Friday, 9:55 PM
High-Level Journal Summary: Getting a blood test today which postponed cycle 4 of IV-based chemo by one week. My Platelet count is so low that an immediate blood transfusion is needed.
To start the Memorial Day Weekend, I will be at the Inova Hospital on Saturday morning for a 6 AM blood transfusion. Amazing -- the transfusion starts at 6 AM, so it is a quite early start to everything. However, this will give my body more time to respond and get better. Then, I will be in better position to start cycle 4 of IV-based chemo on 6/3/08.
These graphs of White Blood Cell Counts, Neutrophils, Platelets, and Hematocrit Data over the past 2.5 years reveal how much things have started to swing in 2008. Why? It is a reaction to the toxicity of treatment, as expected. This is not a statement about patient. Rather, it is a statement about actual treatment.
Countdowns:
1.) Day 18 of 28 in Cycle 3 of Carboplatin + VP-16 chemotherapy. Yes, it is now a 28 day cycle and no longer a 21 day cycle.
2.) Meet with Inova Hospital at 6 AM on 5/24/08 (Saturday) to get a blood transfusion. My Platelet count is so low that it must be transfused immediately.
2008 Seizure Activity:
1.) Last Simple Partial Seizure, or SPS, was 6 days ago. I came close to having an SPS in the middle of the night last night, but it chased away at the very last moment.
2.) In 2008, I have had 68 SPS's in 144 days. This is an average of 1 SPS every 2.1 days.
Actual Journal: Surprise. We found out today that my Platelet counts are so low that an immediate blood transfusion is needed. Not only that, the next IV-based chemo cycle can no longer start next week after 21 days of waiting. Instead, we will need to wait a total of 28 days so that my body has time to respond to this blood transfusion.
Is this a surprise?
Were we expecting this today? In my 5/22/08 online-journal entry, this was one of the purposes of meeting today with Dr. Dipti Patel. We knew that Platelet count was an issue. However, we indeed found out that we could not yet proceed to the 4th cycle of this chemo cycle. Not just yet.
An immediate blood transfusion and another week to recover will help change this overall situation, though. This will help ensure that my Platelet count is healthy enough to handle the next IV-based chemo cycle. This is certainly showing the response that patients have to the toxicity of the Carboplatin + VP-16 chemo cycle.
No guest tonight
My Dad will be taking me to the Inova Hospital at 5:30 AM on Saturday morning. This is the same location where I was admitted on 5/13/08 and 5/14/08. That is an early start, so I am racing to complete this complex journal. (Creating all the graphs below are complex to create.) So, there is no time to have a guest "read" this journal for a little humor. Next time -- I promise!
Instead, let these graphs speak for themselves. They are starting to swing much more than when taking Temodar chemotherapy as I did from 10/31/05 until 12/19/07. Here are the dates over the past month for checking my blood levels. All of them are newly included.
• 5/1/08: (Day 17, cycle 2 of IV-based chemo)
• 5/16/08: (Day 11, cycle 3 of IV-based chemo)
• 5/20/08: (Day 15, cycle 3 of IV-based chemo)
• 5/23/08: (Day 18, cycle 3 of IV-based chemo).
Blood numbers
These partial hematology results are compared to data since the start of Cycle 1 of chemo. White Blood Cells (WBC), Neutrophils (NEU), Platelets (PLT), and Hematocrit (HCT) are the critical counts for me.
The "expected range" for WBC is 4.60 - 10.2 THOUS/MCL. This range is what normal people NOT on chemo would be expected to have if randomly tested.
The "expected range" for NEU is 2.00 - 6.90 K/uL. This range is what normal people NOT on chemo would be expected to have if randomly tested.
The "expected range" for PLT is 142 - 424 K/uL. This range is what normal people NOT on chemo would be expected to have if randomly tested.
The "expected range" for HCT is 37.7 - 53.7 %. This range is what normal people NOT on chemo would be expected to have if randomly tested.
Platelet counts matter
There is more explanation to come about what is going on with this blood transfusion. Context is needed. Explanation is needed. This all needs to spelled out to better understand what is happening.
Still, I feel as if showing the actual graphs of how these levels have swung over 2.5 years is extremely helpful for our medical team. Just seeing these numbers rather than reading them helps me better understand the impact of taking the current IV-based chemotherapy.
This change in overall graphs is a statement about the treatment, not a statement about a patient. I was told that this could be a harsh treatment, but now we are seeing strong insights into what this implies. Anybody who goes through this kind of treatment could well be impacted in similar ways. What a powerful learning lesson in this cycle 3, all in the past 2 weeks.
