Day 15 (amended)

Over the course of the day, I have had one central question for the nurses and doctors here on the bone marrow ward. Essentially, it has been this: what is the one number, the one count of cells, that will be the primary determining factor for my release from this round of chemo hospitiliazation? Thus far, I have been led (perhaps purposefully, perhaps not) to believe that it was my white blood cell count that would lead me from this bed, this ward, this hospital, this city, this state.

After a confusing discussion with Dr. Schwartz this morning about this very subject, she introduced the concept of neutrophils. We talked about it briefly, and what I took from the conversation was, well, not much. Somehow I gathered that the number the doctors were really looking at was this neutrophils number, which is a number or percentage within the white blood cell number.

Okay, wait.

Neutrophils are basically the ass-kickers of the white blood cells. They do the dirty work, sort of like the first cops at the scene of the crime. We need them to walk down the street and stay healthy enough to make it to our destination. So, this is the number they really need to know about. But Dr. Schwartz explained it in terms of percentages, and almost seemed to be hiding my own holy grail from me. I sought a simple enough answer, I thought: what is the number you will be basing my release upon?

Later in the day, I brought the subject up with my RN, Kelly, who provided me a much clearer picture of the situation. The number they are really looking at (and it is based on the white blood cell number) is something called the Absolute Neutrophils Count (ANC). The number is derived at through the use of an equation that is beyond my understanding of any of this (see previous link). But what I know now is that they are waiting for two consecutive days when my ANC is 500 or greater, or a single day where it is 1,000. Today it idles at a mere 300 – but wait, that’s good too. Because remember for the past days, the past weeks, they haven’t really been in there at all doing what Dawn would refer to as “hi-yas” (aka karate chops).

Does everyone get it now? I’m just relieved to finally have been given a clear indication of what this waiting game is all about.

Oh, and if you are further curious, here is the the dry-erase board that has been tracking my blood counts since November 5:

Tracking Mike's blood

Tracking Mike


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: