Expect the unexpected

As I explained a little while back, each round of chemotherapy has a pattern. It involves the following:

Day 1- Get chemo

Day 10- Get bloodwork to check cell counts. If cell counts are too low, medications may have to be given to raise them. For instance, if white blood cells are too low, a shot of 'Neupogen' may be administered, which boosts white blood cell counts. If platelets are too low, a blood transfusion may have to be given.

Day 21(The day before the next round of chemo)- Get more bloodwork to again check cell counts. At this point, the cells must be at a certain level in order to recieve chemo the next day. If the cells are not at the required level, then chemo has to be delayed by one week.
Following blood work, there is an appointment with the doctor to review how everything went over the last round of chemo and to answer any questions that may have come up.

Thursday (Dec. 7th) was Day 21 for me, which meant I needed to get bloodwork and have my appointment with Dr. MacCormick. The bloodwork, which is now becoming like a part of my daily life, was done and I was informed that they would have the results in about an hour and would call me at home only if the cell counts were too low to have chemo the following day.
I then went in to wait for Dr. MacCormick, who showed up fashionably late (about an hour), which seems to be the norm with doctors (another thing I am learning about the medical system).

Dr. MacCormick immediately brought up the reaction I took to Stemitil (see the post "Never Rule Out The Rare") and wanted to know all about it. He informed me that the reaction was not an allergy, but a sensitivity in my central nervous system. He said that this sort of reaction is not common among the normal population of people taking this drug, but it is actually quite common in young people who take it. This is because young people have stronger and more keen nervous systems, and an ingredient in many of these anti-nausea meds effects the nervous system (it works with a neurotransmitter called dopamine, which controls movement). Thus, the jerky movements, tightened mouth and jaw muscles, clenching teeth and other such symptoms I was experiencing, had to do with a lowered level of dopamine which my nervous system was paticularly sensitive to.

We then discussed the nausea, which was almost non-existent except for the one day of vomiting and the two following days of upset stomach. I guess this was not enough to convince the doctor that a prescription for medical marijuana was necessary, as he simply advised me to take Zofran (my regular anti-nausea med), Gravol and Ativan for nausea from now on. Ativan is a sedative used to relax patients. It is often given to people who are nervous of certain medical procedures (i.e. if you are chlaustrophobic and need to have an MRI they will often give you an Ativan under the tongue). He said that Ativan helps with nausea and would prevent any reactions like I had to Stemitil by relaxing the muscles. In addition, I can take Ativan to relax me if I have any feelings of anxiety (as I mentioned in a previous post, I have been extremely anxious and nervous since taking the reaction to Stemitil ... see the post from Sun. Nov.26).

We discussed a few other minor issues and were about to go our seperate ways, when the results of the bloodwork came in. Dr. MacCormick sat me back down and informed me that my white blood cell counts (the immune cells) were too low to recieve chemo tomorrow! I was actually extremely shocked because it was something I was not at all expecting. I felt completely healthy and normal, so I assumed that my body was ready for another bout of chemo. But the tricky thing is that there are no symtoms of low white blood cells. The only way to know is through blood work. I asked the doctor why this was happening--did I do something wrong? He informed me that this was merely an effect of the chemotherapy and was a sign that the drugs are doing what they are supposed to. He said that this tells him that the dose he gave me was the perfect dose for me.

I was then informed of 2 major downfalls of low white blood cell counts. The first downfall is that I have to wait an extra week to get my next session of chemo. This is awful because it just delays my whole chemotherapy experience. I just wanted to get it all overwith. Instead of being on chemo for about 10 weeks, now it will be 11 (this does make a difference!). The second downfall is that in order to prevent this delay from happening again, I will now have to give myself shots of Neupogen (a shot that feeds you white blood cells) following every chemotherapy session. I will have to give myself the shots 72 hours (3 days) after each chemo session everyday for 5-7 days. I will be taught to give myself the shots in either the inner thighs or the stomach. OUCH! Just another thing for me to worry about.

So as of now, I am living my life as normal (well, as normal as it can be right now), waiting to get the next chemo session over with. The faster that happens, the faster I can get on the road to recovery and begin living my life once again. I definitely dread giving myself daily shots in the stomach, but if that means I can get this all over with faster, then that is what I will have to do. For now, I will take advantage of feeling fine and being able to spend Michael's 24th birthday with him without feeling sick. Yay for that!