01.12.96 - Chemo Continues

Friday

While the rest of the world was grateful that the weekend was near, I no longer knew what day it was, nor did I care to know. To me, it was day 3 of chemotherapy.

It was also day 5 of not showering and, despite sweating constantly, I had no desire to shower. In fact, I would agree to never shower again if it meant that the nausea would stop. As expected, the dry heaving was finally replaced with vomiting or as my physicians described it "heavy emesis."  It was bad enough to warrant the addition of Ativan to my growing list of antiemetics and a shift in my antiemetics from "PRN" (as needed) to a regular schedule. 

I was no longer attempting to eat and was on a strict "diet" of TPN (total parenteral nutrition) through my Broviac. I was miserable and although I didn't leave my bed, I was exhausted. In my chart, I was mostly described as being "pale" and "asleep but arousable."

TPN (aka my milkshake). Photo from TeamShaun.

By the afternoon, the drugs curbed the nausea enough that I felt 'hungry' but not enough that I worked up the courage to eat. I was refusing to take my Allopurinol, which lead my physicians to order IV Allopurinol for the following day. 

My Counts
If you've ever followed a leukemia or lymphoma patient's story, at some point you've probably heard them talking about 'their counts.' Within the first couple of days, we started to learn the importance and the meaning behind my counts with my ANC (Absolute Neutrophil Count) being the most important. 

A mature neutrophil ready for action.

  I was very familiar with the implication of a low platelet or hemoglobin count- in fact, I was transfused with another bag of platelets and PRBCs in the morning. But the ANC seemed to be even more important. It reported the number of neutrophils (type of white blood cells) in my body. Neutrophils were important to follow because they helped my physicians understand how able or more accurately, how NOT able I was to fight an infection. On January 12th, 1996, my ANC was 3088 and dropping. It wasn't in a critically low range yet (<1000), but I would be soon given that there were still 4 remaining days of chemo. For that reason, my physicians started me on Bactrim- an antibiotic often used in immunosuppressed patients to protect against some particularly awful bacterial infections.  

Killing Cancer?    
Things sucked; however, there was some good news. The Ara-C and Daunorubicin seemed to be working as indicated by my white blood cell count starting to drop. "How could this not be working?!?" I thought, but it was somewhat unpredictable. Everyone tip-toed around saying that things might be going well and no one, mentioned the 4 letter word that we wanted to hear (cure). Fortunately, the nausea and vomitting consumed almost every conscious moment so I didn't have a lot of time to be scared of my leukemia.

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