Day 11

Today's counts:

Hg 6.8

WBC 0.1

Platelets 21
Creatinine 1.26

Today was rough.  I spent all night tossing and turning because of the heartburn.  Then I started spiking fevers around 1am, so the tech came to draw blood cultures around 3.  They ran my CBC at that time and found that my hemeglobin fell 1.2 g/dL in 19 hours.  Apparently that's a lot and that kind of loss usually occurs when patients are bleeding.  Since my platelets were so low my doctors were concerned I was bleeding somewhere in my GI (and since I'm still not regular they can't check my stool for blood).  I didn't have any belly pain, which would have been associated with bleeding, so they decided to start me on blood and see how the numbers react in tomorrow's CBC.

I spent most of the day sleeping and sweating as the fevers would come and break.  The culture tests will be back within a few days.  If anything is found growing in the blood, identifying it will allow the doctors to target antibiotic treatments against it.  For now I was put on two broad-spectrum antibiotics in addition to my antiviral and two antifungals.  Infection also causes problems with controlling glucose levels, so I'm back on the insulin drip.  I think my endocrinologists are being overly-cautious, but they felt strongly that it should be closely monitored until this infection-nonsense is sorted out.

The vision in my left eye has further deteriorated.  Most of my field of vision in that eye is now blurred beyond my ability to discern objects at any distance.  The black spots (where there is no vision at all) also grew, but the change is less extensive.

And I've developed a cough.  On the plus side, my terrible indigestion seems to have mostly passed.  Hopefully tonight I'll get some decent sleep.

Day 10

Counts:

Hg 8.0

WBC 0.1

Platelets 9

Creatinine 1.10

So GoLYTELY followed by  Village Wok was a bad idea last night (it all seems so clear now).  It really did a number on my stomach and so I've had ridiculous heartburn all day.  I just slept.

My platelets dropped below 10,000 today so I received a platelet infusion.  Tomorrow I'll probably get a blood transfusion to raise my hemeglobin.

Day 9

That's the laxative - called GoLYTELY.  You drink it (4L of fluid) and get ready for one hell of a poop. It did wonders, I haven't had a good BM since I got in the hospital.  What a way to start the new year.  Now I'm super hungry!  I think I'll order chinese, ha.

Counts for today:
Hg 9.0
WBC 0.1
Platelets 16
Creatinine 1.07

Nothing else to report.  Have a great New Year's Eve.  Dietz rounded up some noisemakers and my nurse found some donated poppers, so we're gonna have a party in my hospital room.

Day 8

Counts:
Hg 9.3
WBC 0.2
Platelets 24
absN N/A
Creatinine 1.00

Today I felt pretty good, the vampire diet yesterday helped with that.  I'm still plugged up though, so tomorrow they're planning more drastic measures to get things moving.  My belly's starting to distend so I think it's time.

Dr. D'Cuhna stopped by today, he just wanted to make sure my doctors aren't over-reacting to these fluid pockets I have where my left lung used to be.  Before I began chemo I had a CT scan.  The radiologist who read the scan saw the pockets and was concerned they were harboring infection.  He then recommended in his report to my oncologist that they be drained and cultured.  This got my oncologist all concerned since pockets of fluid breeding infection in a chemo patient is dangerous news.  These pockets, however, are normal for two months post-pneumonectomy.  Dr. D'Cuhna has been viewing my CTs and feels they're nothing to be concerned over at this point.  If there was infection it "wouldn't be subtle" and an attempt to drain and culture them would most likely lead to infection.  My pulmonologist concurs with Dr. D'Cuhna, and once my oncologist explained my surgical timeline to the radiologist he changed his recommendation.  So we're all on the same page.

Last day of my steroid treatment was today.  Tomorrow they should switch me completely back to my pump.

Day 7

Counts:
Hg 7.5
WBC 0.5
Platelets 34
absN 0.5
Creatinine 1.07

I received two blood packets today because my hemoglobin was low.  This means I should have more energy tomorrow than I did today.  I'm less constipated tonight but there's room for improvement.  I'm still pleased that I have no nausea or other side effects.

Tomorrow will be my last day of my anti-nausea steroid treatments, so hopefully I'll be off the insulin drip (no more hourly glucose checks!) and completely back on my pump.  My fingers need the break.

Day 6

My counts for 12/28:
Hg 8.4
WBC 0.8
P 51
absN N/A
C 1.06


Another sleepy, constipated day.  I spent most of it sleeping, then Kathleen and Dietz came to visit and the Vikings lost.  I'd feel great if my bowels were moving.  Hopefully that'll change tomorrow.

Day 5

Every morning I have blood drawn and am given my "counts" for the day - the levels of cells and cellular products my doctors watch to monitor my progress through therapy.  I decided to begin including these values in my posts.  Here is a brief explanation:

• Hemoglobin (Hg) - The total amount of the oxygen-carrying molecule found in red blood cells.  Given as grams per deciliter (0.1L) of blood.  Normal is 13.3-17.7 g/dL, mine usually hangs around 11 g/dL.  Low values cause sleepiness.
  
• Total White Blood Count (WBC) - The absolute number of white blood cells circulating, given as an integer times 10^9 cells per liter.  Normal is 4.0-11.0 x 10^9/L.  Low values indicate a compromised immune system, high values indicate current infection.
  
• Platelets (P) - Absolute count of the blood-clotting agent, given as an integer times 10^9 platelets per liter.  Normal is over 100 x 10^9/L.  If the platelets are too low (<10 x 10^9/L) blood won't clot and a transfusion is necessary.  If it is too high (>500 x 10^9/L) clots can form spontaneously.
  
• Absolute Neutrophil Count (absN) - a count of neutrophils circulating, given as an integer times 10^9 cells per liter.  Normal is 1.6-8.3 x 10^9/L.  The lower this number, the less able my body is to fight infection.  Anything <1.0 x 10^9/L is considered neutropenic.
  
• Creatinine (C) - A chemical biproduct filtered by the kidneys, given in milligrams per deciliter.  Normal is less than 1.25 mg/dL.  I need to stay under 2.0 mg/dL to be eligible for marrow transplant.

My counts for 12/27:
Hg 8.6
WBC 2.0
P 62
absN 3.0
C 1.31

Tonight I received my last dose of chemo.  Still haven't felt much nausea.  Eyes remain poor and glucose continues to be well controlled.  My temperature is consistently normal (which means no uncontrolled infection), my blood pressure down (I had difficulty with that last time), and my percent oxygen saturation in my blood is always around 100% (meaning my lung is efficiently exchanging oxygen and carbon dioxide.  This would be down to 90% or lower if I was struggling with a pneumonia). My hemoglobin is down today so I felt tired, but my doctors aren't surprised that it's dropping.  Platelets, red blood cells (and thus hemoglobin), and white blood cells are all produced from the same stem cells, and all three will drop due to the chemotherapy.  I'm also constipated but my appetite remains well.  I guess I'll just keep cramming it in.