Lower counts and little issues

When I blogged about Nadir last, I mistakenly stated/remembered that it was days 7-10 after starting chemo. So I was pretty happy that I did pretty well this weekend, just needing a little more rest, and was looking forward to Monday (Day 10) being over the worst and moving on. And then my nurse said something like, "just remember that days 10-14 can be very intense and some people lose their appetite and really do need to take those naps that you are trying to avoid, and it can be a rough couple of days." And then I remembered that Nadir is 10-14, and not 7-10.  I wasn't just getting out of it, it was just getting INTO it.

My counts continue to remain low:
WBCs holding steady at 0.3 the last few tests
HGB bouncing around 6.4, 7.7, 6.7, 7.3
Platelets also bouncing 14K, 33K, 20K, 43K

I received both blood and platelets yesterday even through my platelet level was above the cut-off. I'll get more of both today, too. (More on that later.)

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My wonderful, generous friend, Team Phoenix sister, and leukemia survivor Vanessa came to visit yesterday. Vanessa immediately reached out to me when she heard of my diagnosis and has provided such a "been there" perspective since the start. Talking with her yesterday in person was wonderful. She also works for an organization called Tricia's Troops, which provides all sorts of amazing support to all kinds of cancer patients all over Southeastern Wisconsin. Vanessa brought me a lovely chemo support bag, and the group helps with things like housework or child care or transportation. If you're a cancer patient (or love one), check them out. And if you're looking for a place to donate, also check them out.

And after a not-terribly-long visit with Vanessa, I absolutely crashed and slept all afternoon. Guess this exhaustion thing is no joke. I had a few hours of awake time, visited with Greg and Ash, and was asleep again before 9:00 pm. Wow.


Unfortunately, what's been overlaying all of this for the last two days is a troubling side effect of, I assume, the chemo. I was showing some signs of a possible GI tract bleed, which resulted in lots of (not) fun observations and measurements. While I haven't been nauseous (knock wood), my stomach has been ouchie (for lack of a technical term), and I've developed heartburn, and some intestinal cramping. Just enough for my comment of, "I'm in no pain," to no longer hold 100%. So it's caused some changes in protocol. They bumped up my blood count tests from 24 hours to 12 hours (and now 6 hours). They immediately gave me more platelets, regardless of my count, and they changed the cutoff from 10K to 25K (it has since risen to 50K). I also got whole blood and the HGB cut-off is raised from 7.0 to 8.0. From what I can tell (supported by research that my amazing PH researcher friend Susan has done), this GI stuff is very common with these chemo meds (the bleeding less so, but we're working on that). And I'm on two antibiotics, which always impact my stomach. The most frustrating thing is that when the stomach cramping hits, it hits. So I've been afraid to walk as much and be far from my room, and going down to the Healing Garden seems way too far. These both make me sad. I'm hoping that the bleeding stops soon so I won't be burning through the platelets so quickly.

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Finishing this blog with stuff about today.

Day 11 was pretty similar to day 10. I had a pretty productive morning with several cool visits, and then a complete crash shortly after noon. After a nice snooze in the sun, and a visit from massage therapy, and a shower and a walk around the floor and in the healing garden (without an IV!), I'm back in my room, hooked up to fluids, awaiting the latest CBC counts to see if I need more platelets, and I also just found out that they think the rash on my stomach is in response to one of the IV antibiotics that I'm on (Cefapine). So I'll be switching from that one tonight. Unfortunately, instead of a half hour run time, the new one will be an hour and a half, but only once a day. I hate to be running out of antibiotics I can use, as I'll be on a lot of antibiotics for a long time.

And I had a little more energy today than yesterday. I'm not back to walking as much (and haven't been on the exercise bike), but I was able to add the squats back into my walk this afternoon. I was thrilled to see another patient working hard on strength exercises at one of the windows as I made my circuit.

I did get to meet the (new) Chair of the department yesterday and had a long talk with him about my plan. I'll try to write that up tomorrow. Until then, keep visualizing my bone marrow being completely destroyed and cheer with me when I feel crappy, because that's probably a sign that it's working. :) 2/5 days of Nadir in. I can do this!