Some thoughts

I am calling Dr. McAndrew today.  I want to know why they don't just give me the Neulasta shot right now to prepare for next week.  I read Sharon's blog last night to refresh my memory and she got the shot after her 7th cycle and she was getting the weekly treatments so what the heck?!?!  Although she did make it to her 7th cycle without incident, she had some kidney toxicity after her 6th cycle.  It appears I don't have as strong of bone marrow or something (if that even makes sense).  I don't really want the shot but am just confused why it wasn't even brought up as an option...

I love and hate the Internet at the same time. It has so much useful information right at your fingertips but it also has very wrong and hurtful information as well.  It's just like anything else. You have to take the good with the bad. Researching last night about what having a low white blood cell count means has me concerned that I could get sick and have more serious complications.  Here's what I learned.

This is the 411 on the composition of your B L O O D.... Ahh ahhh ahhh (said by the Count from Sesame Street) from the Mayo Clinic and chemocare.com.

• White blood cells. These cells help your body fight infection. A low white blood cell count (leukopenia) leaves your body more open to infection. And if an infection does develop, your body may be unable to fight it off.
• Red blood cells. Red blood cells carry oxygen throughout your body. Your red blood cells' ability to carry oxygen is measured by the amount of hemoglobin in your blood. If your level of hemoglobin is low, you're anemic and your body works much harder to supply oxygen to your tissues. This can make you feel fatigued and short of breath.
• Platelets. Platelets help your blood to clot. A low platelet count (thrombocytopenia) means your body can't stop itself from bleeding.

The most serious complication of low blood cell counts include... 

• Infection. With a low white blood cell count and, in particular, a low level of neutrophils (neutropenia), a type of white blood cell that fights infection, you're at higher risk of developing an infection. And if you develop an infection when you have a low white blood cell count, your body can't protect itself. Even a mild infection can delay your chemotherapy treatment, since your doctor may wait until your infection is cleared and your blood counts go back up before you continue. At times, your doctor may choose to lower the dose of chemotherapy you receive in order to decrease your chance of developing seriously low white blood cell counts. Your doctor may also recommend medication to increase your body's production of white blood cells.
• Anemia. A low red blood cell count is anemia. The most common symptoms of anemia are fatigue and shortness of breath. In some cases fatigue becomes so severe that you must temporarily halt your treatment or reduce the dose you receive. Anemia can be relieved with a blood transfusion or with medication to increase your body's production of red blood cells.
• Bleeding. Low numbers of platelets in your blood can cause bleeding. You might bleed excessively from a small cut or bleed spontaneously from your nose or gums. A low platelet count can delay your treatment. You may have to wait until your platelet levels go up in order to continue with chemotherapy or to have surgery.

The low platelets explain my bloody nose, the dizziness and the headaches I have been having plus he random bruises I just noticed I have on my thighs and legs upon further inspection.  Well, it's that or the fact that I am a klutz sometimes.  I never paid attention to the little "bang-ups" I got on a daily basis before but I should start to pay better attention.

The biggest issue with low WBC is that you may NOT have the usual signs and symptoms when developing an infection such as redness, swelling, cough, nasal drainage (from a sinus or a respiratory infection), pus formation (at the site of an injury or incision) (Ew!).  That means I need to be on high alert to any change in how I feel and take precautions.

Anyway,  I am instructed to pay attention to my body and inform my doctor if I experience any of the following symptoms (it's a hypochondriac's dream):

Condition	What to look for
Low white blood cell count	Fever higher than 100.5 F (38 C) Chills Sweating Sore Throat Mouth Sores A white coating on my mouth or tongue Signs of a bladder infection
Low red blood cell count	Fatigue Chest pain Dizziness Shortness of breath
Low platelet count	Bleeding Easy bruising Heavy menstrual bleeding Source: American Cancer Society, 2009

The Mayo clinic suggests that I can cope with low blood cell counts by doing the following:

Eat a balanced diet. Your body needs all the vitamins and nutrients it can get to heal itself during and after your treatment. Eat plenty of fruits and vegetables. If treatment complications make eating difficult — for example, if you experience nausea and vomiting or mouth sores — experiment to find foods you can tolerate.

Avoid injury. Many everyday activities put you at risk of cuts and scrapes. A low platelet count makes even minor abrasions serious. A low white blood cell count can turn a small cut into a starting point for a serious infection. Use an electric shaver rather than a razor to avoid nicks. Ask someone else to cut up food in the kitchen. Be gentle when brushing your teeth and blowing your nose.

Avoid germs. It's impossible to avoid all germs, but avoid unnecessary exposure when you can. Wash your hands frequently. Avoid people who are sick and stay away from crowds. Have someone else clean the litter box, bird cage or fish tank. Don't eat raw meat or eggs.

Rest. If you feel tired, stop and rest. Your body is working hard to fight the cancer cells and heal the healthy cells damaged by your treatment. Don't feel guilty about taking time for yourself and asking others to help you. Plan your most important activities for the time of day when you feel most energetic.

What a joke.  Dr. McAndrew JUST told me that anything I do won't change the outcome of my blood count.  But they are still good suggestions.  Now if I could only make my body sleep when I want to.

I do know that I CANNOT be around anyone who is sick, is getting "over" being sick or "feels like they may be coming down with something"... Chemocare went so far as to say that I should shield myself away from young children, diaper changing and/or pet care. Wow, that sure isn't going to happen in this household!!

It does beg the question though of whether I should be taking Abby to these toddler classes or not.  Kristen told me last week not to go to Miss Nancy's class and be exposed to the germfest.  I hadn't even thought of that even though both the nurses at Tower and Dr. Gordon have told me numerous times.  I was just feeling guilty that I haven't been to Miss Nancy's class with Abby. Talk about a thick head. Apparently I only hear what I want to hear.  That must be where Abby gets it from!  Pfffft.  And I just finished ranting and raving a couple of posts ago about the moms who bring their kids to class with runny noses and say "it's just allergies" or they had a cold.  NO!!!  They don't get allergies younger than two and if they "HAD" a cold and were over the cold there wouldn't be the runny nose.  Ugh. Ugh. Ugh.  Makes it unsafe for Abby to be in class and for me to even be there.  I need to remember my own rantings and keep myself safe. No sick kids. No classes. No crowds. Reduce exposure to germs.

WASH YOUR HANDS.  WASH YOUR HANDS.  WASH YOUR HANDS!!!