville nine that day: The score stood four to two, with but one inning more to play, And then when Cooney died at first, and Barrows did the same, A pall-like silence fell upon the patrons of the game. The crowd was in despair. Down two in the bottom of the ninth with two outs, they were beginning to leave the stadium. The next two batters were the bottom of the order and offered little hope, but Flynn hit a single, and Blake a double. Suddenly, there was hope for the Mudville nine, for the top of the order, none other than the mighty Casey, was coming to bat with two men in scoring position. Even a base hit would keep the game alive, and a home run, well that would end it in a glorious, ecstatic victory.  Now Casey, apparently, had embraced the hype about hi...
Read more