White blood cells fight infection. The white blood count (WBC) is part of a complete blood count (CBC) that is used to check your blood counts. There are several types of white blood cells.
**ANC=Absolute Neutrophil Count
One measure of risk is the absolute neutrophil count (ANC). The ANC is calculated by multiplying the total white blood count by the percent of neutrophils (also called segmented neutrophils, segs, polymorphoneucleated cells or PMNs, polys)
Ok so here it is folks...the long awaited treatment update. I have told this story so many times and updated it on Facebook so frequently that I forgot to blog about it!! I haven't slept a wink all night from the steroid I got at chemo yesterday so now is as good a time as any :)
Since it has been quite a while since treatment started and things have changed pretty dramatically from the original plan, I'm going to start from the beginning and timeline this treatment for you. I feel more and more forgetful from the chemo brain every day so with the help of my calendar and what memory I have left, I'm piecing this together. Please forgive any repetition and if you get bored... there's a better blog post on its way :)
The basic idea of chemotherapy is to rid the body of faster growing cancer cells. While doing this, the drug also has an effect on the faster growing normal cells in our bodies. These include; the hair, the lining of our mouth, or the cells in the bone marrow that produce white blood cells (which help to fight infection), red blood cells (which carry oxygen through our blood), and platelets (which help to clot the blood and stop bleeding). The chemotherapy is timed to allow the body's normal cells time to recover between treatments.
Starting on August 11 and ending on September 22, I got 4 rounds of AC (Adriamycin and Cytoxan) chemo, with a two week break in between. The typical side effects of AC: alopecia (you know I was bald, right??), decrease of white blood cells, red blood cells and platelets, mouth sores, nail changes, discolored urine, severe sunburn with sun exposure, decreased appetite, taste changes, changes in menstrual cycle, bladder irritation, nasal congestion. Like having cancer isn't bad enough, right?
Well, lucky for me, I experienced VERY few of these. Ok, so I lost my hair. I actually met a gal who referred me to a site for an ice cap that you can wear during chemo to freeze your hair follicles and save your hair. You all know how much I loved my hair, but to be totally honest, in retrospect, I needed to lose my hair. I think it was like a rite of passage. It empowered me to battle this disease with confidence and to realize that I am defined by so much more than my long crazy tresses. I'm sure I already knew that, but what a great reminder. I felt really amazing bald! :) (note: I intend to grow these locks out, but I'm going to have some fun on the way there!)
I never had mouth sores, my nails are healthy and strong. I refuse to discuss the color of my urine with you, but I'm sure it's fine. I went to Colorado in August with normal sunscreen and didn't get burned so I guess that one's out. I am the hungriest cancer patient alive...ask any of my chemo dates or my running buddies! They'll all tell you that I never stop eating. Lori would only come to one full treatment and swears she gained 5 lbs because I had so many goodies (I think she's exaggerating a tad!) :) I haven't gained more than a couple lbs through all of this though because I'm still running and eating super healthy. My menstrual cycle wasn't your business before and is none of your business now so we're not going to talk about it :) I suppose my bladder is irritated...or maybe it's just me that's irritated since I have to pee so often! I drink water like I'm trying to drain Clinton Lake so it's not a surprise... Oh, I suppose I've had a bit of nasal congestion, but with a few neti pots, that was cured quickly (and no amoeba in my brain either!). So, I guess what I'm saying is that I made it through AC feeling pretty damn lucky!
So next up was 12 consecutive weeks of Taxol. The side effects were supposed to be much less, but since I didn't really experience any except the hair loss and chemo fog/chemo brain, I wasn't sure what to expect. The typical side effects are decrease of white blood cells, red blood cells and platelets, allergic-like reaction, numbness and/or tingling to fingers and toes, muscle aches, bone pain, mouth sores, hair loss, diarrhea
I did ok with WBCs (white blood cells) and the rest of my counts through most of AC until we got to the end. I was supposed to only have to wait 3 weeks to start the new chemo, Taxol, but I ended up having to wait 4 weeks instead. This was when the WBC/ANC monkey climbed on my back and I haven't been able to shake it yet. My friend Shelley2 (or Dr. Shelley) had taken the day off work to come with me to my first round of Taxol so it was really tough for me to tell her that my WBC's and ANC's (absolute neutrophil count) were too low for them to treat me. It was really the first roadblock I had encountered and it really did break my spirit...temporarily...until I met her for a drink that afternoon and took a deep breath, realizing that it was just ONE week out of 5 months and my body really needed it. My Dad was planning on flying in for my birthday the following week anyway so it really worked out for the best. I had to get 2 Neupagen shots to boost my counts on the two days prior to my first round on October 20. After weeks 2 and 3, my counts started to drop again so we changed the original plan of 12 consecutive weeks and decided to go 3 weeks on, 1 week off until the 12 rounds were completed. Chris was with me at the visit when I found that out and it really took the wind out of my sails. I was so thankful to have him there and that hug was one of the most necessary of my entire treatment. Don't get me wrong, they're all important, but that one got me back on track. It was with the realization that my WBC's and ANC's hate me that doc and I decided that short term disability from work was the best idea. Low counts really just mean that I have very little immune system and sitting in Dr. office lobbies during flu season is just downright stupid. I love my docs, NPs, nurses, and staff, but they didn't want to see me under those conditions either. (I miss you ALL!)
I definitely experience some muscle and bone pain which is a complete pain in the ass when I'm trying to keep running. I took a pilates reformer class and some yoga to help and the acupuncture is helping too. Still no mouth sores and no diarrhea (you were curious, weren't you?). And hair loss? Well, my eyebrows and eyelashes are thinner but my hair is growing back!! Maybe not as quickly as it will when chemo is all over, but I've definitely got hair! And if one more person tells me that I looked better bald... well, I know already! But I've got to go through this awkward stage if I ever want to get my hair back...and I do :)
Ok, so where are we now? I am still carrying this damn monkey and it's getting heavy! Despite starting a regular acupuncture regimen (which has helped with curbing the neuropathy (tingling) in my fingers & toes and energy levels) and a test run with some herbs to boost my counts, the only thing that has gotten me back to treatment has been my monthly shot of Neulasta on the Friday after my 3rd consecutive week of chemo and then a week off. So this is what the Taxol treatment plan looks like:
Oct 20, 27, Nov 3- Taxol treatments
Nov 3- Dr. Sharma visit to update treatment plan
Nov 10-OFF treatment
Nove 17, 25, Dec 1-Taxol treatments
Dec 1-Dr Sharma visit
Dec 8-OFF treatment
Dec 15, 22,29-Taxol treatments
Dec 28-Dr Sharma visit
Jan 5-OFF treatment
Jan 12, 19, 26-Taxol treatments
Jan 26...DONE chemo!!!!!!!!!! :)
My Taxol treatments are short and my days are nothing like the old AC days. In fact yesterday, Rick and I went out for a nice lunch, drank some beer, and had an amazing pasole dinner with Chris and Adam. Jealous? Yeah, they're all pretty amazing and awesome. :) I've had the luxury of having incredible chemo dates throughout my entire treatment. I'm throwing a shout out to my Dad and Mom (who hit quite a few between them), my work partner Lori (who is SO supportive), Chris (who is the busiest man I know but has been around more than anyone), Adam (who has been my 'crew' and has recently been appointed my Life Coach :) We are also organizing a flash mob if you are interested.) My little sister Lauren (who wins the 'longest distance traveled for a chemo date'. Let's hear it for Fairfax, VT!!) <3, my good friend Amber (who moved back from Salt Lake City just to be my date...or because her job moved her back...), Julia (whose 9 month old nephew just underwent a successful (!) MAJOR cranial surgery in Dallas yet she still found time over the last few months to worry about me), my friend Erin (no offense to anyone else, but she easily wins 'best chemo date gift'. She made me a fleece blanket that is so AWESOME that I sleep with it every night and bring it to treatment every week), Kelly and Desiree for frequently showing up to give me girl time and support. Andrea for the goodies on my first visit, Erin M for driving my loopy ass around, and my BFF Rick for taking an entire day to sit with me at chemo right before Christmas, and for continuing to feed me nutrient rich foods including the ridiculous pasole! Dr Shelley for TRYING to be my date and even taking a day off work for it...wait til surgery Shell, I will NEED you then! My friends Margit and Bart (and baby Roosmarijn) for bringing me organic veggies from their farm in Eudora and welcoming me and the kidlets into their home for dinner on more than one occasion. My kids for making me laugh...Annika for making breakfast every morning now and Josh for kissing my head every day before school. I love them without limits!! EVERYONE for the cards, the gifts, the words of encouragement, your time. I feel so lucky, so loved. And if I missed you and you don't feel like you belong in the EVERYONE category, I've got two words for you...chemo brain. You know I love you :)
After this chemo business is over (just 4 treatments away!!), we're going to start talking boobs. So if you're one of those who has been following and paying close attention, waiting for some good boob talk, stay tuned! I've decided to get a second opinion from a different plastic surgeon but either way, I'll be under the knife in late February/early March. And yes, they'll be fake, and eventually they'll be fabulous :)
Oh, and guess what!!! Next week, Kelly and I will be featured in an article in Ink magazine here in KC! Dec 28....look for it!
xoxo
Shelley
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