a bit better today

Chris is doing better today.  He's still mostly sleeping but he is much more lucid when he is able to stay awake.  His appetite is also back, a good sign; I brought him in kolaches this morning at his request.  Bowel issues are still an issue, effect of the chemo.  If he is up to it I'm planning on wheelchairing(I like to make up words) him out of his room for a bit and maybe even outside for awhile.  He's either been in a car or a hotel or a hospital room for over a week.

I got him some Dr. Suess pj pants - I knew they'd amuse him.  

He hasn't really been able to use his phone these last few days.  

More info after the page break.

When he is out of it from the drugs and chemo it helps if I'm by his side as much as possible and help the nurses.  I take his temperature for him and have learned how to restart his IV pumps when they set off the "air in line" alarm.  

The more chemo he goes thru the rougher its on his body, this hospital stay is the most immobile I've seen him before.  I continue to tell him he's doing a great job and that I know it's been really tough but he can get thru this.  When I'm in his room to care for him I must put aside all the stress I'm feeling so he can see me strong and hopefully get strength from me.  

I've had many nurses comment on what a good job I do taking care of him.  When they say that I mostly think about the fact that they must notice my level of care and patience with him because other patients don't have similar caregivers.  It horrifies me to think of other patients going thru this that don't have someone by their side doing whatever they can for the patient.  

As hard as this is on me to see my husband in this state, I can't even fathom what it's like for him.  I just have to try my best everyday to get thru that day and be strong for him.  Some days I'm better at it than others, but I think I'm finding more strength everyday.  

I've attached the spreadsheet I made in August to keep track of some of the info that comes on his near daily blood counts.  The "normal ranges" for each are in black below and along the left side are the dates of his blood draws with his readings to the left.  Red values mean they are either too high or too low.  

I started tracking some additional #'s listed on his CBC's (complete blood count) within the last week.  I'm attempting to define what these things mean that I am tracking for those interested in understanding more.  (I started writing this about 2 hours ago but need to stop and start to help Chris out so in an effort to get it done I'm copying & pasting definitions of terms from wikipedia or other sources, which will be in italics).  

Don't take my definitions and explanations as complete by any means, I've only starting learning about these things since Chris' diagnosis and learn more everyday.  

Here is what one page of his near daily CBC's look like when I request a copy (highlights are my doing):

WBC = white blood cell count.  White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is dealing with cancer treatment.

HGB = hemoglobin.  The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body.  The value of this determines whether or not he needs blood transfusions.  Generally he gets blood transfusions if he has an HGB level of 8.5 and below.  

Platelets: Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets, there is a chance of a blood clot forming in a blood vessel.  He hasn't had platelets within normal ranges since before Thanksgiving.  Generally he gets platelet transfusions if he has platelets of 10 and below.  

neutro = neutrophils are a type of white blood cells that are "first responders" when the body has an infection.  His are always quite low due to treatment which makes him very susceptible to infection.  That's why he has to go to the ER every time he has a fever, an little infection that would be minor and maybe not noticeable to you & I could send him into intensive care if not treated quickly.  Many cancer patients that die, die of infection because of a weakened immune system due to the treatment and other factors.  Chris' leukemia is so aggressive that if he was left untreated it would probably kill him within 6 months to a year, so the risk of death and other side effects from treatment is a risk that has to be taken.  

  

Blasts %: Blasts are immature white blood cells and individuals with leukemia have an excessive number of blasts in their peripheral blood and bone marrow.  

Absolute neutrophil count (ANC) (This is in Column G) is a measure of the number of neutrophil granulocytes^[1] (also known as polymorphonuclear cells, PMN's, polys, granulocytes, segmented neutrophils or segs) present in the blood. Neutrophils are a type of white blood cell that fights against infection.  

A normal ANC is above 1,500 cells per microliter. An ANC less than 500 cells/µL is defined as neutropenia and significantly increases the risk of infection. Neutropenia is the condition of a low ANC, and the most common condition where an ANC would be measured is in the setting of chemotherapy for cancer.

Chris has been neutropenic since February 1st and has been neutropenic many times since treatment began in July.  His ANC today is 110.

Note: If you look at this WBC counts in column B you'll notice that they rapidly increased starting around 2/26.  While it is a good thing it went back into normal ranges it's actually dramatically increased due to the aggressive leukemia.  Upon diagnosis most leukemia patients have an extremely high WBC count.  Since the last chemo (augmented hyper-cvad) did not work the leukemia cells came back aggressively.  If he had not started chemo on 3/2 his WBC levels would have kept climbing.  

Since he was neutropenic before he started the chemo the odds of him being back in the hospital after discharge for neutropenic fever are high.  He will probably get out Monday or Tuesday.  

Most patients do not start chemo with their counts as low as his.  For instance before we knew he had relapsed back in December in Austin his oncologist there did not want to start chemo until his platelets were 80 or higher.  But now because the doctors at MD Anderson know how aggressive his leukemia is they can't wait until his platelets slowly slowly climb higher.  If they did that they would risk him dying of the leukemia itself.